What is the Difference Between Live-In Care and 24-Hour Care?

The benefits of in-home care for aging adults are enormous—from respite for family caregivers, to social connection, to health and hygiene. For an elder who wishes to age in place, there might come a time when round-the-clock care is the only way to keep them at home safely.

Depending on what state you live in, your family will have the option of “live-in care” or “24-hour care.” These sound like the same thing, but there are a few differences that are important to understand.

What is Live-in Care?

Live-in care is where at least two caregivers live 24 hours a day at someone’s home. Here is the federal U.S. Department of Labor requirements for live-in care, though the hours for each requirement vary by state:

1. A caregiver must have a place to sleep.
2. They are not considered to be a resident of the home.
3. The same caregiver can only be booked for a certain number of days in one period. Another caregiver would need to take the other shifts.
4. A break must be given to the caregiver during the 24-hour period. Private sleeping quarters in a home-like environment must be provided.
5. If a caregiver is interrupted during the sleep period, they must be paid for that time.

Each state has different rules around the exact hours of care that can be provided each day.

What is 24-Hour Care?

If your state does not allow live-in care, or you do not want or have accommodations for live-in, consider 24-hour care. This is also an option for those who need care around-the-clock and are unable to give a caregiver a solid block of uninterrupted sleep.

24-hour care may be the right choice for you if your loved one needs care at any hour of the day. That care may be difficult to anticipate so the caregiver needs to be available at all times to respond to wandering, helping someone to the bathroom, preparing meals, giving medication reminders. For people with dementia, 24-hour care means someone is available at all times to keep them safe.

Live-in care, due to sleeping requirements, may not cover all of the care that your family member needs.With 24-hour care, two caregivers are booked daily and work 12 hours each, or three or more caregivers work for eight hours or less. One caregiver can work a maximum of four 12 hour shifts per week, thereby eliminating the need for sleep breaks. However, you can allow the overnight caregiver to sleep if you choose.

Advantages of 24 Hour Care

1. Sleeping quarters do not need to be provided. That doesn’t mean the caregiver doesn’t sleep on duty at night, but it is not required.
2. There is a lot of flexibility on how and when you want to schedule caregivers. As a family member of your loved one, you can decide how to best structure shifts.
3. A caregiver can actively monitor someone at night. This can be especially helpful for people who tend to sundown and are more agitated during night hours or need to get to the bathroom.
4. 24-hour care means you know that someone is always there to respond to emergencies and to report on your loved one.

Don’t wait for a crisis. Know your options and plan now. When the time comes, you will be well-prepared to make the best and safest choice for your loved one.
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