When Is It Time for 24-Hour Home Care?

Is your parent or older loved one’s health declining, even with some in-home care? Are you or other family caregivers losing sleep at night or feeling overwhelmed? Whether your loved one lives in their own home or with a family member, it may be time to start full-time care—for everyone’s benefit.

Setting up 24/7 care can sound daunting to some families. But the alternatives are often worse—suffering a serious fall which leads to a rapid decline in health, fires or other safety issues caused by confusion or cognitive issues, or having to move to a facility. If you want to help your loved one continue to live safely where they’re most comfortable, here’s how you know it’s time to get more support from a professional caregiver.

10 Signs Your Loved One Needs 24/7 Care

1. Frequent falls or compromised balance
2. Confusion between day and nighttime
3. Difficulty eating or drinking without assistance
4. Fainting or confusion due to dehydration
5. Wandering from home or getting lost
6. An increase in bathroom accidents
7. Sleepwalking or wandering during the night
8. After surgery, a hospitalization, or stay in a rehab facility
9. Bedbound and/or developing bedsores
10. Family caregivers are suffering sleep deprivation or have chronic stress that interferes with their own health, wellness, and quality of life

How to Get Started with 24-Hour Care
It’s best to look to a licensed, insured home care agency to fill any need for care for an aging parent or spouse, especially 24/7. Hiring a caregiver through an agency brings confidence, a greater sense of security, and built-in back-up caregivers, if needed.

While each state has its own regulations (California law, for example, does not permit live-in care), there are two ways to structure around-the-clock care:

• Live-in Care: One caregiver who works a full day, with breaks, followed by eight hours of rest in a private bedroom in the client’s home.
• 24/7 Care: Two caregivers working in 12-hour shifts or three caregivers working in 8-hour shifts. Unlike live-in care, the evening caregiver stays awake throughout the night to help with trips to the bathroom, changing briefs, medication reminders, and any other needs that arise.

Questions to Ask a Home Care Agency

• How many caregivers should I expect during a shift? How are shifts divided?
• Can I interview each of these caregivers? Can my parent or spouse meet with each caregiver to see if there’s a good fit?
• Will the same caregivers rotate throughout the week?
• What if someone can’t make their shift? How do you handle “fill-in” caregivers?
• Can family caregivers share duties with agency caregivers? How will we coordinate this?
• Who do I contact if there are problems?
• Are any of the agency caregivers Certified Nursing Assistants (CNAs)?
• Are there any tasks a caregiver is not permitted to perform?
• Will a supervisor visit my home? How often?

Why is an agency better than a private-hire caregiver for 24-hour care?

Some families prefer to hire a private caregiver to care for their loved ones.

While this might seem like a simple, straightforward option, it’s important to understand that working without agency support means you are responsible for scheduling—and finding backup support if a caregiver can’t make it to a shift. And, as a private employer, you’ll also be responsible for payroll, taxes, workman’s comp, and liability insurance.