Caring for a loved one at home can truly be a labor of love, especially as their care needs change. What happens when they need more than assistance during the day? You may wonder about the feasibility and costs associated with 24-hour home care. Additionally, round-the-clock care can mean different things depending on whether you want a caregiver who is awake and alert at all times, or if you just need to know that someone’s there should your loved one need assistance.
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The national median cost of hiring a live-in caregiver is $11,587 a month, which is approximately $382 per day.[02] The median monthly cost of 24-hour care is $18,250 a month at a rate of $30 per hour, according to A Place for Mom’s 2023 Cost of Care and Senior Living report.
Agencies and private caregivers have different price structures for continuous home care, depending on the number of care aides, sleeping arrangements, hospice services, and room and board. Other factors can also affect the cost of care, such as where you live and whether you hire a private caregiver or work with a home care agency.
As you consider this care option for your loved one, you might also want to factor in the amount of time you plan to use this service, suggests Todd Austin, president of Home Care Pulse.
“The timeline varies a lot by chronic conditions. This isn’t something that is [a] standard amount of time. On average, private-duty in-home care has a standard service time of 15-20 months,” says Austin.
In some cases, such as home care for hip replacements, your loved one may only need intensive care for a short period of time to safely recover from a hip replacement. However, a permanent disability may call for home care for an indefinite period.
From a budgeting perspective, this may be costly, and you may want to consider what payment options a home care agency will accept. Most home care agencies work with private pay clients, but some may accept veterans benefits or long-term care insurance.
Most seniors wish to live in their homes for as long as possible, as noted by the AARP’s 2021 Home and Community Preferences Survey.[01] For healthy seniors, aging in place makes sense. But if you’re questioning whether living at home is still right for a senior who requires care 24 hours a day, consider the level of care your loved one needs.
The home care services you receive won’t change if you’re going from hourly care to 24-hour home care services. Providers of 24-hour home care typically offer the following services:
If your loved one has done well with this level of care but simply needs it at all times of day, then 24/7 home care may be a good fit. But if you suspect your loved one needs more than this, round-the-clock home care may not be enough. Instead, in-home nursing care or a senior living community may be the better option.
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While 24/7 care may sound straightforward, you’ll need to make important decisions about what you want this care to look like. Austin notes a clear difference between hiring a live-in caregiver and true 24-hour in-home care.
“A lot of time, there is a difference between live-in and 24/7 care,” Austin says. “Live-in care is a single caregiver that is living at home, billed at a live-in rate. They are provided a bed and an eight-hour period of sleep at night. 24/7 means that someone needs to be cared for around the clock. Most [agencies] are going to staff with two 12-hour shifts, no sleeping.”
How you hire a caregiver may also affect what this looks like, as agencies may be less interested in offering live-in care. An independent caregiver, however, may be more likely to accept a live-in arrangement.
Additionally, labor laws surrounding sleeping shifts have affected how home care agencies allow their caregivers to work.
“We’re seeing a lot of companies in states not doing live-in care anymore [that are] moving to a 24/7 model. This removes overtime risks for active working versus passive working,” Austin says.
A live-in caregiver means your loved one won’t be alone, but that’s not the same as having someone on call around the clock.
On the plus side, hiring a live-in caregiver offers the following benefits:
On the other hand, having one caregiver means you’ll need to allow for the following potential lapses in care:
Working with an agency or multiple independent caregivers to provide constant supervision provides peace of mind as well as its own challenges.
Having an always-awake caregiver can help with the following:
On the other hand, there may be some downsides:
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Deciding whether your loved one needs 24/7 care can be a difficult decision for many reasons. Your loved one may have had a few nights where they needed extra help, but you may not think you need a caregiver every night.
As you weigh your options, Austin suggests a care supplement to consider.
“I believe a big education point could be around remote patient monitoring (RPM) as a supplement to care for times when a caregiver isn’t required in the home. Also, partnering with an agency that offers services like RPM could be very helpful fiscally,” says Austin.
RPM may be offered through different devices based on your loved one’s medical needs. It could include a wearable patch or other devices such as the following:
Your loved one’s health data may be collected via Bluetooth or added manually. If your loved one still has periods of time where they can be on their own, this may be a helpful way to monitor their health and keep you aware of any changes in their health needs.
Home health care offers a higher level of care than home care. Essentially, a home health aide can provide more extensive care if your loved one needs more than help with activities of daily living or homemaker services. Sometimes a doctor may recommend home health care as part of your loved one’s care plan.
If your senior loved one has a chronic health condition and needs medical assistance around the clock, 24-hour home health care may be fitting. It may also benefit seniors who need round-the-clock medical assistance due to a recent surgery or hospitalization, or seniors going through rehabilitation or who need assistance with wound care.
While the median cost of 24/7 nonmedical home care is $21,840 per month,[04] the cost of 24-hour home health care will likely be higher and can vary greatly. Cost depends not only on the care your loved one needs, but also on their insurance and the qualifications of the person providing their care. In some cases, Medicaid may cover qualified home health care costs.
Whether you’ve previously worked with a home care agency or are considering at-home help for the first time, choosing care isn’t easy. Many agencies offer an in-home care assessment to help ensure that they can meet your loved one’s needs. Plus, because there are so many home care agencies to choose from, finding the best fit for your loved one can be difficult.
If you’re unsure of how to proceed, or if you want to explore additional options such as assisted living, consider working with one of our Senior Living Advisors. These senior living experts can help you find a home care agency that’s right for you and your family — all at no cost to you.
AARP. (2021, November). Where We Live, Where We Age: Trends in Home and Community Preferences.
A Place for Mom. (2023). A Place for Mom 2022 Community room prices and fees.
Health and Human Services Health Resources and Services Administration. (2022, October 28). Telehealth and remote patient monitoring.
A Place for Mom. (2023). Cost of long-term care and senior living.
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