Live in or 24 hour care – How to ensure a smooth experience with compassionate and comprehensive care plan

Navigating the best way to provide 24 hour care or live in care at home for a loved one can be pretty complex, but when done right, very seamless and smooth. There are multiple considerations to balance including cost, day to day shifts complexity, and differing dynamics of night vs day time care.

What is live in care or 24 hour care and how is it staffed?

Live in care

It is typically provided viaa team of 2 caregivers per week (plus their backups) – each caregiver stays at the home for several consecutive days, providing compassionate and comprehensive care. The caregiver is typically provided with a separate room and access to a bathroom. They can either bring their own food or the client provides food.

24 care

It is typically provided by caregivers who work for typically 8-12 hours per shift. This model of care delivery has a team of 3-4 caregivers that work together to provide 24/7 coverage in their respective shifts. The billing rates for this are typically higher than live in care.

When looking for full time care, Following are a few key things we tell our client families to plan and consider. These practical considerations apply to clients’ families that apply across all types of conditions that their loved one may be in (for example: Hospice, post surgery recovery, Dementia, Parkinson’s, Alzheimer’s, ALS, a person with special dietary needs, physical therapy or speech therapy considerations)

  1. Live in care and 24 hour care is significantly different than having a caregiver come in for a few hours’ shift in your home – for example, a live in caregiver needs to the ability to have 4 hours of uninterrupted sleep so that they are alert and fully focused on providing care during the other hours they are awake and providing care. Therefore, as a client, you will need to plan for a separate, private room that the caregiver can use.
  2. Shift management and careful planning:
    • Night time shifts are usually very different than day time – there is usually a lot more activity and visitors around the home in the day time, so day shifts are typically more taxing on the caregiver, and nights are quieter. Depending on the condition, level of medical and clinical familiarity is typically heightened at nights and hence caregivers with usually more experience handling night time emergencies is preferred.
    • Depending on live care or 24 hour care model, shifts across caregivers are carefully planned to balance personalized client specific considerations with caregiver availability, distance, personal time off and personal schedules. For example for a 12 hour hourly 7 AM – 7 pm daily shift, we try to keep caregivers within a 5 mile radius of the client’s home. But for a “7 on, 7 off” live in shifts where one caregiver is in client’s home for 1 straight week and then rotates with another caregiver, the caregivers may live more than an hour away and balance their personal and family commitments on their off week.
    • Similarly, weekend shifts and weekday shifts are not the same. Weekend shifts and backups typically tend to need more planning and may need to be priced higher.
  3. Experienced and high-quality caregivers that specialize in 24 hour care and live in care know how to plan their time to balance maintaining a schedule across key activities of daily lives (e.g meals, bowel movements, sleep, engagement, exercise) while enabling clients to direct their own care and schedule and maintain independence without compromising safety or drop on medication compliance.
  4. If you need round the clock care and are budget conscious, live in care is usually more cost effective (approx. $16-17 per hour) vs hourly care (which at our company is typically around $25 per hour). However, one should balance that with shift complexity – having 2 caregivers each stay 3-4 days at one time is a lot simpler in schedule management for client families – with 12 hour shifts, in a week one is looking at 14 shifts typically staffed by 3-4 caregivers, so the moving parts and handoffs are that much more.
  5. Experienced caregivers are specialized – typically the night time caregivers don’t do day shifts. And quality caregivers that do live in 24 hour care models prefer those and they don’t do 4 -12 hour shifts. This is because their experience and expertise spikes in one model and they plan the rest of their personal life around that model.

If you are considering 24 hour care or live in care, give us a call. We have strong institutional expertise with doing live in care and 24 hour models for more than one and a half decades across the Dallas and Forth Worth metroplex. We will be happy to help understand the specific context of your and your loved one’s situation, and guide on balancing multiple considerations to help you successfully ensure a compassionate and comprehensive care plan for yourself or your loved one.

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