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Live-in Caregiver

November 21, 2021

Live-in care is an alternative to assisted living that allows elderly and sick people to receive around-the-clock personal help in their homes. In this article, we take a look at the pros and cons of employing a live-in CDS caregiver, how much the service typically costs, and offer some useful tips on what to include in your contract.

What Is a Live-in Caregiver?

A live-in caregiver provides personal care and assistance to individuals with disabilities, elderly people, and patients suffering from chronic illnesses, such as Alzheimer’s disease and dementia. Live-in care is offered within the patient’s home setting. This may be an ideal solution when daily care is no longer sufficient, but your loved one prefers to keep living at home rather than moving to a residential or nursing facility. 

Why Would One Need Live-in Care?

The elderly are often hesitant to move to an assisted living facility, even if they are aware that they need help with different aspects of their lives. In fact, statistics show that nearly 90% of American adults over the age of 65 prefer to remain in their own homes as they age. 


Live-in care makes it possible for the elderly to stay in their homes where they feel safe and comfortable and where they’re able to maintain their independence and routine for longer. 

Live-in caregiver responsibilities

A live-in caregiver provides assistance with a wide range of tasks, including personal care, health care, housekeeping, as well as emotional care and companionship.  

Personal care

Live-in caregivers typically assist the elderly in meeting their personal care needs like bathing, grooming, oral hygiene, and getting dressed. People with reduced mobility may also require a caregiver’s assistance with using the bathroom and cleaning up after themselves.

Household care

A live-in caregiver is expected to help with light housekeeping tasks, including cleaning, doing the laundry, changing bed sheets, washing dishes, and dusting. Responsibilities may also include planning for, preparing, and cooking meals. In addition, patients with impaired mobility are dependent on their caregiver for feeding.

Mobility

Some elderly patients and people with disabilities require assistance with mobility, for example, transfer from bed to chair and vice versa, turning and changing position, as well as assuring fall prevention. 

Health care

Hiring a live-in caregiver is helpful when it comes to medication management, particularly for seniors with Alzheimer’s and dementia who forget to take their medication. In addition, a caregiver may help with administering medicines and picking up prescriptions. 

Emotional care

One of the main advantages of live-in caregivers is providing emotional care and companionship to the patient. Having conversations and engaging in meaningful activities can make the patient’s day engaged and fulfilling and help them feel less isolated when living at home.

Live-in Caregiver vs. Assisted Living

Many families face a tough choice between in-home care and assisted living for their loved ones. Below, we list some pros and cons of both: 

In-home care

Pros

  • The senior gets to remain in the comfort of their own home as they get older.
  • Your loved one can choose the person who will be providing care.
  • The patient receives one-on-one care, rather than being cared for by several different people.
  • In-home care offers more flexibility when it comes to care arrangements. You can combine different types of care, such as family help, adult day programs, privately-hired caregivers, agency caregivers, and home health care.
  • In-home care can be cheaper than assisted living depending on what amount of work and skill level your loved one requires.

Cons

  • Live-in care can be expensive if the patient requires around-the-clock care.
  • The family is responsible for hiring and managing a caregiver, in addition to planning backup care options.
  • Living at home can lead to social isolation that may contribute to health problems like depression and cognitive decline.
  • If the senior lives at home, you may need to do some modifications to ensure safety and wheelchair accessibility, for example.
  • Unlike assisted living, doctors and emergency care are not immediately available when living at home.

Assisted living

Pros

  • Assisted living is a more affordable option if your loved one requires 24/7 care.
  • Assisted living allows you to focus more on your relationship with your loved one and spend less time managing and scheduling their care.
  • Nursing home residents are given many opportunities to socialize with others.
  • The level of care in an assisted living facility can easily be increased if needed.
  • Doctors and emergency care are readily available.

Cons

  • Contrary to live-in care, the care provided in assisted living facilities is not personal and consistent. 
  • The quality of care provided may vary depending on the staff.
  • If your loved one needs significant one-on-one care, it may still be necessary to hire a private aide.
  • Assisted living may not be the best option for seniors who don't enjoy group living environments.
  • Your loved one may be reluctant to move to an unfamiliar living environment.
  • Most assisted living facilities prohibit pets.

Benefits of Live-in Caregivers

A live-in caregiver can be of great help to both the patient and their loved ones. Some of the benefits include: 

  • Live-in care allows seniors to retain as much independence as possible.
  • Your loved one can find comfort in familiar surroundings, in addition to retaining their possessions and keeping their pets.
  • The senior’s family and friends may visit whenever they like.
  • The patient isn’t required to follow strict schedules imposed by long-term care facilities.
  • The home environment is often healthier for seniors than an institution as there is less risk of exposure to infections.

How Much Does a Live-in Caregiver Cost?

The cost of live-in care depends on the location, the amount of care required, and other factors. It can be as low as $1,000 per month to as high as $5,000 per month. 

Will Insurance Cover a Live-in Caregiver?

Health insurance

Most private health insurances only pay for very limited types of long-term care. They don’t cover personal home care services such as live-in caregivers.  

Long-term care insurance

Unlike traditional health insurance, privately paid long-term care policies cover in-home care services for individuals aged 65 or older who require constant supervision due to a chronic or disabling condition.

Medicaid

Some state Medicaid programs will cover a limited amount of long-term in-home care for eligible individuals. These are, in particular, people whose physical or mental condition is severe enough to qualify them for Medicaid nursing home coverage. 

Medicare

Medicare can cover the cost of home health care visits, but it does not provide assistance for live-in caregivers. 

Important Elements To Include in a Contract

Considering that most states don’t have live-in caregiver laws and regulations, it is advisable to sign a contract between a live-in caregiver and a patient. The contract should include the following points:

  • A detailed job description of the live-in caregiver
  • Estimated monthly hours
  • Hourly pay rate and pay periods
  • Overtime compensation
  • Detailed care plan when it comes to companionship, personal assistance, pet care, cooking, housekeeping, and transportation
  • Use of caregiver’s vehicle and reimbursement
  • Guest and pet policies
  • Areas and rooms of the home to which the caregiver will have access and those which are off-limit
  • Contract termination rights of both parties
  • Anything else you’ve agreed upon during the interview process.