Many seniors and their families prefer the idea of a live-in caregiver over an assisted living facility because a caregiver can provide overnight, around-the-clock care without the senior having to leave their home. In this article, we’ll explore the workings of live-in caregivers. As well as the costs, benefits, and financial assistance, and payment options.
What is Live-in Care?
Live-in caregivers come in two varieties: those who live with their client, and those who do not. The living situation impacts the kind of care provided, as well as the cost. But in both cases, the senior being should have a room available for the caregiver.
Non-Residential: Non-residential caregivers generally work in teams of two who take turns sleeping over at the senior’s residence. They also provide care during the daytime and general around-the-clock care. Non-residential care is better for seniors with more significant care needs. These types of caregivers offer frequent nighttime assistance, at the expense of their sleep, and do not receive free room and board.
Residential: Residential caregivers often provide care at night while the senior receives other care during the day. The presence of a residential caregiver is usually more of a safety precaution for seniors who don’t need care every night. Residential caregivers receive partial compensation in the form of room and board, and they will sometimes work other jobs during the day.
Live-in caregivers perform the same duties as other home health care and home care workers. Said responsibilities include living assistance, personal care, companionship, and possibly nursing services. The quality of the care provided can be equivalent to that received at a care facility. Live-in caregivers will also often assist seniors with transportation, shopping, and cooking. Senior’s with Parkinson’s related dementia or Alzheimer’s will usually need a caregiver to provide mobility assistance and supervision.
Live-in vs. Residential Care
Compared to residential care, live-in care offers seniors more personal, one-to-one care, control over their diet, the ability to keep pets, and the ability to continue living in their own homes. While residential care offers more opportunities for socializing and recreation, as well as more serious medical support.
Live-in Caregiver Compensation & Costs
There is a lot of variance in the cost of a live-in caregiver; prices can range from $1,000 a month to $5,000. The cost is largely dependent on where the senior lives, the kind of care they will require, and if the caregiver is residential or non-residential. Providing room and board will offset the cost of a caregiver, by how much, exactly, should be based on the cost of renting a room in your area.
Another factor is whether the caregiver is providing a vehicle or if the senior provides the vehicle, and if the senior allows for personal use of their vehicle by the caregiver. There’s also the fact that live-in caregivers can expect to have their sleep schedule heavily disrupted by the needs of their client. For seniors who require fulltime supervision or care, a live-in caregiver is generally cheaper than a nursing home or fulltime home care but is financially comparable to assisted living.
For both the caregiver and the client, it is necessary for both parties to sign an agreement or contract, due to most states’ lack of regulation concerning live-in care. If you’re hiring a caregiver through an agency, the agency will likely provide the agreement, but if you’re hiring a private individual, you’ll need to make your own agreement. This agreement (in addition to the standard contractual information) should include the following items:
- Estimated monthly hours of active care provided
- Estimated monthly number of “on call” hours
- Total payment for the caregiver
- Portion of payment offset by room, board, or other expenses
- Overtime compensation and expectations
- Caregiver vehicle usage expectations and reimbursement
- Which areas the caregiver and the client will have access to, and which will be off-limits
- Contract termination rights, to prevent sudden loss of care or sudden loss of residence
- Miscellaneous house rules or conditions, like pet or guest policy
Live-in care is usually paid for out-of-pocket. A senior can offer free room, board, or vehicle usage to offset the cost. If financial assistance is available, it is often not meant for live-in caregivers, but general home care. Below are some common financial assistance programs for seniors, and how they can be used to pay a live-in caregiver.
Medicare will not provide money for live-in caregivers. In a limited capacity, it can cover home health care visits. But only for those who can’t physically leave their residence, and just for medical appointments. Also, Medicare supplemental insurance will not cover caregiver services, only services provided by Medicare.
Medicaid benefits vary depending on the state, but many states do provide financial assistance for live-in caregivers. This assistance is offered through HCBS waivers, which are programs for people who need nursing home levels of care but would prefer to stay in their homes. These waivers allow for flexibility in the choice of care provider and the type of care that is needed. Seniors with Medicaid can hire a live-in caregiver with their allocated personal care budget. There are also Medicaid waivers for adult foster care, which allows seniors to move into another person’s home, but it can also allow for a caregiver to move in with a senior.
The VA does not have a formal program to provide veterans with live-in caregivers, but they do have programs that can offer veterans and spouses financial assistance to hire a caregiver.
Reverse mortgages allow seniors to receive part of their home equity in cash every month. But since a homeowner must live in the home to collect their money, said money can’t pay for nursing home residence. But it could be used to pay for a live-in caregiver that provides the necessary assistance for a senior to keep living in their own home.