As Americans age, many are remaining in their homes longer. In fact, nearly 75% of adults over 50 would prefer to stay at home for as long as possible, according to the AARP’s 2021 Home and Community Preferences Survey. As a result, in-home care has become a popular option for older adults who wish to age in place. But what if your loved one requires round-the-clock care? One alternative to a senior living community is 24/7 home care.
What is 24-hour in-home care and how does it work?
Round-the-clock home care, or 24/7 in-home care, is provided by a team of caregivers who work in shifts so that their senior client is never alone. Caregivers can provide a variety of services that include assistance with activities of daily living (ADLs) like dressing, bathing, and transferring. In-home caregivers also provide companionship and may be able to help with tasks such as cooking meals and light housekeeping. If a senior requires a high level of skilled care provided by medical professionals, 24-hour home health care is also available.
It’s common to have three caregivers work consecutive eight-hour shifts to cover a senior's 24-hour care needs. A single day of care typically consists of a day shift, an evening shift, and an overnight shift. Another common variation is for two caregivers to work back-to-back 12-hour shifts. Often, home care agencies will work with families to help them create the best schedule for their loved one.
How much does 24/7 in-home care cost per month?
The median cost of 24/7 in-home care is approximately $19,656 per month. This is based on Genworth’s Cost of Care Survey, which multiplies 168 hours per week by the median hourly cost of $27. With this model of care, caregivers are awake throughout the night and actively supporting their client, even as they sleep. The price of 24/7 home health care is difficult to estimate, but you should expect much higher costs since this higher level of care is provided by medical professionals.
You might find home care agencies that offer flexibility with the way shifts are structured and the way they charge. For example, an agency may provide a sleeping shift option where the overnight caregiver is allowed to sleep, but can respond if a senior wakes up or if there is an emergency. You can expect a flat-rate sleeping shift to cost between $120 and $200.
Costs of 24/7 home care by state
Home care pricing varies depending on where a senior lives. Some states require home care providers to have specific training or certifications, which can affect the cost of care. It’s also common for families to pay more for care in areas with a higher cost of living.
The Genworth figures below illustrate how widely the costs of 24/7 home care vary from state to state.
These are the states with the highest median monthly rates for 24/7 home care:
- Minnesota: $26,390
- Washington: $25,116
- Colorado: $24,388
- California: $23,296
- Oregon: $23,296
- Rhode Island: $22,750
- Massachusetts: $22,568
- Maine: $21,840
- Hawaii: $21,840
- Alaska: $21,840
These are the states with the lowest median monthly rates for 24/7 home care:
- West Virginia: $13,650
- Louisiana: $14,196
- Mississippi: $14,560
- Alabama: $14,705
- Arkansas: $16,016
- North Carolina: $16,744
- Georgia: $16,744
- Texas: $17,472
- Tennessee: $17,472
- Kansas: $17,836
What’s the difference between 24/7 in-home care and live-in care?
Live-in care is usually less expensive than 24/7 in-home care, but there are also differences in the way care is provided. The median monthly rate for live-in home care is $10,646, according to proprietary data gathered by AgingCare’s senior living referral service counterpart A Place for Mom. This is significantly less expensive than the median monthly price tag of $19,656 for 24/7 in-home care.
A live-in caregiver lives with their client and must be provided a bed to sleep in. Because there is only one aide as opposed to a team, live-in care may be a good option for seniors who need or want the same caregiver consistently. In contrast, 24/7 in-home care provides a team of caregivers who are present around the clock, but they don’t live in the client’s home.
While 24/7 home care provides continuous care and supervision, a live-in aide is afforded at least one waking break and an eight-hour sleeping break each day. Live-in caregivers also typically get at least one to two days off per week, but this can vary. Breaks and time off will leave the client without care unless coverage is provided by another paid caregiver or family member.
How to pay for 24/7 in-home care
Generally, 24/7 in-home care is paid for out of pocket. Sources like Medicare, Medicaid, veterans benefits, and long-term care insurance may help cover some home care costs if certain criteria are met. However, they will not typically pay for 24/7 home care.
Read: How to Pay for Home Care
How does 24/7 in-home care compare to other care types?
As seniors age, their health, emotional needs, and ability to safely live at home alone will likely change. While there are alternatives to 24/7 in-home care, none offers a senior the option of living in the comfort of their own home while receiving one-on-one care. However, senior living may provide a safer environment and more comprehensive care options.
24/7 in-home care vs. assisted living
Despite sharing similar services, these care types differ when it comes to pricing. The cost of 24/7 in-home care is approximately $19,656 each month, and the median cost of assisted living is $4,500 per month.
Another major difference between the two care types is that assisted living pricing includes the cost of housing. With 24/7 in-home care, your loved one remains in their home, but they’re responsible for costs such as a mortgage, taxes, insurance, and maintenance. That’s in addition to the cost of care.
Both 24/7 in-home care and assisted living provide round-the-clock supervision in addition to assistance with activities of daily living, transportation, and help with common household tasks such as laundry and cooking. While both can offer hands-on help, neither provides the medical assistance you might receive with home health care or in a nursing home.
24/7 in-home care vs. nursing homes
The median cost of a private room in a nursing home is around $9,034 per month. Nursing homes are staffed by nurses, therapists, and other licensed medical professionals.
For seniors with serious health conditions or very limited mobility, a nursing home can offer the round-the-clock assistance and medical attention they need. By comparison, the same level of care at a senior’s home would be very expensive. One drawback of a nursing home is that a senior would need to move out of their home.
Where to find help understanding the costs of 24/7 in-home care
Managing the needs and costs of care for a senior loved one who lives at home can be challenging. For assistance finding the right in-home care solution for your loved one, AgingCare offers comprehensive information on providers and how to pay. AgingCare’s Care Advisors are also available to help you find 24/7 in-home care providers that fit your loved one’s needs and budget.
Reviewed by senior care expert Leslie Fuller, LMSW, CDP.
Where We Live, Where We Age: Trends in Home and Community Preferences (https://www.aarp.org/research/topics/community/info-2021/2021-home-community-preferences.html)
What is the Difference Between Live-in Care and 24 Hour Home Care? (https://www.nursenextdoor.com/blog/what-is-the-difference-between-live-in-care-and-24-hour-care/)
Genworth Cost of Care Survey (https://www.genworth.com/aging-and-you/finances/cost-of-care.html)
Genworth Cost of Care Survey, Median Cost Data Tables (https://pro.genworth.com/riiproweb/productinfo/pdf/282102.pdf)
A Place For Mom’s Proprietary Cost of Care Data
VA nursing homes, assisted living, and home health care (https://www.va.gov/health-care/about-va-health-benefits/long-term-care/)
Caring for America's Seniors: The Value of Home Care (https://www.hcaoa.org/uploads/1/3/3/0/133041104/value_of_home_care___secured.pdf) Home Health Services (https://www.medicare.gov/coverage/home-health-services)