Live-in Care
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Live-in Care

Live-in Caregivers

If there is one thing that is a shared experience for all of humanity, it is aging. That can present challenges for people who value their independence. With polling showing that 90-percent of older Americans desire to live at home as they get older, options like live-in care enter the conversation.

So, what is live-in care? It is a form of support that helps you with your daily and personal care needs. The assistance given allows older adults to remain in their homes for as long as possible, prolonging or eliminating the need for moves into assisted living facilities/nursing homes.

Live-in care also helps identify and relieve things that might otherwise go unnoticed. That includes reducing the feelings of isolation and cognitive decline that seniors living alone suffer. While live-in care might not meet everyone’s needs, it is something to consider when finding the best lifestyle for those experiencing age-related issues.

A paid live-in caregiver provides the services needed by seniors living at home. Unlike informal caregivers such as family and neighbors, these individuals might have certifications for the jobs that they perform. Qualifications for live-in caregivers depend on state laws, insurance requirements, and the company offering their services.

How Does Live-in Care Work?

When it comes to live in care for seniors, understanding how it works starts with acquiring a caregiver. There are three ways you can hire a caregiver for yourself or a loved one:

  1. Private hire;
  2. Referral agency;
  3. Home care agency.

Private Hire

A private hire refers to the process where the individual or family hires an individual directly. The interview and hiring process is often more involved, as you have to do more research. Clients and their families shoulder more responsibilities with private live in care for seniors.

Referral Agency

These agencies offer caregivers and access to insurance or other resources needed to employ them. They act as a broker between family members and caregivers by sorting background and credentials ahead of time. A referral agency can also provide resource contacts for payroll, insurance, and other needs (this is why referral caregivers cost more than one hired privately).

Home Care Agency

The most expensive caregiver will come from an agency dedicated to live in care for seniors. Background, certifications, payroll, insurance, and other necessities have already been taken care of by the agency. A home care agency monitors and substitutes caregivers as needed, meaning that all you have to do is pay for the services.

The Initial Interview

Once you have determined the source used to hire a caregiver, your next step is the interview process. These are some of the things you need to ask, no matter if it is a private, referral, or home care agency:

  • Background check – You will want to perform a criminal background check at the federal and county level for any candidate. Referral services or a home care agency should have records of a “live scan” that looks into criminal and civil matters. References are not a reliable background source but can help determine a caregiver’s success in the field;
  • Driver’s license/Vehicle insurance – A valid driver’s license aids in checking for moving violations, suspensions, or other relevant details. Up-to-date insurance covers their vehicle in case of an accident. Make sure you can add the caregiver to the insurance policy covering you or your loved one’s vehicle;
  • Bonded and Insured – Homeowners insurance may or may not cover someone who gets injured on the job at your residence, so verify that your policy has worker compensation insurance (or get a rider). Liability insurance is also critical for protection against property damage and negligence. A fidelity bond embezzlement, theft, and other types of financial mismanagement;
  • Agency coverage – You need to know which of the items mentioned previously are covered by the agency you use and which are not. Referral agencies will usually have a live scan and perhaps verify driver’s license and vehicle insurance, while a home care agency covers most items. Private hires will require you or your loved ones to take care of most of the things on this list.

Other things you should ask about when you interview a potential caregiver to provide live in care for seniors in your family include job references, certifications, degrees, work experience, and personal traits. What limitations or health concerns does the senior deal with, and what experience does the caregiver have with them? Along with those questions, ask questions that identify a good match with personalities between the senior and the potential caregiver.

Make All Pre-arrangements Ahead of Time

Once you have identified a caregiver you want to work with, you need to determine what pre-arrangements should be in place before a contract is signed. When it comes to live in care for seniors, these can include:

  • Living arrangements – These include lodging accommodations like a room, as well as access to appliances for cooking and cleaning;
  • Hours worked – Decide on the amount of time a caregiver is “on the clock” and what time they will have for themselves. Also clear up details for part-time or full-time jobs;
  • What are the job details – Layout schedules for supplying medicines as well as occupational (dressing/hygiene) or physical (exercise/movement) engagement. What home jobs are required (cooking/cleaning) or transportation for the senior (appointments/shopping);
  • Boundaries and limitations – It is just as important to determine what a caregiver should not do and at what point they need to contact family members, medical staff, or other agencies. Establishing boundaries also protects a senior’s dignity and privacy to make live-in care as stress-free as possible for all involved;
  • Emergency and backup plan – Now is also the time to establish procedures to follow in case of emergencies, including family and medical contacts. Also, you should make a plan (especially with a private hire) to cover a caregiver if they can not perform their duties.

Who Is Live-in Care For?

When it comes to live-in care, there are several instances where one can benefit from it:

  1. People who experience age-related complications;
  2. Those suffering mental degeneration;
  3. Individuals with physical limitations;
  4. Elderly people living in isolation.

Aging Issues

Your cells, organs, and tissue change as you age, with those changes often displaying a loss in functions. That can lead to difficulties in performing everyday activities like cooking or driving. Live-in caregiving helps to overcome complications experienced by seniors getting older.

Mental Health

While cognition remains intact in seniors, slower reaction times and problem-solving occur. Alzheimer’s and other forms of Dementia make a caregiver a must as they progress (in fact, these diseases will require 24-hour care). Depression can also lead to a reduction in the quality of life in the elderly.

Physical Impairment

Reduction in muscle mass, coordination, and balance occur as you get older. Injuries and the onset of certain diseases can limit mobility, which requires occupational and physical assistance. Live-in care supplements what seniors can do, allowing them to maintain more independence.


Aging can negatively affect socialization, and isolation can be a serious issue among the elderly. Live-in care can provide companionship and help stimulate meaningful activities, including conversations, friendship, and access to social events.


Do live-in caregivers get breaks?

Possibly. Depending upon the job description and the needs of the senior, a caregiver can get breaks during down periods of activity, or they may have scheduled breaks during their workday.

Do live-in caregivers get time off?

Yes. Most caregivers will work either part-time (a few hours each week) or full-time (several hours during most days of the week). They do get time off to rest and do things for themselves.

Do live in caregivers pay rent?

No. The cost of room and board is part of the contract signed with the care agency, referral service, or private caregiver.

What if I can not get along with my live-in caregiver?

If you find yourself in a dangerous situation, ask the caregiver to leave and contact family. If the caregiver comes from an agency, contact the entity to seek a substitute. Private hires will take longer as you need to finalize payments and other obligations.

Live-in Care vs. 24-Hour Care

You might have heard people use the terms “live-in care” and “24-hour care” interchangeably. The fact is, however, that they mean two different things.

While live-in caregivers live on-site and are around 24-hours a day, they take time off for sleeping and personal business. With 24-hour care, two or three caregivers work in 8-12 hour shifts, so there are no unsupervised downtimes.

The advantage of live-in caregivers is that they form a closer bond with the client at the expense of needing downtime. Several caregivers working in shifts means critical care and hospice care continue with 24-hour care, but these services cost more money.

What Are the Benefits of Live-in Care?

Seniors can live at home and feel more independent with a live-in caregiver. Benefits include:

  • Help with meals and household chores;
  • Assisting with occupational things like dressing and hygiene;
  • Reminding seniors to take medicines or organize paperwork;
  • Provide transportation for appointments or shopping;
  • Provide companionship and socialization;
  • Help with exercising, hobbies, and pet care.

Cooking meals, doing laundry, and keeping a clean house are challenging for everyone, but it is even harder for seniors. Caregivers can assist clients or do the jobs for them.

Aging and diseases can limit mobility and coordination, so caregivers can help the elderly keep themselves clean and feel comfortable with fresh clothing that fits.

It is easy to forget medicines, even with alarms or other reminders. Live-in caregivers can keep seniors on schedule and help them fill out paperwork, bills or make phone calls.

Driving is a big issue when coordination and reflexes slow down, so transportation becomes a crucial part of a senior’s care plan.

Humans are social creatures, and people need to remain engaged and stimulated with others. One of the benefits of a live-in caregiver is the companionship they provide.

Exercising is crucial to maintaining the quality of life for seniors, as are hobbies or pets. Caregivers can help clients enjoy these things by performing the tasks that reduce participation.


What are the pros and cons of Live-in Care vs. Care Homes?

There are advantages to live-in care that include:

  • Cost – Live-in care costs less;
  • Freedom – Seniors can do what they want at their own pace;
  • Age in place – Familiar surroundings and personal items help outlook.

The advantages of care homes are:

  • Continuous care – Trained staff on-site for medical, physical, and occupational needs;
  • Protection – Facilities are secure and clients are monitored, helping reduce accidents and wandering;
  • Evolving care – As seniors age, the level of care can change with their needs.

What are the pros and cons of Home Care Agency vs. Private Live-in Caregiver (Private Hire)?

Private hires offer you:

  • More cost-effective – You will not have to pay for the agencies services, just the caregiver;
  • Selective – You can be more specific with personality and qualifications;

Home care agencies will:

  • Keep it simple – They take care of background checks, payroll, etc.;
  • Provide backups – It is easy to substitute caregivers who are unavailable;
  • Easy to find – Using an agency offers access to several qualified caregivers at one time.

What Are the Live-in Caregiver Duties?

As stated previously, a live-in caregiver provides seniors in need with the ability to maintain their independence at home for as long as possible. The caregiver helps with physical, mental, and emotional support. During the hiring process, the client and caregiver (or agency) outline the details of what is and is not part of those duties.

  • Physical assistance comes in many forms including, meal preparation, light housekeeping, laundry, transfers, dressing, and other forms of activities that the client might struggle doing.
  • Mental support includes helping with reminders for medications, appointments, building shopping lists, filling out paperwork, and mailing bills or letters.
  • Emotional stability is important for everyone, and caregivers can observe and report anxiety, depression, and cognitive decline that might otherwise go unnoticed. They can stimulate conversations and thinking, participate in mental exercises and engagement, and build comfort through companionship.
  • Other activities might include driving to the store or transporting seniors to appointments, feeding or walking pets, and acting as an observer for family members and health care providers.


What are the typical qualifications and skills of live-in caregivers?

When it comes to certifications, the minimum will often be just a High School Diploma, with higher levels in training being awarded with:

  1. Basic Caregiver License;
  2. Certified Nursing Assistant (CNA);
  3. Home Health Aide (HHA);
  4. More specialized certificates.

Further training could include special conditions, like palliative or hospice care, or basic first aid and emergency certification.

Caregivers should display both empathy and communication skills. Patience, organization, and observation are other skills that a caregiver should have, at minimum.

What are the different job titles for live-in care?

Each agency or facility has a hierarchy where various titles might indicate different roles, but most private hires have the same qualifications no matter what their title might be.

There are no certifications that distinguish between aide, assistant, or caregiver.

How Much Does Live-in Care Cost?

Some estimates put the average cost of a live-in caregiver at $21 an hour. Prices can vary based on the type of hire (private, referral, agency), local economy, and demand.


Does insurance cover live-in care?

Most private policies do not, meaning that you might need to purchase a “Long-Term Care Policy.”

Does Medicaid pay for live-in care?

It covers services limited to medical only (no personal care) and does not assist live-in caregivers. Coverage and amounts vary by state laws.

Does Medicare pay for live-in care?

Medicare will pay for medical-related expenses, not custodial (personal) costs, or compensate live-in expenditures.

Does the VA pay for live-in home care?

Veterans can receive homemaker and health aide care coverage based on their needs and living situation.

How to Find a Live-in Caregiver?

Locating a private hire involves searching job site registries and listings. You will find it easier to search out caregiver referral services, many of which offer resources for things like taxes and insurance. The best option is using Home Care agencies that provide caregivers and take care of payroll, taxes, and other extras.


1. Geriatrics and Extended Care – U.S Department of Veterans Affairs

2. Aging changes in organs, tissue and cells – Medline Plus

3. Home Matters: Aging in Place Housing Survey – AARP

4. Social isolation and loneliness: relationships with cognitive function during 4 years of follow-up in the English Longitudinal Study of Ageing – National Library of Medicine

5.Using Live Scan Fingerprinting for Background Checks

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