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What are the pros and cons of live-in care vs. assisted living?

Katie in Chicago, IL
Aug. 16, 2017

My elderly grandma wants to live at home, obviously, and we have the potential to hire a live-in caregiver. She's willing to have taxes paid out, etc, but I'm concerned about the legality of the rate of pay. We'd offset part of her salary for room/board/food, but there's also the 24/7 aspect of the job that concerns me. Legally, are we unable to have one caregiver because she'd be responsible for my grandma ALL the time? I've been trying to research this, but it's hard to find information that will answer my questions. Thanks in advance for your help!

Answers

For 11 years I was I was the live-in care-giver for a lady throughout her 90's, plus. Whenever she could not stay alone while I went to church, or otherwise to get some time off, then a family member would come visit her. If they were not prepared to do that they had to hire a respite care person. That could be from an Agency, or privately as they hired me. Sometimes she went with me when I did the shopping, but more often stayed home alone. I have had several other, and much shorter, live-in jobs where it was done the same way. As for pay; I was paid a salary, or I imagine one could figure a rate for the main hours when attention is needed. I always say that if I am not needed at night then I don't need to be paid for that time even though I would be there on call, just in case. That benefit could cover the value of food, etc. I hope that helps, and that it works out for your mother and all of you! Liz T.

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User in Folsom, CA
Aug. 5, 2017

Live-in care allows for the client eat and sleep at their own rhythm, with a team of known care givers. They can rotate schedules to accommodate time off and have family and friends visit them in their own environment. Seniors give up their lives a little at a time through the aging process, allowing for them to remain at home makes a huge difference in morale and quality of life and care.

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Hi, I've worked in both settings, live in and assisted living. I would advise you to keep your mom at home. Not only is being in her own home much more therapeutic but I find assisted livings to be more impersonal, one and one attention is not given. They would actually advise the families to get a private aide for one and one. It would be smart to hire two caregivers if you choose to go private or an agency if you want more security and pay more.

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I have an exposure working for a Senior in an Assisted Living Facility. As we age we look forward to quality of life. With an ALF one caregiver takes care of 8 to 10 residents. Due to this it takes longer time before they can get to a senior's room asking for help. With this, you won't be able to give your family the quality of life they deserve.

With one-on-one, care is more focus since the caregiver can prepare a meal specifically for the client. Nutritious meal shall I say. Likewise, all other needs of your family regarding activities of daily living (adl) will be covered.

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ALFS are way expensive ! and make patients feel alone , there is nothing an ALF can do that a live in care giver cant. plus a lot of things go unseen at an ALF and no one talks about it.

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User in Powell, TN
May 2, 2017

No one could reasonably be expected to care for mom 7 days a week. You might have to get a live in and then someone else to come in two days a week. Also give the caregiver the option to leave your grandma alone while she goes to the store or pays bills etc. You could get a daytime caregiver and then get a night time caregiver to spend nights there, so grandma would be safe and the caregiver will have reasonable work/life balance.

Hello I was a live in caregiver for 9 months with a woman with dementia. I had my own bedroom, the food I purchased was 4 born of us. I took her everywhere, Dr appointments, church you name it. I only had a replacement when my son changed ranks in the navy and I took a week and half off to just get away. I was part of the family. I cleaned the home and worked in her small flower beds outside as well. I kept the home immaculate. The son watched the purchases on the computer and I was the only one who had the card and turned in the receipts monthly. It can be done. :)

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Brittany in Krum, TX
May 16, 2017

I would suggest doing multiple caregivers. Especially if you find good ones. I personally wouldn't do an assisted living.

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she'll be more comfortable in her home so just hire a care giver

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User in Fremont, CA
May 14, 2017

If the client require 24 hours care, live in care giver is appropriate. As long you have room for her to live and food, you can negotiate for the salary, may be less money. For assisted living if the client still able to take care himself mentally and physically, the care giver only assist and remind him, and come part time.

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I would strongly advise you to not put her in assisted living. My mom was in a "reputable" one for a few years after a stroke, and the care was not good! She needed help with many ADLs, and many of the caregivers would skip them -- like not brushing her teeth every day or taking her to the bathroom! The AL caregivers are stretched very thin, probably taking care of 15 residents at a time. After some really negligent care, I moved my mom to her own condo with live-in caregivers, and she couldn't be happier. Yes, figuring out all the laws is daunting. I'm in IL too, so I'll share what I've learned. IL has a "One Day Rest in Seven" law that applies to caregivers, so you will need two caregivers for the week. You must also pay minimum wage: IL minimum is $8.25/hr. (If you're in Chicago, you might have to pay higher - not sure)  In IL, caregivers are also subject to the overtime laws of 1.5 regular wage if they work over 40 hours per week. However, if the live-in works at least 5 days a week, they are considered to be live-in on a permanent basis, and are not subject to overtime. Additionally, you can exclude 8 hours sleep time under certain conditions (should have written agreement, caregiver needs private quarters in homelike environment, and can sleep uninterrupted). So, having a 5 day caregiver and 2 day caregiver is the way to go.  For the two day caregiver, you can still exclude 8 hours sleep time with similar but less-stringent caveats as the 5-day. Just make sure the two day person is working two 24-hour shifts. You won't have to pay that one overtime either, as their hours per week, net of sleep, will be 32 hrs.  In my own research, I was not able to determine whether it was OK to offset room/board etc against pay in IL. For me, it became a moot point, as market daily rates were above IL minimum wage anyway.

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It will be ok to hire someone but it's always good to have two people because,u never no when someone needs to be off or get a family emergency as for taxes.she can always do a 1099 hope this helps.

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Seek the advice of eldercare lawyer

you can seek an home health aide

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I would definitely suggest more than 1 caregiver.  We have 3 caregivers for my grandmother that work 3 days a week from 8a-8p and 1 that works on Sundays for 12 hours.  She is not at the point yet that she needs someone during the night time so I do not know what we will do when that is needed.  But I know we had a lot of trouble when we were going through an agency for caregivers.  Most of the people they were sending would steal from her or were just plain crazy.  We had to hire privately which we have been much happier with.  

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one of the pros for some people is if they are looking for room and board, but there is more cons then pros. because live in take people away from their family most times its just a means to an end. most people would like to go home at the end day.

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the pros about living at home, home is ae familiar place its filled with memory if there is great caregiver it makes it even better. Home is just much more comfort. As for assisted living isn't for everyone. people who like to social gathering will like it, but very often I speak to a elderly person in an assisted living they complained how their children put them there and they don't want to be there. even so if some people don't have a good caregiver with them it hurt more then it help.

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Laure in Edmonds, WA
July 30, 2018

My boyfriend's little sister has cerebral palsy and has never walked and is in a wheelchair but teaches at the local community college for Math. Her caregiver Dave worked out an arrangement with my boyfriend (who manages his sister's care and house) to YES let Dave live there free of rent for his pay and it's worked out GREAT. We love him.

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Susan in Jackson, MO
July 23, 2018

Live in caregivers have to be checked out thoroughly if you don't know one. Try someone in the family first. Background checks are a must. Don't let anyone talk you out of one. Making her home more accommodating for her age requirements and disabilities is something you will have to do. Equipment for the person to help her at home would be imperative. Food schedules and things she will eat are a must, so the person must shop and cook good meals. No frozen ones. You may be able to get her "meals on wheels" or what ever your area calls them. Assisted living would be on that company to provide with good care. All of the above. Unlike her home,The living space is also very much accommodating to the elderly .And this can be expensive. She may have to sell her home also.

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Yes We can help you. All this needs to be governed by your grandmothers health at this time.

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Tina in Elm City, NC
July 23, 2017

Live in care means you be there all night 24/7. Assisted living means you there maybe eight hours a day.

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I always advocate aging in place at home with a caregiver(s) if possible. I don't recommend room & board to off-set a flat or hourly rate based on expected work hours per day. There is a problem for the care giver if there's not enough savings to move on when the case ends for whatever reasons. Compare what the average rates are in your area and negotiate a rate that works for both parties. And it's wonderful when the family can work together to off-set the cost of respite.

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User in Yelm, WA
May 14, 2017

They are awesome caregivers around that would do a live in and negotiate what you can pay if they like your mom and like living there.  I had several caring for my mom at home and we reached a point we couldn't pay that. Then a woman met my mom and loved her so much that she just wanted to be around her and care for her...not just for the pay . (That's really ideal..and it can happen alot) . I did same myself for others when they couldn't pay normal rates but i just wanted to be with the person and it was worth it to have a position with someone i really loved. But give what you can don't take advantage of those who give all they can regardless of pay. If you can find someone like that and a back up just in case needed...and if family can fill in too ...it's better than any other option. What we finally ended up with..the woman who just loved my mom...was the best we had and they all were really really great.  The last one and best one stayed with her for many years and they had a wonderful time every day. They sang songs, went to the park, ate well and had great conversation. The caregiver was from Jamaica and was a totally high spirited happy to be alive every day of her life ...person. Even before that it was hugely better for my mom and us to have people take care of her in her home and every person i ever talked to said the same about their own experiences.  How would you feel if it was you?  As for the pay, i think you can negotiate anything for that and people will work for negotiable fees and i believe that is legitimate depending on if a live in and 24 hour care is considered live in so fees are negotiable for that..even if only do some and not all days..and  you split it up with another caregiver..but check with other sources ...some local senior programs sometimes have confidential counseling on all aspects of this.

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User in Muenster, TX
Aug. 16, 2017

The future of care giving is in the home with live-in care.  It's personal and individuals are accountable where no one in the facility needs to be concerned.  Live-in care also allows selection of care-givers based on credentials and personality.  Plus, care.com encourages background checks.  Credit checks may be just as effective but those are offered by the credit reporting agencies directly.  Good luck on your search for good care.  I hope this site will help us all to locate the best care givers out there.

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User in Salem, MA
Feb. 15, 2019

Assisted living means 24 hour care without worrying.

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User in Tampa, FL
Jan. 21, 2019
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Paul in Rockford, IL
Jan. 15, 2019

Assisted living is 1 to 3 short visits a day. It is for people or get around very well and need little to no supervision. Live-in care is for people who need a high degree of supervision and are comfortable in their home. For Alzheimer's, this is critical that they stay in their home. If you need help for your wealthy parents with Alzheimer's anywhere in the US, visit my profile.

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Check with your local labor board

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User in Tacoma, WA
Oct. 18, 2018

I've been a private caregiver for 20 years, and personally I would hire 2. You can either have someone do rotating 24 shifts or someone for days and someone else for nights. It is not possible for 1 caregiver to handle the load of 7 days a week/24 hrs a day. They will burn out and you will keep re-hiring.

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Laura in Garner, NC
Oct. 15, 2018

I wouldn't offset the help's salary too much due to room and board. That comes with the territory of having 24/7 help. It's a sacrifice not being able to sleep in your own home. Pay her wage and let her decide if she wants to purchase food separately or split the food bill. I would pay a minimum of $150/day. Encourage her to take a several days off per month and have someone be her backup. Otherwise, slave mentality will set in and you will have a very frustrated, burned out worker.

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User in Surprise, AZ
Oct. 9, 2018

Your grandma wants to stay her home, That is fine. Let her to move with you or you or your family members take to turn move with her, hire caregiver for 4 hours a day to do chores, actives, games, or personal needs. My mom from another state, she had to move with me in Minnesota. She just changed her life style, go to Adult program 3 days a week, and rest at home with her own space like read some books, and write notes. so eat dinners with her after I work. and go out active weekends. Take her nail salon every two weeks, she likes pamper.

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Elyse in Houston, TX
Oct. 2, 2018

Try contacting your states Ageing and Disability department.

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Hoai in Orlando, FL
Sept. 9, 2018

If you can arrange, don't send your grandma to assisted living or nursing home. Live-in care is expensive but it's helping your grandma don't feel lonely or depress

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Call the Office of Aging to inquire or possibly the Dept. of Labor. It's possible that your grandma could qualify for aide services in the home through the Office of Aging or her health insurance provider.

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I have not experienced live in care.

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It REALLY depends on the quality of the assisted living home. I just answered a similar question about one. In my years of picking up patients from them, they aren't the best, not unless you put your parents in the best of the best, which can get expensive fast. Does this caregiver have to be a registered nurse? That will be more expensive of course. Based off the mental state of your grandmother, and how stable she is on her own, one caregiver may be enough. In my research, I don't think that it would be a problem to have just the one caregiver if your grandmother doesn't have any problem breathing on her own. Don't quote me on that though.

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Alan in Nutley, NJ
Aug. 8, 2018

Staying at Her home will make her feel more comfortable. Although many Assisted Living facilities are very good. You have to visit them, and do your homework.

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An idea is to find 2 twelve hour care givers. The live-in could possibly be a nursing student that attends school during the day, while another was hired to come in for an 8 or 12 hour shift. The nursing student would NOT get paid in exchange for a roof over their head. Nursing students usually do NOT have classes or clinicals on weekends so she can be there for your family member. When she needs a break, your family members could rotate to help on weekends also. It has become a "Village Effort" these days! If your grandma is SAFE and not a High Fall Risk, she could go to assisted living, but look at shelling out 4-5 GRAND a month easily! Assisted living are only for those independent and do not need 24/7 supervision. Also, it is always best to keep a loved one in their familiar home environment for as long as possible. Good luck! Deb RN

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