Looking after an older adult with as much love, care and compassion as a family member can be life-changing. To that point, it’s incredibly rewarding, as you’re helping your client stay in a comfortable space and age in place versus going to a nursing home, explains Christine Randall, author of “The Perfect Caregiver: 5 Steps To Hiring A Caregiver For Your Aging Loved One.”
Meanwhile, this professional path can provide you with the opportunity to develop meaningful relationships and have flexibility in your schedule, according to Quincie Novella, a case manager at Salus Homecare. And the need for qualified caregivers is great, she adds.
However, for those first starting out, it can be difficult to establish what to charge for live-in caregiving services. If you’re considering becoming a live-in caregiver, here are the basics on providing this type of service and how much you can expect to make.
How to determine your rate as a live-in caregiver
“Pay can vary depending on whether you work for an agency or are hired privately by a family,” explains Novella.
If you work for an agency, certain benefits — health care, paid time off, 401K, training and other insurance — add value and should be taken into account when considering the pay rate you are offered, she points out.
Other factors that can impact overall pay:
- Existing training or certifications.
- Past experience.
- Willingness to work off-hours or around the clock versus working only daytime shifts.
- Proficiencies in additional languages.
- Willingness to work with clients who might require a higher level of assistance.
But in order to determine an appropriate rate to charge for your services, Anh T. Dang, owner of CareWorks Health Services, a California licensed home health and in-home senior care services agency, notes you’ll want to consider the following:
1. The duties and level of care required
These responsibilities can range from:
- Provide activities of daily living (ADL) personal care, such as bathing and dressing.
- Preparing meals for the senior.
- Planning activities to keep him or her engaged and active.
- Keeping a log of medications they take and documenting any changes in their behavior or moods.
- Running errands, such as picking up groceries or prescriptions.
2. Hours you’re expected to work
Also, will you be expected to wake up when the client needs help or wakes up at night? Just because you are filling a live-in role doesn’t mean that you work 24/7.
3. The senior’s medical conditions and mental health status
Consider the following:
- Do they have a condition that requires special care such as dementia, Parkinson’s, diabetes, etc.?
- Are they combative or a wanderer in personality or behavior?
- Are there physical requirements, and if so, can you easily handle the weight or transfer?
4. Assistance you might receive from others, such as the senior’s loved ones
5. Rest breaks and time off
6. Pet care
The client may have animal companions and need help with their care. You’ll want to get details on how many pets they have and what kind of care will be expected from you.
7. How frequently you’ll be paid
8. Your food and lodging during shifts
You’ll want to see who pays for this and if the client will allow you to eat their food.
9. What is the client’s personality?
Learn if they’re eager for you to be in the home or if they’re resistant or combative.
10. How does the family treat one another?
Although not necessarily directly related, this type of drama can at times be more difficult for the caregiver than the actual job description.
11. How will the client and his or her family treat you?
Some clients are a joy to work for. “Others run their homes like a drill sergeant or have a five page spreadsheet outlining your duties down to the minute,” says Dang.
“Working as a live-in caregiver comes with a unique set of challenges, which should be reflected by pay that adequately compensates the work.”
— Sean Marchese, registered nurse
What to know about different types of live-in care
To pinpoint your rate, Dang recommends taking into account the different types of live-in caregiver and which role you’d be filling.
Live-in with sleep time and on-site breaks
With typical “live-in” caregiving, a main caregiver works between three and five days each week, providing 24-hour help during this time.
“The aide is given eight hours of sleep per night — with bed required — which may be interrupted by emergencies or occasionally need requests,” she says. “The caregiver remains on-site, even during their daytime breaks since the client can’t be left unattended due to cognitive impairments or they may be a wanderer.”
That’s why the caregiver always has eyes on the client, even during breaks, except for when a relief caregiver covers for the remainder of the week.
Live-in with sleep and client can be left alone
This is similar to the above, except that the client can be left alone for short periods of time, explains Dang. This allows the caregiver to leave and run errands or shop for clients — but usually for no longer than 90 minutes.
24-hour caregiving
Some people require round-the clock care, which is provided by two or three caregivers working 8-12 hour shifts. “This type of live-in caregiver provides constant, attentive visits around-the-clock and may not allow for sleeping breaks unless a family chooses it themselves,” says Dang. “This style would be more appropriate to those who need higher levels of assistance due to their illness.”
Live-in with overnight care
In this case, a daytime live-in caregiver has a relief or overnight caregiver. “The daytime live-in works 16-hour shifts and is relieved by an overnight aide, who generally provides help an hour or so before the client goes to bed, during the night and when they wake up in morning,” says Dang. “This means that the overnight aide must remain awake at night.”
Other factors that influence pay
In addition to the aforementioned factors, your rate will vary based on the state, county and city in which you’re working as well as the local aide wage requirements. In California, for example, Dang says that the U.S. Department of Labor comes second to the state’s labor board laws. This means that pay practice defaults to whatever benefits the employee the most.
To figure out what’s appropriate for your location, level of experience and responsibilities, Dang says it mainly comes down to the following:
- At least minimum wage. Check your local state, city and county for this information.
- Overtime = 1.5x. California considers overtime anything over 9 hours and 40 hours depending on if you are full-time.
- Niche care. If the client’s needs require a specially trained caregiver, then add on a few more dollars per hour.
In general, Randall says to expect at least $300 per day — unless you work for an agency as many pay the provider less. “If you’re hourly, [expect] $18-22 and up, per hour,” she says.
Other factors that you can use to help set your rate, according to Randall:
- Having a state HHA certified home health aide certificate.
- Having at least 2 years experience.
- Having great references.
- Experience with more difficult health.
- Availability to work on holidays.
Ultimately, you’ll want to be sure to research what the median pay is in your area and evaluate the responsibilities of the job alongside your experience and qualifications. However, as Sean Marchese, a registered nurse with a focus in oncology and patient caregiving, adds: “Keep in mind that working as a live-in caregiver comes with a unique set of challenges, which should be reflected by pay that adequately compensates the work.”
