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What to expect when hiring live-in senior care

How this arrangement differs from live-out care and what families should budget for

Live-in senior care is different than live-out senior care

Families start to consider live-in care for an elderly loved one when they get to the point where constant supervision is necessary. There are many reasons why this can occur, but making the decision to arrange for someone to move into a family member’s home can feel overwhelming. To make the process a little easier, we’ll go through a few of the unique items that make live-in senior care different from live-out senior care.

What is the difference between live-in care and 24-hour care?

This is something many families get confused about because the terms seem synonymous. However, there is an important distinction because 24-hour care can mean that a family hires multiple caregivers to work in shifts throughout the day. Live-in care, on the other hand, generally means one of two things:

  • A single caregiver physically resides in a family member’s home. This is the most common live-in scenario.

  • A single caregiver works five 24-hour shifts in a work week (at least 120 hours). A caregiver in this situation can have their status change from live-in to live-out if their hours vary.

Regardless of the setup, live-in care can be preferable for seniors with cognitive decline that benefit from seeing a familiar face, or for seniors that have simply bonded with a caregiver and now need increased supervision.

What job duties do live-in senior caregivers perform?

A live-in caregiver manages most of the same tasks that a live-out caregiver would. These can include:

  • Helping with activities of daily living, such as bathing, dressing, moving, using the restroom and eating.

  • Entertaining the senior throughout the day with various activities.

  • Providing nursing care if they are trained in this area.

  • Assisting with cooking, cleaning and other household chores.

  • Taking the senior to appointments.

Live-in caregivers can differ from live-out caregivers by being available at odd times where care isn’t expected. This is not to say that a live-in caregiver is on-call 24 hours a day, but having someone available should the senior need help in the middle of the night is unique to a live-in senior care situation.

What are the hours a live-in senior caregiver should expect to work?

This is specific to every family’s needs, but generally speaking, caregivers work five days of the week with the family or another caregiver covering the other two days. For the days the caregiver works, they should have a couple of breaks throughout the day to be on their own if possible. In terms of how to count working hours, the caregiver is on the clock and should be paid for any time they are not free to leave the senior’s home to do as they please.

Do families have to pay a live-in caregiver during the night when they’re sleeping?

This is one unique scenario where live-in care is different from live-out care. With a live-out caregiver, federal law allows families to exempt up to eight hours of sleep time if the caregiver works a 24-hour shift. But with a live-in caregiver, this isn’t usually necessary because the caregiver is simply paid for the hours they’re working. This means sleeping time would be time off-the-clock, and if the caregiver is needed at some point during the night, they would be paid for the time they were providing care.

Do live-in senior caregivers earn overtime?

There is an overtime exemption in federal law where families do not have to pay a live-in caregiver overtime for hours worked over 40 in a week. Instead, families pay the caregiver the same hourly rate for every hour they work. However, the states of California, Hawaii, Maine, Maryland, Massachusetts, Minnesota, Nevada, New Jersey, New York and Oregon have different live-in overtime rules. Check the requirements in your state if you live in one of these areas. 

Besides paying the live-in caregiver, what other items should families consider in their budget?

It’s impossible to anticipate every expense that could come up, but at a minimum, families should have these items in their senior care budget:

  • Household employment taxes, which are generally 10 percent of the caregiver’s wages.

  • Workers’ compensation insurance in case the caregiver is hurt or sick while working.

  • Increases in the cost of groceries and utility bills since there will be another person living in the senior’s home.

  • Using a service like HomePay to manage household employment taxes and the caregiver’s payroll.

  • Any tax breaks that can apply because the family is paying legally.

  • How much cost reduction can be expected if long-term care is covered by insurance.

Read more about each of these items in our article about budgeting for in-home senior care.

Hopefully you now feel more organized and at ease about planning to bring a live-in caregiver into your loved one’s home. And if you have questions about the tax, payroll, labor law or HR aspects of employing a senior caregiver, our experts are just a call away at (888) 273-3356. 

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