Live-in caregivers: What they do and how much you can expect to pay

As an older loved one experiences physical and cognitive declines, the level of help they require can range for weekly family visits and errands to companion care. Even if a senior’s care requirements escalate to the point where it is no longer safe for them to be alone 24/7, some wish to remain at home and age in place. This can put immense pressure on loved ones trying to provide around-the-clock care themselves. The most practical option for some: hire a live-in caregiver.

A live-in caregiver is just what it sounds like, explains Christine Randall, author of “The Perfect Caregiver: 5 Steps To Hiring A Caregiver For Your Aging Loved One.” This is someone who lives with a patient, providing care 24 hours a day for either several days or weeks at a time or daily on an indefinite basis. “The goal is to give families peace of mind and their aging loved one quality of care by a skilled professional,” she says. 

If you’re just starting to explore this option, you may be unsure of what to budget for this type of care or the rate you can expect to pay. If you’re considering hiring a live-in caregiver, here are the basics on what you can expect to pay. 

“The goal is to give families peace of mind and their aging loved one quality of care by a skilled professional.”

— Christine Randall, author of “The Perfect Caregiver”

What to know about the various types of live-in caregivers

Before trying to figure out how much you can expect to pay a live-in caregiver, it’s important to understand that this is actually a blanket term. Anh T. Dang, owner of CareWorks Health Services, a California licensed home health and in-home senior care services agency, explains that this title generally refers to someone who remains in a senior’s home for 24 hours, assisting for a few days in a row until they’re relieved by another caregiver. However, there are a couple different types of live-in caregivers. 

1. 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 caregiver is able to sleep for eight hours at night — the bed must be provided,” says Dang. “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.”

2. Live-in with overnight care

Another type of live-in care is when an overnight aide provides help during sleeping hours — which usually adds up to anywhere from six to eight hours —  so that the day caregiver can rest. This type of care is recommended in situations where the senior wanders, wakes frequently, has personal or special care needs or requires repositioning to prevent bedsores, explains Dang. 

How live-in caregiver’s rates are determined

Unfortunately, there’s no industry standard, and many factors play into how much a family or senior will pay out of pocket for this type of care, including whether you are hiring privately or working with an agency. 

Randall, who also helps screen and hire caregivers for families, adds that different areas in the country will have different rates. “If you pay an agency, you will likely pay $400 per day or more, while direct pay to the caregiver averages $300 per day,” she notes. 

Other resume points a caregiver may have that can impact overall pay: 

• Existing training or certifications.
• Willingness to work off-hours, around the clock and on holidays versus working only daytime shifts.
• Proficiencies in additional languages. 
• Willingness to work with clients who might require a higher level of assistance. 
• Possessing a state HHA certified home health aide certificate.
• At least two years of experience.
• Experience caring for more challenging cases.

What you can expect to pay for live-in care

If you’re hiring through an agency, your caregiver must be paid minimum wage for all hours worked in addition to time-and-a-half pay for any overtime hours, notes Kelli Bradley, an in-home care agency owner and founder of The Devoted Daughter, a resource for family caregivers. “If a caregiver is working a 24-hour shift, has separate sleeping quarters and can sleep uninterrupted for eight hours, a sleeping exemption of pay may occur,” she adds. 

However, she notes that sleeping exemptions (periods of sleep when caregivers aren’t paid at all) are rare; therefore, most agencies charge the client hourly. “Keep in mind that if the agency charges hourly, you will accrue overtime charges every two days unless a shift change occurs at 40 hours,” she says. And with the variation in rates by state and agency, she says that you can typically expect to pay anywhere from $18-35 per hour.

That said, the rate you pay will also depend on how many hours per day and days in a row a live-in caregiver works. In general, Randall says live-in care seekers can expect to pay at least $300 per day. 

“Caregivers should be compensated for their time and effort. Make sure both of you are comfortable with the working arrangement.”

— Anh T. Dang, owner of CareWorks Health Services

How to discuss pay with a potential hire

If you decide to go the private route instead of working with an agency, it will be up to you and your potential live-caregiver to determine their rate. But first, you need to put on your employer hat, and remember that although you’ll likely be paying less hourly, you’ll now be responsible for covering benefits like insurance and worker’s compensation as well as taking point on a contract that specifies your caregiver’s schedule and responsibilities, notes Bradley. 

“It’s important to note that caregivers should be compensated for their time and effort,” reminds Dang. Most importantly, she concludes, “Make sure both of you are comfortable with the working arrangement before [moving forward].”