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If your aging loved one needs more support at night and you’re feeling exhausted or anxious about their safety, you’re not alone. In fact, sleepless nights and safety concerns are two of the most common reasons families seek overnight care, says Hillary Wootton, business operations manager at Homewatch CareGivers, LLC. Many families will reach a point where overnight care becomes not just helpful — but essential.
Bringing in a caregiver who can provide that essential nighttime assistance can ease your worries and ensure your loved one is safe and comfortable. Tailor the overnight support to match your loved one’s specific needs — whether that’s help with bathroom trips, medication reminders or simply having someone there for peace of mind.
How much should you expect to pay for this kind of personalized support? Learn the basics on overnight caregiver services — and how much they cost.
Key takeaways
- Overnight caregivers provide highly individualized care for older adults, helping with evening and night tasks, such as medication reminders, personal hygiene and helping them in and out of bed.
- They are typically live-in caregivers or work hourly in shifts that, on average, are about 12 hours.
- Overnight caregivers generally paid an hourly, weekly or monthly rate.
- Overnight rates vary, based on a number of factors, including location, experience, duties and more.
What is overnight care?
Overnight care is as individualized as any other type of care, so there is no one specific way to describe it, explains Quincie Novella, case manager with Salus Homecare. “In most cases, it entails a 12-hour shift,” she says. “Some agencies provide sleep care where the caregiver sleeps for up to eight hours during their shift.”
Like daytime care services, overnight caregiving responsibilities generally depend on a senior’s needs. “We see clients needing assistance with medications or visiting the bathroom during the night,” says Wootton. “Sometimes, clients with dementia will suffer from sundown syndrome, which often manifests itself in wakefulness and wandering at night.”
Types of overnight care: hourly overnight caregivers vs. live-in caregivers
Overnight care typically falls into two categories, which will impact roles as well as their pay:
- Hourly overnight caregivers.
- Live-in caregivers.
With both overnight care and live-in care, activities are personalized in collaboration with family members, the case manager, any medical professionals involved in care and the client as appropriate, adds Novella. However, it bears noting that tasks included in the plan of care are often quite specific and always non-medical in nature, says Novella, as the caregiver is not licensed to provide medical support.
“Caregivers are expected to remain awake during the night shift in case the care recipient might wake up and require assistance.”
— Kevin Tagarao, chief operating officer, 1Heart Caregivers Services
Hourly overnight caregivers
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The most common overnight caregiver responsibilities, according to Kevin Tagarao, chief operating officer of 1Heart Caregivers Services:
- Preparing the senior for bed: going to the bathroom or using a bedside commode.
- Assisting in reminding them to take medications.
- Changing clothes when needed.
- Prompting oral hygiene care.
- Tucking them into bed.
- Assisting with any of these needs throughout the night.
“The caregiver would also be responsible for being alert during the entire duration of the shift, making sure the client does not develop bed sores or fall during the night,” he adds. “Caregivers are expected to remain awake during the night shift in case the care recipient might wake up and require assistance.”
Although a caregiver that’s “on the night shift” needs to be awake through the night, there’s some flexibility as far as sitting in a chair in the same room or in a nearby room where they are awake and available for what the client needs overnight, adds Glenn Lane, CEO of Westchester Family Care. But overall, a caregiver working on a night case needs to be awake, as they are generally paid by the hour, he explains.
Live-in caregivers
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Live-in care is different from overnight care in that the caregiver remains in the patient’s home for 24-hour shifts, three to four days a week. These caregivers typically sleep at night along with the client but still provide assistance.
The Department of Labor defines live-in care as having a single caregiver who spends at least 120 hours (five consecutive days) in the client’s home per week, explains Wootton. “In this situation, the client’s needs might be the same as with a 24-hour client, but care must be taken that, in those five days, that caregiver is given an opportunity to sleep,” she notes.
How much does an overnight caregiver cost?
So what can you expect to pay for overnight senior care? Typically, overnight caregivers are paid either an hourly, weekly or monthly rate. However, the set amount will vary based on a range of factors, including:
- Your location.
- The older adult’s care needs.
- The caregiver’s experience and any certifications.
- Whether you are going through any agency or hiring an independent caregiver.
- Whether you are hiring a live-in or an overnight hourly shift caregiver.
Current posted in-home care cost in top U.S. cities*
Here are some examples of the average starting rates posted by in-home caregivers, based on location, according to recent Care.com data. Rates will vary and may increase, based on the factors mentioned above.
| City, State | Hourly In-Home Care Rate |
|---|---|
| Atlanta, Georgia | $19.80/hr |
| Brooklyn, New York | $23.17/hr |
| Charlotte, North Carolina | $20.34/hr |
| Chicago, Illinois | $21.77/hr |
| Denver, Colorado | $24.73/hr |
| Houston, Texas | $18.80/hr |
| Orlando, Florida | $20.28/hr |
| Philadelphia, Pennsylvania | $21.09/hr |
| Phoenix, Arizona | $23.56/hr |
| Portland, Oregon | $24.61/hr |
| San Antonio, Texas | $18.69/hr |
| San Diego, California | $24.74/hr |
| San Francisco, California | $27.81/hr |
| Seattle, Washington | $29.45/hr |
| Tampa, Florida | $19.15/hr |
| Washington, DC | $23.34/hr |
According to the most recent Cost of Care survey from Genworth and CareScout, the national hourly median cost for a home health aide (defined as someone typically with a high school diploma who can help with a patient’s daily activities including cleaning and bathing, toileting, dressing, housekeeping, scheduling, transferring, shopping for groceries and serving meals), is about $34. However, this drastically changes depending on location, ranging from $22 to $44 per hour.
In each community, there are additional resources available that can help you determine caregiver rates for your area, says Glenn. These include:
- Referral sites that list agencies.
- Your insurance company.
- Local home health and nursing agencies or assisted living facilities.
- Caregiver listings on Care.com and ZipRecruiter. This can also give you an idea of how much live-in caregivers make in your area. “If you offer too little, you will either find no one to fill the position or find poor candidates,” adds Melanie Musson, a senior care provider and a senior life insurance expert at Life Insurance Post. “The better you pay, the better your candidates.”
- Word of mouth.
The cost to the client for live-in care will vary depending on the type of provider they are working with, adds Wootton. “When working through an agency, prices will tend to be higher because of the accrual of overtime costs,” she says. “An independent provider sets their own rates.” (However, it bears noting that in certain states, overtime is required for live-in caregivers in some capacity. More on that in a moment.)
How overtime, sleep time deduction and taxes can impact cost
Although you can take the above averages into consideration, what you’ll ultimately pay for an overnight caregiver will vastly vary depending on the precise type of overnight care you are looking for and any related built-in overtime, sleep time deduction and taxes, explains Lane.
Live-in assistance with overnight care
The Department of Labor Wage and Hour laws require caregivers to be paid for all hours worked, including any applicable overtime, she adds. “Most states allow for 24-hour caregivers to have up to eight hours of unpaid time, known as the sleep time deduction,” she says. “There are rules that govern how many hours can be deducted on any given night, depending on how much assistance a client will need.”
Under the Fair Labor Standards Act (FLSA), the sleep time deduction works like this: An employer may exclude sleep time from an employee’s hours worked hours, meaning they can only bill for up to 16 hours a day, if certain conditions are met:
- If both employee and employer agree to “regularly scheduled” interrupted sleeping periods of up to eight hours.
- The employee provides “adequate” sleeping accommodations.
- The employee is able to get at least 5 hours of uninterrupted sleep during the 8 hour time period that is being deducted.
The pay to the caregiver — if they work for an agency and are not a private caregiver — is always based on hours worked and is subject to overtime laws. “This is true whether the caregiver is performing an eight-hour overnight shift, a 24-hour shift or is live-in,” says Wootton. “Again, only in states where the sleep time deduction is legal can a caregiver not be paid for hours spent in the client’s home.”
Hourly overnight care
This role is paid by the hour but any time over the 40-hour work week will be paid overtime.
Caregivers hired privately to work in someone’s home are categorized as non-exempt workers under the Fair Labor Standards Act, Carolyn Livingston, director of partnerships for Care.com HomePay, previously shared. “This means they must be paid overtime for all hours worked over 40 in a seven-day work week,” she says.
Although live-caregivers are exempt from overtime pay, according to federal law, certain states have special overtime laws for live-in employees. These include: California, Hawaii, Massachusetts, Maryland, Maine, Minnesota, New Jersey, Nevada, New York and Oregon. Specific requirements can be found in the nanny tax requirements by state.
Families also need to be aware of the nanny tax when hiring a senior caregiver. This is a combination of state and federal taxes outlined in IRS Publication 926. It impacts those who pay a household employee $2,800 or more in a calendar year and it’s important to note that these caregivers can not be classified as independent contractors.
A final note to consider as you make a decision
Opting for a live-in caregiver can be “very price-efficient” if your older loved one can’t be left alone, points out Lane. “A client has someone with them who is available 24/7 but is only being paid 16 hours of 24 hours,” he explains, adding that this might result in an expense that is less than hourly care.
Ultimately, figuring out which type of overnight caregiver is right for you, your senior loved one and your budget is a highly personal decision that’s worth researching before making a final call.
