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Hourly and Live-in Care Services and Rates

Senior Home Care Agencies offer hourly care and live-in care. There are a few agencies who only offer hourly care as live-in care requires a different staff and more management.

Hourly Care

Usually a minimum of 3 to 4 hours of care per visit are required to begin hourly care services. Many agencies will begin services with one visit per week, knowing that seniors are sometimes resistant to start care. Typically a senior who is resistant to care will be open to more hours of service once they experience the benefits of a Caregiver’s visits. Senior Home Care Agencies will ask clients to commit to a regularly weekly schedule, in order to staff a qualified, consistent Caregiver. It is acceptable to change the hours after your initial start-up, as often the real needs are exposed after the Caregiver has started services. The agency will also ask if you would like a substitute Caregiver to provide services if your Caregiver is unable to fulfill an assigned shift. Some clients prefer their regular Caregiver to change hours when they need off, rather than to have a substitute Caregiver. Some Agencies will send Care Managers or Field Supervisors to introduce the substitute Caregiver. Most Agencies will have a Care Manager or Field Supervisor introduce and train the Caregiver on the first visit.

Hourly Care Overview

  • Minimum Hours per Visit: Usually 3 to 4 hours
  • Cost: $15 - $25 per hour (varies in geographic areas, most metropolitan cities charge $18+ per hour)
  • Schedule: Regular schedule required to staff consistent Caregiver, acceptable to change schedule
  • Payment: Two-week deposit may be required; Agencies bill weekly or every other week
  • Benefit of Hourly Care: Agency responsible to make sure a Caregiver is always there at scheduled time

Connect with a Senior Home Care Agency in your area to learn about their services and pricing.

Live-in Care

Seniors who need someone to be with them around-the-clock, but are able to allow the Caregiver to adequately sleep at night, will require a live-in Caregiver. Live-in Caregivers work a few days at a time and are paid a daily salary, not an hourly rate. The Caregiver does not actually “live” with the senior, but will go to their own home between shifts. Typically a team of two Caregivers will rotate days to provide the client with a consistent team. The client is required to provide food for the Caregiver and a place for them to sleep. Usually a food delivery service is used or a family member of Care Manager will provide grocery shopping services. If Hospice is involved in the care, they will work with the live-in Caregiver to provide training. It is important for the senior client to be comfortable with someone sharing their home. If the client’s medical condition changes and they need the Caregiver to regularly be up with them at night, then it will be necessary to switch to around-the-clock hourly care.

Live-in Care Overview

  • Cost: $160 - $250 per day
  • Schedule: Minimum of two Caregivers will rotate days
  • Payment: Two-week deposit may be required; Agencies bill weekly or every other week
  • Benefits of Live-in Care: For nearly the same cost as a nursing home, a client receives one-on-one care from a devoted Caregiver and is able to remain in their own home

Medicare Coverage

Medicare does not pay for long-term care in the home. Medicare will pay for a short-term stay in a nursing home (up to 100 days, with medical doctor approval). Medicare will pay for “Skilled Care” home visits which includes a Registered Nurse (R.N.), Speech Therapist (S.T.), Physical Therapist (P.T.), Occupational Therapist (O.T.). These skilled professionals are preapproved for visits by a medical doctor and will make hourly visits to the home to provide their care services. Medicare Home Care Agencies provide these services and most medical doctors and hospitals have relationships with one or two Medicare Home Care Agencies. Some hospitals own their own Medicare agency. If these services are required, typically the doctor approves the service upon discharge from the hospital or nursing home.