Hiring Live-In Caregivers for Alzheimer’s / Dementia & How They Differ from 24-Hour Care

Last Updated: September 24, 2018

In most cases, elderly persons, including those with Alzheimer’s disease and related dementias, prefer to age in their homes. People with dementia in the early stages might require only minimal assistance, such as reminders of a word or help finding their car keys, but at this stage of the disease, live-in care is not required. However, live-in caregivers can make all the difference for persons in mid to late stage dementia. Live-in caregivers provide an option to allow persons with dementia to continue to live at home, rather than require placement in an assisted living facility, a memory care unit, or a nursing home facility. (To learn the differences between assisted living and memory care, click here).


What Do Live-In Caregivers Do?

Live-in caregivers provide an alternative to residential living. In mid-stage dementia, persons generally require some assistance with activities of daily living (ADLs), such as bathing, personal hygiene, and dressing, and instrumental activities of daily living (IADLs), such as light housecleaning, laundry, and shopping for groceries. In late-stage/end-stage dementia, persons need extensive help, as mobility and the ability to communicate are eventually lost altogether. Other services live-in caregivers might provide include companionship, meal preparation and clean up, transportation to/from doctor’s appointments and social outings, medication management, payment of bills, and monitoring one’s health, such as if symptoms of dementia are becoming worse.

There are also live-in caregivers that specialize in Alzheimer’s and dementia care, sometimes referred to as memory caregivers. These caregivers have very specific training in order to understand how to approach and communicate with persons with dementia, how to handle specific behaviors commonly seen in persons with the disease, such as sundowning, wandering, and mood swings, and techniques to provide hands-on care while still allowing persons to maintain some autonomy (as long as they are able).


Benefits of Live-In Care

For persons with dementia, and their families, there are many benefits to having a live-in caregiver. First of all, unfamiliar settings and routines can create confusion, anxiety, fear, and stress for persons with dementia, possibly resulting in disruptive behavior. With live-in caregivers, persons with dementia can continue to live in their home, or the home of a family member, and remain in a familiar home and continue with the same daily routine. Having a live-in caregiver can give family members peace of mind knowing that their loved one with dementia is being supervised and assisted with his/her needs. Live-in caregivers can also take the pressure off of family caregivers, allowing them to work full time and take time to properly care for themselves. In addition, the person with dementia receives one-on-one care, which would not be the case if he/she were to reside in a residential facility.

 For those who do not yet require the extensive care of a live-in caregiver, there are also in-home caregivers that offer flexible days and hours. Learn more here. If residential care might be more suitable for your loved one’s needs and situation, learn more about assisted living and memory care units here.


How Live-In Caregivers Differ From 24-Hour Care?

It can be easy to confuse live-in caregivers with 24-hour care. While the same services are generally provided with both types of care, there are differences between them. With live-in caregivers, the shift is 24-hours, but the caregiver is able to sleep during the night (the caregiver must be provided with a place to sleep). He/she also gets lunch breaks and personal breaks. With 24-hour care, shifts are generally 8 to 12 hours long and the caregiver does not sleep during his/her shift. Said another way, supervision and assistance is available 24-hours/day. Generally, with 24-hour care, there is a minimum of two regular caregivers that provide care for the person with dementia. With live-in caregivers, there is generally just one caregiver. However, a second caregiver may need to be hired, or friends or family may have to step in and help provide care, if the person with dementia cannot be left unattended.


Cost of Live-In Care

The cost for live-in caregivers is generally a flat rate per day, rather than an hourly rate. On average, live-in caregivers cost approximately $3,000/month. However, this rate will vary based on the state in which one resides and even the geographic location within the state. In addition, live-in caregivers that specialize in dementia care maybe slightly more costly due to their experience and knowledge. Please note, for 24-hour care (mentioned above), caregivers are generally paid an hourly rate, making it a more expensive care option. In addition, the cost of live-in caregivers is much more cost effective than is assisted living, memory care units, and nursing home facilities.


Finding a Live-In Caregiver

Finding live-in caregivers can be challenging.  This is both because, many home care agencies do not staff for live-in caregivers and because of the shared residence, a caregiver and care recipient must have a good personality match.   Our organization has partnered to provide a service that helps to match caregivers with care recipients.  Start your search here.