Acknowledging your elderly parent or loved one isn’t as self-sufficient as they used to be is difficult for many people to accept, but recognizing the signs and taking the proper steps is important for their long-term health. As your parent becomes older or their condition deteriorates, you may find yourself having to devote more time attending to them as their demands increase. Even if you have the time, some parents may require constant supervision and care from a trained professional that you may be unable to provide.
If you’re currently caring for an elderly parent or loved and are wondering whether they need 24/7 care, here’s some information to help you know when it’s time.
Signs That an Elderly Parent Needs 24-Hour Care
In cases where your parent has a prominent medical condition, their physician or primary healthcare provider may tell you they require constant supervision and care provided by a professional. However, sometimes the signs won’t come up in a visit — so it’s important for you to watch for them outside of doctor visits.
Here are signs that may indicate a need for 24/7 care:
- Mobility issues, including being able to stand and walk independently
- Increased reliance on assistive devices
- Continence issues, including being able to mentally and physically use the bathroom with control
- Difficulty eating without assistance, but not necessarily food preparation
- Inability to self-groom and maintain personal hygiene
- Frequent loss of balance resulting in falls and bruising
- Feelings of isolation or being overwhelmed by the idea of caring for themselves
- Signs indicating neglect of household maintenance
- Confusion or uncertainty when performing familiar tasks, and forgetfulness
- Medication management issues, such as forgetting to take pills
- Wearing dirty or tattered clothing
- Notices of late or missed payments from the bank or collection agencies
- Loss of interest in hobbies
- Missed appointments
- Poor dieting, including notable weight loss or gain
- Inability to dress on their own, including making appropriate clothing choices and changing in and out of clothes without assistance
Types of 24-Hour Care
If your loved one does require 24-hour care to maintain their health, there are several options to choose from including options that involve them staying in their home, with you, or moving to a type of assisted living community.
1. Live-In Care
Live-in care involves one or more caregivers who are booked for a 24-hour shift to provide support throughout the day. Each state has unique laws and requirements for this type of care (for example, California does not allow live-in care), but in general it requires:
- The caregiver must be given a break during a 24-hour period, usually 4 hours during the day and 8 hours at night.
- The homeowner must provide a private sleeping quarters for the caregiver
- Caregivers who are interrupted during their sleeping period must be paid for the time
- Caregivers can only be booked for set number of days in each period, usually 4-5 max
- Caregivers are not considered residents of the home
As a result of the break requirements, a single live-in caregiver is usually not enough to fully support an individual because there will be a 4-hour period during the day and 8-hour period at night where care is not provided. Family members may choose to care for the loved one by themselves during these periods, or they can hire an additional caregiver to ensure 24/7 care. One advantage of live-in care is that with only 1-2 caregivers, the loved one can form a closer bond than they would with a larger team such as what they might get at a nursing home or assisted living community.
2. 24-Hour Home Care
With 24-hour home care, two or more caregivers work in shifts to provide care throughout the day and night. Typically, 24-hour home care involves two caregivers working in 12-hour shifts or 3 caregivers working in 8 hour shifts. It’s similar to live-in care, except there are no sleeping breaks so a caregiver is always supervising the loved one during the day and night.
Although live-in care and 24-hour home care are similar, the latter offers more flexibility with scheduling and there are no requirements for a private sleeping quarters. In states like California where live-in care is not allowed, 24-hour care can serve as a substitute service.
3. Assisted Living Community
In an assisted living community, the elderly parent or loved one moves out of their home and into a facility or residential community where they can receive care from professionals. Assisted living is intended for individuals who can live independently, but require some assistance with tasks such as meal preparation, housekeeping, laundry, and access to medical services as needed. Typically, a schedule is created to cater to each resident’s needs. Support is available 24/7, but assisted living does not include constant supervision so it is not ideal for individuals who require critical care.
4. Nursing Home
Nursing homes involve a loved one moving into a facility or community where they can receive fully assisted 24-hour support including more extensive services than what is available at an assisted living community. Unlike assisted living communities, nursing homes tend to be more like a hospital than a residential community. In some cases, people will live in a nursing home while rehabilitating from a temporary condition or while recovering from physical trauma, and then move back home or into an assisted living community when they no longer need the same level of care. Criteria for nursing homes is much stricter than admission requirements for an assisted living community, and it may require a physician’s sign-off to get in.
How Much Does 24-Hour Care Cost?
The cost of 24-hour care varies based on the type of care you select, but the average cost ranges from $4,400 per month for live-in care up to $9,500 a nursing home. However, these expenses are expected to increase as a result of inflation at a rate of about 3% per year. Additionally, the nursing home staff shortages may require family members to choose care at a more expensive facility than anticipated based on limited availability.
How to Pay for 24-Hour Care
With a cost that could range between $52,800-$114,000 annually, you likely have questions about how care expenses will be paid for.
If you can’t pay out of pocket, you should first check and see how much Medicaid will cover. The federal government doesn’t allow states to pays costs related to room and board, but you may be able to receive assistance with other personal care services for your loved one. You should also check if your loved one has long-term care insurance, or consider purchasing a policy if they are in a condition of health that does not require 24-hour care yet. If the loved one is a veteran or spouse of a veteran, they may also be eligible for VA benefits that can help cover care costs.
After doing all of the above, if you still end up short — you’ll need to look at personal assets. You can start by looking at the loved one’s personal savings and investments, but may need to consider selling assets such as their home. Before doing this, you should check and see if they have a life insurance policy that can be sold. Many people don’t realize their life insurance policy is one of their most valuable assets, sometimes equatable to the value of their home. You may be able to sell the policy and receive up to 60% of the death benefit value to help fund 24-hour care, which would allow you to hold onto a cherished home or other assets.