in-home caregiver assisting an elderly patient

Many elderly individuals will require some form of caregiving as they age. For those who need around-the-clock care, receiving this care at home is often a good option. When organizing full-time home care, it can help to know the differences between 24-hour in-home care and live-in care.

If you have already decided on home care over facility care for your loved one, you will need to choose between 24-hour in-home care and live-in care. Both provide around-the-clock care for patients, often with similar services and resources. They vary, however, in the duration of a caregiver’s shift and the number of caregivers someone might have over the course of the day. They can also vary in the type of payment plan and cost. 

The Basics of 24-Hour In-Home Care

The term 24-hour in-home care might sound self-explanatory, but it is helpful to know the details of the services provided. 

Caregiver Shifts

With 24-hour in-home care, a patient will receive full-time care from caregivers who work in 8 to 12 hour shifts. This means that in a 24-hour period, a patient will typically have 2 or 3 different caregivers working in their home.


Payment for 24-hour in-home care is usually at an hourly rate. 

The Basics of Live-In Care

Live-in care is similar to 24-hour in-home care in many ways, but it varies slightly. The main differentiation with live-in is the way that caregiver shifts work. 

Caregiver shifts 

With live-in care, a patient will receive care from one caregiver in a 24-hour time period. Out of the 24 hours, the caregiver will sleep for 8 hours, and has a 4-hour break during the day. Families can decide to hire supplemental caregivers for these break periods, provide their own care, or leave their loved one without immediate care at these times. 

Live-in caregivers can be scheduled for multiple days at a time, but usually only work for 4 to 5 consecutive days. This is intended to give a caregiver adequate rest from the demands of a live-in situation. On a primary caregiver’s off days, a patient might have an alternate caregiver that works fewer days of the week. 

Providing Room and Board

It is important to note that clients must provide room and board for live-in caregivers. If you want to hire a live-in caregiver for your loved one, you will need to confirm that they have access to an extra bedroom or at least a bed. 


Payment for live-in care is typically a daily flat rate. This does not include additional care during the live-in caregiver’s 4 and 8 hour breaks. Coverage from a supplemental caregiver during these times will likely be billed hourly.

Hiring Caregivers

The most common way to hire both 24-hour in-home and live-in caregiving services is through a home care agency. There are many companies that are dedicated to providing professional in-home caregivers for people in need of individualized care. A good care agency will ensure that all of their caregivers go through a rigorous training process, so you can feel secure that your loved one will receive professional, attentive care. 

Because the main difference between the two home-care approaches is the shifts, no the type of care, it is safe to expect a similar style and standard of caregiving. 

24-Hour In-Home Care–Pros
  • Caregivers might be more attentive due to shorter shifts.
  • More flexibility in scheduling.
  • Does not require an extra bedroom or bed to accommodate a caregiver.
  • A greater number of caregivers working can make it harder for a patient to build a deep, trustworthy connection with their caregivers.
  • More caregivers entering the home on a daily/weekly basis might be less optimal during the COVID-19 crisis.
  • The cost is typically higher due to hourly rates.
Live-In Care–Pros 
  • A smaller, more consistent pool of caregivers might allow patients to get to know their caregivers better.
  • Having fewer regular caregivers minimizes contact with outsiders during the COVID-19 crisis. 
  • Typically the more affordable option.
  • Longer shifts might lead to tired, less attentive caregivers
  • Clients must provide sleeping arrangements for the caregiver, which not every home has space for.
  • For care during a primary caregiver’s 4 hour breaks, it is necessary to arrange supplemental coverage.

If you are exploring full-time care services for a loved one, weighing your options is important. Hopefully, this breakdown can help you make an informed decision about the best-suited approach for your loved one’s needs.