FYI: New to the world of caregiving? Check out my guide, What Is a Caregiver, to learn about all things related to care, both skilled and unskilled.
To answer your most basic question: An in-home caregiver costs a national average of $24 per hour, which works out to $4,032 per week and $17,280 per month for 24/7 care. However, costs vary significantly based on the type of overnight care you select and the state where you live.
Because of this, you need a lot more information than just averages to determine what to expect financially.
FYI: New to the world of caregiving? Check out my guide, What Is a Caregiver, to learn about all things related to care, both skilled and unskilled.
As I mentioned previously, many variables affect the cost of 24/7 in-home care. Rates vary most in relation to the level of care, number of employees required, type of overnight care, your geographic location, and your state’s caregiver licensing requirements.
Some seniors may need caregivers in their home for around-the-clock care, helping with occasional overnight needs. Others, especially those with memory disorders or severe mobility and incontinence issues, may need the aid of a carer several times each night.
The amount of care required each night can help you decide which type of overnight care is the best choice for your loved one: non-sleeping visits, sleeping visits, or a live-in caregiver. Each type is priced differently and impacts your overall in-home care cost. Living or sleeping accommodations available to the caregiver are also a negotiating factor.
Non-sleeping visits are the most expensive type of 24/7 in-home care and usually involve one to three carers who work eight- or 12-hour shifts. During these shifts, caregivers remain awake and attentive to the patient the entire time to help them with hydration, mobility, incontinence, disorientation, or other needs.
Using the $24 per hour average, on-sleeping caregiving costs about $17,280 per month or $210,240 annually. Having two caregivers per shift costs approximately $34,560 monthly.
Sleeping visits are meant for older adults who need care and monitoring throughout the day but generally do well sleeping through the night. They may still bring a caregiver in for occasional nighttime help or simply for the peace of mind of knowing someone is available should they need assistance.
In this scenario, the home health aide can sleep when they’re not performing their caregiver responsibilities. Patients use bells and other kinds of alerts to get a caregiver’s attention should they need help. You typically pay a fixed fee of anywhere between $120 to $200 for the 10- to 12-hour overnight shift. If you agree to $140 per night, 30 overnights will cost you $4,200. Add 12 hours of daytime care at $24 per hour, and you can expect to pay a total of $12,840 per month and $154,080 per year.
In exchange for room and board, live-in caregivers provide seniors help with everyday needs and activities and overnight emergency support. While this is often a win-win setup for both seniors and caregivers, conflicts can arise. To prevent problems, you must develop and sign a legally binding care contract that dictates the caregiver’s duties and rate before the start of their employment.
Naturally, more hours of care are required as an older adult’s needs increase or become more complex. As this occurs, expenses will also rise. Families with loved ones with degenerative diseases such as Parkinson’s or dementia should budget for the extra care needed over time.
Did You Know: Did you know that it’s possible to keep your loved one with dementia living at home? To learn more, read my guide: Caring for a Parent at Home with Dementia.
Below, you’ll find four price estimates for in-home care, from just a few visits per week to around-the-clock. To provide estimates, we used the national median per-hour fee for in-home care of $24. This is based on data from Genworth’s cost of care survey.
FYI: For people with degenerative health disorders, the cost of 24/7 in-home care can be prohibitive. In these cases, you might want to consider memory care.
Most Affordable
Least Affordable
You have two routes in which to hire in-home care. Either you can go through a home health or caregiver agency, or you can hire privately. Naturally, each method has its pros and cons.
Private In-Home 24/7 Care | Agency In-Home 24/7 Care |
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Other Options: Depending on your loved one’s health, palliative care might be an option worth considering. To learn more, read my guide: What Is Palliative Care at Home?
An abundance of considerations is involved in choosing in-home care or a residential care home. This includes: the patient’s preference, carer-to-patient ratio, quality of life, distance to family, access to health-care experts, and in-home care affordability. The chart below details the monthly and annual expenses for non-sleeping in-home care, nursing home costs, and assisted living costs.
Type of Care | Monthly Cost | Annual Cost |
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24/7 In-Home Care (non-sleeping) | $17,280 | $210,240 |
Nursing Home | $8,821 | $105,850 |
Assisted Living | $4,300 | $51,600 |
*estimates based on national averages
While price is often a weighty issue when deciding whether to choose home care or a facility, it’s important to remember that not all costs are financial. So before taking the leap, ask yourself if moving your loved one to a residential facility that may be two hours away is truly worth their happiness. If not, there may be options that can help you cut down the cost of in-home care.
Budgeting for the in-home care of a parent, spouse, or other loved one can be a significant source of stress. Fortunately, not all your expenses have to come directly out of your pocket. Before you hand over your cash to pay for care, check out the variety of nonprofit and government funding options available:
Original Medicare covers skilled nursing care, but only under strict guidelines. Under no circumstances does it cover custodial home care, which involves help with activities of daily living as well as assistance with health-related care that individuals can typically manage on their own.
To qualify for in-home care coverage with Medicare, your loved one’s care must meet the following requirements:
Even when home health is covered, time spent by skilled staff on non-medical service is still not covered. If, however, your loved one is enrolled in a Medicare Advantage plan, they may be eligible for some non-medical care coverage, depending on the plan. Always check with your Medicare Advantage provider to see what your specific plan covers.
In most states, Medicaid pays for the non-medical home care of low-income seniors, partly as a result of a recent push to delay moving seniors to residential institutions for as long as possible. But, of course, in areas where Medicaid does provide aid for home health expenses, it typically only covers part of the cost. To learn about your coverages, contact your state’s Medicaid offices.
Several Veteran Affairs programs help pay for the in-home care of qualifying veterans. These include Aid and Attendance pensions, Veteran Directed Care, and Comprehensive Assistance for Family Caregivers. Each program has its unique requirements and benefits.
You or your loved one may have purchased a long-term care insurance policy years ago. If so, the policy likely covers caregiving and in-home care. However, you may need to satisfy specific requirements to ensure your plan will pay out.
Did You Know: Some permanent life insurance policies with cash value can be applied as long-term care insurance. Should the covered individual die, the death benefit reduces by the amount of money used for care.
Reverse mortgages, unlike regular mortgages, don’t require homeowners to make payments. Instead, they allow seniors over 62 to receive a monthly fee in exchange for a portion of their home equity. Reverse mortgages can be a great source of funding for in-home care. However, you should keep the following in mind:
Seniors who want a reverse mortgage must be at least 62 years old, own the property in its entirety, have no federal debt, and be the primary resident.
Reverse Mortgage Warning: Reverse mortgages are tricky. If you fail to pay for certain costs dictated in your reverse mortgage loans, such as property taxes, homeowner’s insurance, or maintenance, the lender has the right to evict you from your home. Always speak with an independent financial counselor before making any legally binding decisions.
Once you’ve decided on in-home care rather than options like assisted living or nursing homes, it’s time to begin the hiring process.
According to Genworth’s Cost of Care Survey, the median cost for 24/7 in-home care each month (672 hours per month) without insurance or discounts is between $17,000 and $17,500.
In-home care is more expensive for 24/7 in-home care with sleeping or non-sleeping visits than a nursing home. Sleeping visits cost approximately $12,200 per month for in-home care with sleeping visits, and in-home care with non-sleeping visits has a median cost of about $17,000 per month. A private room at a nursing home costs $8,800 per month on average.
Hired individuals who simply provide older adults with companionship or help them run errands can be paid less than those providing more medical-based care. An hourly rate of around $15 is reasonable in most areas, but you should always ask around about what price points are most acceptable in your local area.
Independent caregivers are considered household employees. Caregivers who work for an agency are generally employees of that agency.
All 50 states have some type of program that allows a family member to receive payment for providing caregiving services to another family member. One example is Medicaid’s Cash and Counseling program. In addition, in many states, Community Care programs offer additional options for funding the payment of a family caregiver.