Understanding Different Types of Home Care – 24-7 Care vs. Live-in Care

24/7 Home Care

When families opt for 24-hour home care, they are providing care around the clock for their beloved family member. Twenty-four seven home care is an excellent option for caring for someone with dementia who requires constant care. While nighttime care may be for emergencies only, it assures that care is available around the clock. Caretakers would work in 12-hour shifts. This may include 2 caretakers per shift. It is up to the family to create the most logical shift schedules. One of the issues to keep in mind with 24/7 health care is that the cost is likely to be costlier than live-in home care.

Live-In Home Care

Families providing live-in home care are bringing in a live-in caretaker who will live and sleep at the home of the ill member. Several caregivers may be called on for health care, with each remaining in-home for several days or a specified amount of time. Keeping the same live-in caretaker allows the family and person requiring care to build trust and a working relationship. The family can make arrangements to cover break and sleep times, either by a family member or by having an additional caretaker on call. This will ensure that the ill family member is never left alone and without care.

Staffing Arrangements for Caregivers

Shift Pattern for 24-Hour Health Care

Families (or health care professionals) create a shift pattern for 24-hour health care to ensure the welfare of both the patient and the caretaker. A reasonable shift choice is critical in avoiding stress on a difficult job.

1. The most conventional shift choices are 12-hour shifts. This gives the healthcare provider the option of working between two and five days with longer hours and fewer days worked.
2. Three separate eight-hour shifts for a 24-hour period are another option. The overnight shift would be the least stressful and the longest in most instances.
3. Split shifts are another way to go, but it is not a popular choice. The caretaker will work a given number of hours, take a break while another caretaker stays on duty for a few hours, then the first caretaker returns. The problem here is that split shifts can be disruptive for everyone concerned. If they are necessary due to the lack of enough caretakers, these workers should be provided with enough rest time.

Live-in Caregiver Schedules and Breaks

A live-in caregiver should be prepared to be available 24 hours each workday. This breaks down to three to five workdays in most cases, which include eight-hours for sleeping and a break during the day that usually includes four hours. During his or her “off-time,” a live-in caregiver is on-site and not active in providing patient care.

This sounds strenuous, but a live-in caregiver usually only works for several days before being replaced by another live-in caregiver. If the patient needs continuous care, the family must fill in during these off-times or hire a second caregiver specifically for break times.

Number of Caregivers needed for 24/7 and In-Home Health Care

Whether a patient requires 24/7 or in-home health care, the number of needed caregivers can vary, depending on the cost involved and whether family members are on-board to offer respite care (this is care offered to give respite to the primary health care provider).

One common method is to schedule a daytime and a nighttime care provider in 12-hour shifts. Frequently, for 24/7 or in-home care, three shifts with one caretaker each shift can also be arranged.

If family is present in the home, full-time care may not be needed. Instead, professional a caretaker may work only four hours a day for as many days a week as needed. This ensures proper care for the patient and sufficient assistance for the family.

In a live-in home care arrangement, one caretaker will provide for the needs of the patient for a 24-hour period on weekdays and another 24-hour caretaker for weekends. It’s a demanding schedule that includes four-hour breaks and an eight-hour sleep schedule. If needed, a respite care provider may be called in during such times.

How to Become a Registered and Certified Caregiver

As the population ages and most families become busier, the need for certified caregivers is growing. Statistics show an anticipated rise of 33 percent by the end of the decade. It is demanding and rewarding work as caregivers see to the health and well-being of needy patients. Medical training is a major requirement for certification. Aspiring caregivers need hours of training in most states, although the exact number of hours varies from state to state.

Certification is important, even if your state does not require it, since it will help you get jobs. It serves as proof that you are a serious candidate. It also indicates your desire to learn and improve for any prospective employer.

Classes leading to certification are available at some Red Cross offices or community colleges. To prepare for the most home health care job opportunities, students can obtain special needs certifications for dementia, Parkinson’s disease, and HHA training – which includes basic home health care with greater emphasis on providing medical care.

Staff Continuity Considerations

According to studies performed at the National Library of Medicine, evidence indicates that when staffing of health care services remains uninterrupted, resources are utilized more effectively, cost is reduced, and the patient is more able to rely on the available caretaker, increasing his or her daily functionality.

Living Space Requirements

Home Modifications Needed for 24-7 Care

While modifications and accommodations for an elderly disabled patient are expected, details such as ramps, electrical outlets close to needed medical equipment, doorways that allow for a wheelchair, lack of clutter, and proper lighting will all help the caregiver do his or her job. If possible, keep the areas used most by the caretaker and patient on the same level.

Accommodations required for live-in Caregivers – Privacy considerations for Live-In Caregiver and 24/7 Caregiver

Certain home modifications may be needed for a live-in caregiver. A live-in caretaker will need a private bathroom, shared kitchen and bathroom, and normal meal arrangements. The live-in caretaker is entitled to normal privacy considerations.

While 24-hour care also involves around-the-clock care, such care is divided into two or three shifts. This results in a patient who will have several caregivers during the day. While a sleeping/resting area is appreciated, the family or disabled person is not obligated to provide the same.

Space Optimization Recommendations and Safety Requirements 

When you are arranging for in-home care for a loved one and his or her caretaker, enhanced space optimization is highly recommended.  Easy-to-implement suggestions for both live-in caretakers and 24-seven caretakers are:

1. The more open the space, the easier it will be to maneuver with walkers and wheelchairs.
2. Creative placement of furniture can help a disabled senior hold on and maneuver him or herself across the room.
3. Consider that lightweight furniture is easier for a caretaker and elderly person to move.
4. Keep the most frequently used items within easy reach. No one wants to step on tippy toes to reach a cup.
5. Electrical cords can be a fall risk, so keep them out of the way and secured.
6. Scatter rugs are the optimal fall and crash guarantee. Ensure that your home has only non-slip rugs.

Quality of Care and Service Delivery

Level of Personal Attention Provided by Live-In Caretaker and 24/7 Caretaker 

A live-in caretaker’s daily responsibilities involve tending to the needs of his or her patient. This will include grooming, dressing, the administration of medication, meal planning and preparation, light housework to keep the environment clean and safe, and support with mobility. A live-in caretaker also acts as a companion, providing needed emotional support. An authentic commitment to the patient is required for the job.

A 24/7 caregiver acts as a companion and will help with personal and emotional care and monitor the patient’s progress. Said caregiver should track the patient’s medication but cannot administer them.

Constancy of Care Delivery

When disabled seniors are able to enjoy a high level of constancy from their in-home personal caregivers, it helps achieve an important bond that empowers the patient. The caretaker can observe the patient, and any changes in behavior, over a substantial period of time.

Both the caregiver and patient are apt to develop a comfortable daily routine that will affect the patient’s days on a positive level and will reduce the stress and anxiety that comes with the unknown.

24-7 caretakers support elderly patients around the clock in their own homes to allow them to live more independently. Caregiving includes overseeing medications and daily activities. Care is tailored to the individual patient’s needs.

Emergency Response Capabilities

Having crucial emergency response capabilities is critical to any live-in or 24-7 caregiver. The emergency may be weather-related, such as a tornado or power failure. Moment-to-moment information is crucial, and the caregiver needs to have a plan in place. Power outages also mandate a ready supply of non-perishable food (don’t forget the manual can opener), blankets, flashlights, and batteries.

Both live-in and 24-7 caregivers should have CPR and first aid training. They should also know what signs of medical emergency to look for – this information can and should be provided by the patient’s medical team.

Medication Management Approaches

Proper medication management by an in-home caregiver and a 24-7 caregiver includes the following acts of vigilance. Keep in mind that the in-home caregiver is allowed to dispense medication while the 24-7 is not:

1. The caregiver should keep medications (this includes vitamins) organized to avoid any mix-ups.
2. Discuss medications and their uses with the patient’s doctor and pharmacist.
3. Keep an up-to-date list of all medications to bring to any medical appointment.
4. Caregivers can ensure that the patient’s medicines do not become depleted by monitoring each vial and checking on the amount of refills available.
5. A weekly pill organizer can track the required medications throughout the week.
6. Make the administration of medication (for live-in caregivers only) a scheduled part of the day, such as breakfast, dinner, or before bedtime.

Activity and Social Engagement Opportunities

Patients and caregivers should take advantage of activity and social engagement opportunities. Doing things together will only strengthen their bond. Activities such as exercise classes, gardening, games, and cooking classes, are ideal for learning, growing, and bonding for both parties. A simple act such as seeing a movie can serve as a springboard for interesting conversations.

For elderly patients who remain physically capable, yoga and walking provide excellent exercise.

Making the Right Choice

Making an Assessment of Care Needs

 Assessing the overall physical and cognitive health needs of an elderly family member may be something that cannot be avoided in some families. Such an assessment, which can be made by a geriatric specialist, should be as thorough as possible and should include:

1. Basic mobility
2. Cognitive skills
3. Difficulty in managing daily functions such as bathing, grooming, and running errands.
4. Mood – is the patient depressed and anxious?
5. Is the home environment safe – stove turned off and doors locked?

Family Involvement Considerations

Family involvement in the care of an elderly relative involves communication with both the patient and his or her caregiver to build a three-way trust team. Communication includes delegating responsibilities for care. While both a live-in and a 24-7 caregiver are responsible for the patient’s daily well-being, a beloved family member may wish to remain involved by taking the patient shopping or helping with housekeeping.

The caretaker may need to deal with family dynamics. Certain grown-up children may still feel resentful over imagined or real psychological issues. The caretaker can and should negotiate this road very carefully.

Lifestyle Preferences Evaluation

Before hiring a 24/7 or in-home caregiver, families should discuss the patient’s lifestyle preferences to find a suitable match. The patient may be ill and disabled, but still (or because of), his or her lifestyle should be a consideration.

When evaluating the patient’s preferences, the family and patient can discuss the following:

1. Preferred foods and restrictions.
2. Bedtime routine.
3. Personal hygiene.
4. Level and preferences for physical activities.
5. Level of contact with friends and family.
7. Daily activities, such as reading, television watching, music, etc.
8. Home atmosphere – is the patient inherently neat or messy?
9. Does the patient enjoy the outdoors?

Trial period recommendations

Choosing a healthcare provider for a beloved family member is a major decision, and a trial period is recommended prior to making a final hire.

A basic trial period can be 30 days, although Medicare is willing to certify up to 60 days. This should allow the family and patient to determine the caregiver’s strengths, weaknesses, and ability to adapt to the family’s lifestyle.

This trial period should involve open communication between all parties, including the needs and skills of the caregiver. The patient’s long-term health care plan needs to be discussed, as are the specific duties that will be expected of the caregiver.

Transition Planning Tips

Transitioning to in-home or 24/7 caregiving for a family member can be  daunting and exciting at the same time. This new journey is a tremendous move for the sick family member, whose care will now be prioritized.

The journey begins with an honest family conversion. In-home or 24/7 caregiving is the preferred way to offer new health care opportunities to a family member unable to continue to care for him or herself as it keeps him or her at home, in familiar surroundings.

Deal with any expectations or concerns honestly. The patient may be concerned about not being able to go to the park anymore once a caregiver is on board. Assure him or her that any decision will be based on the patient’s preferences, hobbies, and lifestyle. Yes, the park is still there, green, and awaiting his or her visit. This is the time to assuage any of the patient’s concerns.

A caregiver should integrate into the family smoothly, take part in meals, provide companionship, and become an integral part of the patient’s life. The new caregiver will become part of the patient’s healthcare team and will meet with doctors and therapists.

Everyone should remember that the caregiver does more than taking care of the patient. The caretaker will elevate the patient’s lifestyle in every way.