24 hour care is around-the-clock, daytime and overnight. While each state has its own regulations, typical options for 24 hour care include:

• One caregiver who works a full day, with breaks, followed by 8 hours rest in the client’s home.
• Two caregivers work in 12 hour shifts. The evening caregiver stays awake through the night.

Look for these signs that it may be time to change from hourly to 24 hour care for your older spouse, parent or friend:

• Frequent falls or compromised balance. This can be the result of dementia, a neurological problem, or following an accident.
• Confusing daytime and nighttime, frequently awake in the middle of the night, or agitated in the dark
• Recent hospitalization or stay in a rehabilitation facility after a hip fracture, stroke or heart attack
• Fainting or confusion from dehydration
• Difficulty eating or drinking without assistance
• Wandering from home, by foot or vehicle, and getting lost or confused
• Confused or frightened by short absences of family, friends or caregivers
• New or increased bathroom accidents
• Leaving the stove on unattended
• You are afraid to leave the person at night or are not getting regular sleep because you are tending to their nighttime needs

Getting Started With 24 Hour Care

Most people look to a licensed, bonded agency to fill the need for care for an aging parent or spouse. Hiring through an agency brings peace of mind and security.

24 hours is a long time. Coordinating care should be a partnership between you and the agency you choose. The more involved you are, the better things will go.

Questions to Ask About 24 Hour Home Care

Ask your home care agency these questions to get started with 24 hour home care for your elderly parent or your spouse:

1. How many caregivers should I expect during a shift? How are shifts divided?
2. Can I interview each of these caregivers? Can I have each caregiver meet with my elderly parent, or my spouse, to see if there is a good fit?
3. Will these same caregivers rotate throughout the week?
4. What if someone can’t make their shift? How do you handle “fill-in” caregivers?
5. Can family caregivers share duties with agency caregivers? How will we coordinate this?
6. Who do I speak to if there are problems?
7. How many of the caregivers are certified nursing assistants?
8. What specific tasks is a caregiver allowed to perform?
9. Will a supervisor visit my home? How often?

Coordinating 24 Hour Home Care Without an Agency

You may be tempted to hire someone you know or hire a private caregiver to care for your aging parent or spouse. Do this with your eyes open and attention to detail.

1. You will be responsible for payroll, taxes (if the person is classified as an employee), workman’s comp, and liability insurance.
2. You will be responsible for managing and coordinating schedules for all your parent or spouse’s care.
3. You will need to find, often on short notice, replacements for caregivers who can’t make their shift or take another job.
4. Check with your homeowner’s or renter’s insurance agent. Learn if your policy covers liabilities for domestic workers.
5. Check your state’s minimum wage and overtime pay requirements.
6. Some states do not allow “live-in” caregivers, or exchanging domestic parts of wages for “room and board.”

Having a consistent team of caregivers is more important than people realize. Consistency and continuity of care build trust. Different caregivers coming in at different times of day can be confusing. It can also lead to poor communication. Consistent caregivers lead to consistent care.

However, t is not uncommon for a favorite caregiver to leave. Talk to your parents or spouse about their feelings. Reassure them that you and the agency will find a suitable replacement. Check in frequently to see how things are going and request adjustments as needed.

Paying for 24 Hour Care

24 hour care is frequently less expensive than a private room in a skilled nursing facility or memory care.

Work with Professionals

A financial advisor or elder care attorney can look at the big picture and make recommendations for structuring finances to pay for care.

Be flexible and patient through this process of setting up 24 hour care. Work closely with your home care agency to provide safe, consistent and quality care to your aging parent or spouse.

Sometimes lost in all the planning is the person receiving the care! Unfamiliar people coming into the home and providing intimate care can be a shock at first.

Make an effort to honor and respect your aging parent or spouse’s wishes and needs. Include them as much as possible in selecting caregivers. Respond to their ongoing concerns once staff are in place.