A live-in caregiver arrangement can often be a viable cost-effective way to deliver round the clock care where a patient cannot be left alone for any variety of reasons. Round the clock care on a long term basis is normally prohibitively expensive for most family budgets but a live-in arrangement can be a viable alternative to assisted living, memory care, or even a nursing home. At BrightStar we operate a live-in caregiver rotating either two or three caregivers for two to four day periods with the client. The caregiver works for 12 hours in any twenty-four hour period and has four hours downtime for R&R and 8 hours of sleeping time. Unless the caregiver is accompanying the patient on grocery shopping, visits to the hairdresser, doctor or other errands, the caregiver cannot leave the home during her scheduled days, even during her down-time. The caregiver is expected to be on-call and offer some flexibility with his or her down-time and sleep-time to accommodate the needs of the patient. Having said that, if the caregiver is frequently disturbed during her sleep-time due to the patient needs (for example, if the patient is continually up and wandering the house during the night) then this is not a true live-in situation and the case would need to be staffed on an hourly basis, normally with two twelve-hour shifts per day. As a live-in, the caregiver should be provided with a private room and with meals. So far as possible, the caregiver will sleep when the patient is sleeping and rest when the patient is either with family, watching TV or otherwise relaxing. At BrightStar all of our caregivers are experienced CNAs (Certified Nursing Assistants) able to offer personal care in addition to companionship and one on one attention. Our caregivers are under the supervision of our Director of Nursing who is a registered professional nurse (“RN”) and will prepare, monitor and update the plan of care. Patient medication needs may require some attention when simple reminders are insufficient. BrightStar can work with Medicare agencies or hospices where appropriate or provide nurse visits if there is no family member to assist with medications and in many cases we can establish proxy caregiver arrangements to avoid the need for nurse visits. The major benefit of the live-in service is the dramatic reduction of cost for one on one care. Hourly care by most professional home care agencies will run to over $400 per day. This is unsustainable on a long term basis for most budgets but the BrightStar live-in service is offered at $264 per day, some 35% less expensive. This cost will compare favorably to the cost of a nursing home and the patient can stay in their own home or with the family and, at the same time have the individual attention of a personal attendant who will establish a personal bond, where in many cases the caregivers will become among the most important personal relationships the patient will have in their closing years. Key attributes of the BrightStar live-in service:
- Caregiver rotations will ordinarily be for between 2 and 5 days
- Client should expect two to three caregivers rotating through on a relatively consistent basis
- Caregiver is expected to work for 12 hours in any 24 hour period
- Caregiver should have 4 hours down-time and 8 hours sleep-time in the 24 hour period
- Caregiver will always be on-call but should expect to be able to rest relatively undisturbed
- More than two disturbances during the night (or sleep/down-time) means that the service arrangement is not a true live-in. Care will more appropriately be provided by two twelve-hour shifts in any twenty-four hour period.
- Caregiver has private room for sleeping and down-time
- Caregiver will refrain from use of personal cell phone both for calls and for texting, emails and web-browsing during hours of work
- Caregiver will not leave the premises during the Live-in assignment except to accompany the patient on errands, trips to grocery store, doctors’ visits, etc
- Live-in service is offered at $264 per day, equivalent to $11 per hour