Deciding between Live-in Home Care Aide Vs a 24-Hour Home Care Aide

Choosing the right type of home care for a loved one can be a difficult decision, especially when considering the level of care required. For those who need around-the-clock support, there are two main options to consider: live-in home care and 24-hour home care.

Live-in home care involves a caregiver residing in the home with the client, typically working for several days at a time followed by a few days off. In contrast, 24-hour home care involves a team of caregivers working in shifts to provide 24/7 care.

Each option has its own advantages and disadvantages, and it’s important to weigh these carefully before making a decision. In this article, we will explore the key differences between live-in home care and 24-hour home care to help you make an informed decision about the best option for you or your loved one’s needs.

Before we go any further, it is important that you recognize that this article focuses exclusively on home care aides, who are fundamentally different from health care aides, also referred to as Home Health Aides. You can read our article on the differences between home health and home care aides.

Differences between Live-In Home Care Aide Vs. 24-Hour Home Care Aide

Live-in home care aides and 24-hour home care aides differ in terms of the type and level of care they provide.

A live-in aide resides at the client’s private home for an extended period, for a minimum of about five days a week, providing around-the-clock care and companionship.

On the other hand, a 24-hour home care aide is available for the duration of their shift, typically lasting 8 to 12 hours. Both options allow personalized care from the comfort of a person’s home, but choosing the option best suited for your unique needs is important and requires careful consideration.

Here are a few key factors that differentiate the two:

Number of Caregivers

Live-in home care provides one caregiver responsible for the client’s care and well-being for an entire week. This means that the client can build a close relationship with the caregiver, and the caregiver can provide consistent and personalized care.

Conversely, with 24-hour home care, the client may have multiple caregivers throughout the day, depending on the duration of the shifts. 

Breaks and Paid Leaves

New York State law recognizes the importance of giving live-in home care aides a much-needed break during their shifts. Live-in home care aides are entitled to an unpaid meal break of at least 30 minutes, as long as they have worked six hours.

In addition, they can look forward to three days of paid time off each year and an extra two days after completing one year of employment.

Night Supervision

When it comes to live-in care, nighttime supervision may not always be possible. This is because live-in caregivers are entitled to eight hours of sleep time per night, with five being uninterrupted.

While this break is important for caregivers to recharge and provide adequate care during the day, it means that care recipients may not have direct supervision during the night. This is where 24-hour care is more helpful, as it offers round-the-clock attentiveness to ensure the safety and well-being of the care recipient at all times.

Connection with the Client

Live-in homecare can provide a consistent level of care that allows for trust and understanding to develop between a caregiver and their client. These strong bonds can make a world of difference in the quality of life for those receiving care.

However, it is important to acknowledge the challenges of 24-hour care. While it provides constant support, it can limit the opportunity for caregivers to build a rapport with their clients.

Cost of the Service

In general, live-in home care tends to be more cost-effective than 24-hour home care due to the fact that only one caregiver is needed, reducing overall labor costs. However, live-in home care may require additional expenses, such as room and board for the caregiver, which can add up over time.

On the other hand, 24-hour home care requires multiple caregivers to work in shifts, which can increase labor costs but may provide more flexibility in terms of scheduling and care continuity.

Living Space

In a live-in home care arrangement, the caregiver typically resides in the home with the client, which requires providing a private living space for the caregiver. This can range from a separate bedroom and bathroom to a dedicated living space, such as a basement apartment.

In contrast, 24-hour home care typically involves a team of caregivers working in shifts, with each caregiver leaving the home after their shift is over. This eliminates the need for a private living space for the caregiver, as they do not reside in the home


The advantage of 24-hour care is that aides can rotate shifts and remain vigilant throughout their shifts, which can be invaluable for those who require constant care and supervision.

On the contrary, live-in caregivers may experience exhaustion, which can lead to minor negligence during the shift.


The live-in caregiver may be aware of the client’s personal habits and routines, which can make it difficult for the client to maintain a sense of independence and autonomy.

In contrast, 24-hour home care can offer the client more privacy and independence, as there is less opportunity for the caregiver to become familiar with the client’s daily habits.

How to Choose Between Live-In Vs. 24-Hour Home Care Aides

Choosing between live-in and 24-hour home care aides is an important decision that requires careful consideration. To make an informed choice, several factors need to be taken into account.

  • Level Of Care Needed

If the individual requires constant monitoring or assistance with daily activities, 24-hour care may be necessary. However, if the client is relatively independent and requires only occasional assistance, live-in care may be sufficient.

  • Duration Of Care Needed

If the person requires care for a prolonged period, such as several weeks or months, 24-hour care may be more appropriate. However, if the need for care is more sporadic or short-term, live-in care may be a better option.

  • Cost Of Care

While live-in care might seem more affordable, it may not be the most cost-effective option in the long run. On the other hand, 24-hour care might be expensive, but it offers round-the-clock support.

  • Caregiver Availability And Flexibility

In 24-hour care, there is typically a team of caregivers who work in shifts. Live-in caregivers may have more flexibility in scheduling and may be able to provide more personalized care.

  • Home Environment And Space

If your home is not large enough to accommodate a live-in home care aide, 24-hour care can be a more suitable option.

  • Family Support And Involvement

If family members are available and willing to provide care, live-in care may be a better option. However, if family members cannot provide care or require a break from caregiving duties, 24-hour care may be necessary.

  • Care Recipient’s Preferences

Some individuals may prefer the round-the-clock attention and privacy provided by 24-hour care, while others may feel more comfortable with a live-in caregiver.

It is noteworthy to mention that the Medicaid program, called Consumer Directed Personal Assistance Program (CDPAP), that allows patients needing home care to take an active role in choosing their caregiver and when necessary, letting them go.

Wrapping Up

Deciding between a live-in home care aide and a 24-hour home care aide is a complex decision that requires careful consideration of multiple factors. While cost and the provision of living space are important elements to consider, it’s also essential to think about the level of personal interaction and privacy that the client requires.

Ultimately, the decision of which type of care to choose will depend on the specific needs and preferences of the client and their family. By carefully weighing these factors and discussing them with a reputable home care agency, you can make an informed decision that provides your loved one with the best possible care and support.

Anna Dykshteyn is the president and administrator of City Choice Home Care Services. She has over 15 years of hands-on experience in the home healthcare industry, has a degree in Health Information Management, and is also licensed to operate by the New York State Department of Health.

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