Caregiving: When Parents Need 24 Hour Care


Has a doctor or a healthcare professional told you that parents need 24-hour care and expect you to know what they mean? Acronyms or abbreviations are often used in the care system that consumers or patients don’t understand.

Family caregivers may be unsure what to do when told that elderly parents need 24-hour care. Recognizing why a parent needs care and understanding what it takes to provide 24-hour care is like telling someone to bake a Black Forest cake without providing a recipe.

Sticker Shock When Parents Need 24-Hour Care

Many times just hearing the words 24-hour care can send a caregiving family into a frenzy. The first thought from an adult child or a spouse might be, I have a job. I can’t be a caregiver 24 hours a day.

I know of few individuals or family caregivers who can define 24-hour care.  Yet industry professionals throw this term around like family caregivers are expected to know exactly what this means and make it all happen lickety-split.

Let’s start with costs for when parents need 24-hour care. Depending on the type of care, a doctor’s recommendation may be out of reach for most individuals due to cost unless family members are providing the care.

  • On average, in 2022, the cost for assisted living care is $84,000 a year
  • Nursing homes also called rehabilitation or long-term care communities charge between $300 to $500 per day or between $108,000 to $180,000 per year
  • Due to COVID and staffing difficulties, the cost of in-home caregivers averages $40 to 50 per hour in 2022.

How many individuals or their family caregivers have this amount of money sitting in a bank or investment account waiting to be spent? If parents do not have a long-term care insurance policy or substantial assets, meeting a need for 24-hour care may mean accessing the public benefit of Medicaid or spending down assets to qualify.

Are 24-Hour Care Recommendations Really Necessary?

Recommendations for 24-hour care are commonly made by healthcare professionals who have no idea of the private pay cost. For those working in the industry, it is easy to separate the recommendation from the effect on an elderly person and their family members.

Giving advice for care outside of a hospital is no different from an overweight doctor telling a patient to lose weight. Until the doctor has to implement his or her suggestion, they have no idea of the challenges that might be experienced.

If you are a family member in this situation, the question you should ask when told parents need 24-hour care is, “what is your personal experience with this?” More than likely the answer will be “none.”

Few Healthcare Professionals Understand the Actual Cost of 24-Hour Care

Until the parents of a healthcare professional need 24-hour care, the idea remains a recommendation given only to others. To a doctor or nurse, 24-hour care means nursing home care paid for by health insurance or care provided by family members, so to them, the cost is not real. In a nursing home, the cost of care is temporarily reimbursed by Medicare or if long-term then Medicaid.

The reality of parents needing 24-hour care is very different in each family situation. Another question to ask doctors or others making the recommendation is “for what purpose and for what length of time is this level of care needed?” If an elderly parent is diagnosed with dementia, Alzheimer’s, or another type of cognitive concern that makes living alone unsafe, then permanent 24-hour care may be necessary.

Based on many personal experiences of a parent and multiple clients needing 24-hour care, I know that the answer to these questions depends on the event that resulted in a need for care, the possibility of returning to a prior state of health, and the short and long term prognosis of the health diagnosis.

Evaluating 24-Hour Care Options

What will you do when parents need 24-hour care? Looking at the hard costs of this type of care is it affordable and for how long? Will you or your family take care of your parent personally and financially? Will Medicaid be needed to provide care?

When not if, this is your reality, what will you do? How will you plan? There’s no time like the present to think about the future.

Elderly parents may require 24-hour care for a brief period of time. Others may benefit from ongoing care but may not need 24-hour care. For those who need 24-hour care, what type of care is needed?

Can family members bridge the gap? Will a combination of family caregivers and in-home paid caregivers meet the need? Is short-term nursing care the better option? What if the care need becomes long-term?

A caregiving expert or a geriatric care manager can support family members in evaluating 24-hour care decisions including recommending in-home care services and care communities. There are many moving parts when considering 24-hour care and the future care needs of a loved one.

Make sure that the individual you consult with has the knowledge and has personally been involved in managing 24-hour care situations in a private home, care community, or nursing home. You don’t want to be in another situation of a person offering advice for parents needing 24-hour care who doesn’t realize the costs, how to coordinate the care and the effect on the family.

Creating A Caregiver Action Plan

Let me help you with actions to consider today if you are the caregiver of parents who need 24-hour care. I will use the example of owning a car.  If you have a fairly good driving record, you may have only had to use your car insurance once or twice in your lifetime.

Each time you pay your car insurance are you hoping that you will have to use the insurance because of an accident you cause or an accident caused by someone else? More than likely you have insurance for an unexpected accident.

If you had the ability to purchase insurance that you are reasonably likely to use that has the potential of providing security, peace of mind, and choice for you when you become older, would you? Or, if you could create some type of savings plan to ensure that you can pay for care when you are older, would you?

What is long-term care insurance?

Long-term care insurance is voluntary insurance that you must qualify for when you are in generally good health. This type of insurance can pay for in-home care, home safety equipment assisted living, or nursing home care.

The policies keep changing with time so you will want to consult an expert in health and life insurance to review the options. The benefit for your children, if you have them is freedom and peace of mind from major caregiving responsibility.

The individual benefit is the choice of where to spend the last years of your life and knowing you will receive the type of care appropriate for your needs. Having long-term care insurance is especially important for women who outlive husbands and have no one to care for them.

Why not act today to ensure that you will receive the care you need when you need it. If you need proof that this makes practical sense, then look at the situation you may be finding yourself in with the care of a parent who did not prepare financially. Do you want to find yourself or your children in the same situation wondering how to pay for care?

Article by: Pamela D. Wilson, MS, BS/BA, CG, CSA is a national caregiving expert, educator, advocate, and speaker. More than 20 years of experience as a court-appointed guardian, power of attorney, and care manager serve as Wilson’s platform to increase awareness of caregiving as an essential role in life. She is a content developer, author of all articles on this website, and videos on her YouTube Channel. Wilson hosts and produces The Caring Generation® podcast and is the author of the book The Caregiving Trap. You can reach Pamela by completing the Contact Me Form on this website.

© 2012, 2013, 2022  Pamela D. Wilson.  All Rights Reserved

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