Live-in care guide

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What is live-in care?

Live-in care is a type of home care service. A caregiver will live in the home with you or your loved one to provide full-time bespoke care and support.

Live-in care offers many benefits, particularly when compared to other services such as Assisted living facilities. If you or your loved one needs full-time support, a live-in carer can support you with everything from cooking and home help to respectful personal care and specialist care for various conditions. For many people, the bespoke and dedicated support of live-in care enables them to continue living safely, confidently, and independently at home, surrounded by familiar comforts and routines.

This guide has been produced to help you understand what a live-in care service may entail, who can benefit from it, working in the industry, and if it is right for you.

Types of live-in care. Are there different types of care?

In the same way that there are many types of visiting home care services, from companionship one a week to multiple visits to support with personal care every day, there are also different types of live-in care available to accommodate for different circumstances, requirements, wishes and budgets.

Levels of live-in care

You may come across many different names for different types of live-in care, but there are essentially two main types: managed and self-managed, and both require different levels of involvement.

Managed live-in care

With ‘managed’ live-in care, an agency will take an active role in all aspects of the care you or your loved one receives. A ‘managed’ live-in care service is regulated by the Department of Public Health, which means the agency is regularly assessed to ensure that their practices, policies and procedures are compliant with standards outlined by the State.

Your care management team will usually visit you or your loved one at home to discuss your requirements, wishes and circumstances as well as conducting a risk assessment to ensure everyone will be able to live safely in the property. A bespoke support plan will then be created and your care management team will usually provide a selection of profiles for live-in carers who have been personally matched. You’ll have ongoing support and regular reviews to ensure everyone is receiving the right support.

Managed live-in care is usually offered within a certain radius of the care agency to ensure you’re your care teams are able to reach you to visit, review and respond to any alerts.

As well as assessing, organizing and monitoring your care, the agency is responsible for interviewing, training, employing and paying your care assistant (including tax, national insurance and other legal obligations).

Self-managed live-in care

Self-managed live-in care is also known as ‘introductory live-in care’ because the role of the care agency is to introduce you to a self-employed carer. With self-managed live in care, the agency has less involvement than they would with a managed service. The care agency will usually conduct a telephone assessment to understand your needs and wishes before starting a comprehensive selection and vetting process on the self-employed live-in care assistants they introduce to you (including enhanced CORI search, right to work in the US and full reference checks).

Once a care assistant has been matched to your needs and introduced to you, you will be responsible for arranging any ongoing amendments to the care plan with the live-in carer. You will also be responsible for paying the carer directly, and a fee to the agency for their introductory service. The self-employed live-in carer will arrange their own taxes and insurance.

The care management team at the agency will be in regular contact with you and your carer to ensure everyone is receiving the right support but they do not usually visit the home to conduct the reviews.

Given that you will have significantly more responsibility than with a managed service, introductory live-in care is best suited to families who would like to be as involved and ‘hands-on’ as possible.

Short-term and long-term live-in care

A short-term live-in care placement may be arranged for a number of weeks and is beneficial when returning home from hospital after an operation or recovering from illness, or to cover an extended break from your regular caregiver. Given that the placement for a short-term live-in care arrangement is for a number of weeks, it’s likely that you’ll have the same live-in care assistant for the duration of your care.

Longer term live-in care placements provide ongoing care and can last for any length of time from months to years. With longer-term live-in care placements, a live-in care assistant will usually stay for up to 8 weeks and then a new carer will be introduced to you. This is to ensure that your care assistant has an opportunity to rest between placements to ensure they are able to provide care to the best of their ability. After their break, the care assistant may return for another period of time with you or they may have another placement depending on the circumstances. Your care provider should always strive for consistency in carers wherever possible, which is particularly important for ongoing dementia care where consistency and familiarity is key.

What help & support does a live-in carer provide?

The services included within your live-in care package may vary depending on the provider you’ve selected and the level of care agreed. Live-in care services usually include help with mobility and safety, personal care, medication, night time support, shopping, cooking, housework, pet care, admin, trips out, companionship and emotional support.

Carers’ work doesn’t normally cover heavy moving or lifting, constant night care or nursing procedures, although inclusion of these services may be discussed with your care provider where required.

Some of the typical ways in which a live-in carer may offer support are outlined below.

Daily routine

Help with getting up and morning routine
Assistance with evening and bedtime routine
Support with your lifestyle

Personal care

Assistance with bathing and dressing
Feeding and oral hygiene
Continence care

Medication

Prompting or reminding to take medication
Administering medication

Cooking and nutrition

Preparation of nutritious meals
Encouraging fluids (avoidance of UTIs)

Housekeeping and home help

Laundry and ironing
Cleaning and housework
Household organization
Changing linen and making the bed
Pet care

Well-being

Shopping for nutritious food
Encouraging you to stay active in both body and mind
Ensuring pendants and phone are within easy reach
Planning trips and outings

Companionship

Regular company
Compassionate and engaging companionship
Warm and stimulating conversation
Genuine interest in you and your lifestyle

Hobbies and activities

Activities inside and outside the home
Confidence to maintain hobbies or even explore new ones
Taking you on outings, social trips or to the shops
Keeping your mind and body active

Advice and support from the care provider

Support for family members
Advice on equipment and technology in the home (telecare)
Information about funding and financing
Information about powers of attorney
Liaising with other professionals
On-call support services

Who needs live-in care?

There are a number of scenarios where somebody may benefit from live-in care, and some of the more typical situations are explored below.

Elderly people living alone are more vulnerable to feelings of isolation and loneliness as well as falls and accidents. Live-in carers not only support emotional well-being with compassionate companionship, but also drastically reduce the risk of falling and injuries.

Care for ongoing or progressive health needs

Ongoing conditions such as dementia, cerebral palsy, multiple sclerosis and Parkinson’s bring their own challenges, but no matter what your circumstance, the heartfelt care of a live-in carer enables you and your loved ones to access an enriched quality of life. There are many aspects of everyday life that a live-in carer can support with. From monitoring any changes in health or condition, to assisting with mobility, to assisting with household tasks and accompaniment to medical appointments, a live-in carer’s full-time support enables you to discover a new way to explore life’s adventures.

Live-in carers can support with:

Prompting or administering medication
Personal care such as washing, bathing and changing clothes
Flexible support as physical needs change
Accompanying you to medical appointments
Emotional support for family and friends
Cooking meals and fetching your food shopping
Home help such as laundry and keeping your home clean and tidy
Companionship
Communication with medical professionals

Care support to help you recover after hospital

Research shows that after a stay in hospital, people recuperating at home recover far quicker than if they were to remain in hospital. Our home is the environment we feel most comfortable in, meaning we’re more relaxed with more chance of rest, everything at-hand, and the people we love close by to help with a smooth recovery. Recovery from an illness or surgical procedure with the support of a live-in carer means that you’ll receive specialist care in the comfort of your own home. Live-in carers can support with:

Accompanying you to outpatient appointments, doctors’ appointments and physiotherapy appointments
Safely supporting you with moving around your home
Cooking meals and fetching your food shopping
Home help such as laundry and keeping your home clean and tidy
Personal care such as washing, bathing and changing clothes
Companionship
Prompting or administering medication
Your loved ones will have peace of mind knowing that a professional is on-hand to respond to any alerts or emergencies

Case study

Sheila had a fall and broke her hip which took a while to recover from and then the following year, she fell and broke her other hip. Sheila’s daughter became increasingly worried about her safety and when Sheila then fell again and broke her shoulder, the hospital wouldn’t discharge her unless there was care in place to support Sheila at home. Sheila’s daughter spent much time researching the different options and discovered live-in care. “I really didn’t want to see them in an assisted living facility. I wanted Mum to have one-on-one care at home and to be in charge of their own day and she was never going to get that in a assisted living facility.” When the live-in carer arrived, Sheila’s daughter describes how all their lives changed “It had been such a horrible situation and within weeks she totally turned it around.”

Having a live-in carer meant that Sheila’s daughter was kept updated with Sheila’s health, and when Sheila’s husband began to need more support, the decision was made to introduce a second live-in carer. “I felt so supported when our live-in carer arrived. Knowing that she was there for mum and dad was just such a relief. It meant I could get some of my own life back.”

End-of-life & palliative live-in care services

The home environment is typically rich in memories and offers an unparalleled level of comfort and security. Receiving care at home from a live-in carer means there’s no upheaval and no disruption. A live-in carer will work closely with their client, medical professionals including PCPs, City nurses and specialist palliative care nurses to make sure they are as comfortable as possible. Live-in carers will have received training for specialist equipment and liaise with healthcare professionals to ensure that their care is centred on fulfilling all care needs. A live-in carer can be a truly valued part of the support network by providing care that encompasses physical, psychological, social or spiritual needs.

No matter your circumstances, live-in carers can support with:

Respectful, compassionate and dignified care
Emotional support for family and friends
Using specialist equipment
Personal care such as washing, bathing and changing clothes
Administering medication
Flexible support as physical needs change
Choice in how and where you would like to be cared for
Cooking meals and fetching your food shopping
Home help such as laundry and keeping your home clean and tidy
Companionship
Communication with medical professionals

What conditions can be supported with live-in care?

The top concerns when thinking about parents or elderly relatives with ongoing health conditions are:

Live-in care could be your ideal solution to all of these concerns. The support of a live-in carer would mean you and your loved ones all receive emotional support to avoid any relationship problems and being better value for money than a care home, the bespoke care gives everyone peace of mind.

Dementia care

Live-in care can be an enriching option for people who are living with dementia. As dementia develops, many functions of the brain become affected such as the capacity to process thoughts, perceive surroundings, control emotions and remember details. The comfort of being surrounded by loved ones in your familiar home environment becomes more important, so the support of a live-in carer means you can maintain your lifestyle and routines. When matching a live-in carer to your needs, a reputable care agency will offer candidates who have received specialist training or have extensive experience in dementia care which will give you and your loved ones peace of mind.

Parkinson’s care

Living with Parkinson’s does not mean that you stop living an independent life. As Parkinson’s develops, different symptoms may affect different aspects of your everyday life, but one-to-one bespoke support from a live-in carer will enable you to continue living the life you know and love wherever possible. Given that everyone living with Parkinson’s will experience their own unique symptoms, the flexibility of live-in care means that your carer will be able to accommodate for changing needs and tailor a care plan that best suits you. A live-in carer is able to help people move safely (from as little as helping someone to stand up, to full assistance using a hoist), administer medication, provide personal care and above all, one-to-one heartfelt emotional support.

Stroke care

In the US more than one in five stroke survivors are cared for by family or friends. This can be for many reasons. In some circumstances, the effects of a stroke are mild and simple care needs can be met by loved ones, but needs can change over time and particularly if further strokes, “mini-strokes” or TIA’s (Transient Ischaemic Attack) occur. Stroke recovery can be slow but steady, and having a one-to-one live-in carer who knows and understands your condition can help support this process. Whether you’re in need of respite care or long-term care, a live-in carer will not only provide the practical support but the emotional support for you and your loved ones too.

Multiple sclerosis care

Of over 100,000 people living with multiple sclerosis in the US, no two people will experience symptoms in the same way. The physical challenges that multiple sclerosis brings should not stop anyone living an independent and active life, including continuing to live in the familiar comforts of your own home. The one-to-one care provided by a live-in carer means that they will be able to closely monitor any changes in health or wellbeing, and the flexibility of live-in care means that your live-in carer will be able to respond to any changing needs. A live-in carer is able to support independent living by helping people move safely (from as little as helping someone to stand up, to full assistance using a hoist), administer medication, provide personal care and heartfelt emotional support.

Cerebral palsy care

The bespoke support provided by a live-in carer means that it is absolutely possible to live independently, actively and safely with cerebral palsy. A care provider will match their client to a live-in carer who will support the person in their care to live their life they way they choose. This could be anything from practical experience, to sharing similar interests or matching a carer who can drive so they can share adventures! With many types of cerebral palsy meaning different people experience the condition differently, the full-time support of a live-in carer enables them to monitor any changes in health or wellbeing and respond quickly.

Who will be my carer?

The idea of inviting a stranger to live with you or your loved one at home may feel like a daunting prospect, but a live-in carer sensitively and seamlessly supports the lifestyle and routines in the home with minimal disruption.

Once you’ve decided to arrange live-in care, your care agency will match a live-in carer based on everything from personality and lifestyle to level of support and their specialist training.

Your care provider will introduce you to a selection of live-in carers and they will be able to offer their advice and guidance about which carer would be the best match for you. Sharing your home with a carer can be a daunting prospect, so selecting a carer should be more than a box-ticking exercise. Your care provider should judge a potential carer’s compatibility by matching not only their specialist training and experience, but also their personalities and preferences. By matching live-in carers to clients based on routine, personality, medical needs, experience, even shared interests and activities, you’ll have the best opportunity to find a carer who fully understands you and your lifestyle.

How safe is it to invite a carer I don’t know into my home?

There are several statutory steps which must be undertaken by a care provider when they’re recruiting new carers. Safety is of absolute importance, not only for the person receiving care, but for their loved ones and carers themselves. All care providers require potential candidates to complete an Enhanced Criminal Offender Record Information (CORI) check and some care providers will require a supplementary check called an Adults first check.

Different care providers will have different requirements and procedures throughout their recruitment process. Candidates are usually asked to complete an application which is assessed and shortlisted candidates are usually invited for an interview where their communication skills including fluency in English, their experience and qualifications and most importantly their compassion and suitability for a care position are assessed. Some care providers such as Yamba Care also require all candidates to complete a further personality assessment.

After a candidate has been approved to begin the training process, they will not be officially recruited until they have demonstrated satisfactory knowledge and skills during an induction and assessment. It’s a statutory requirement that any carer received Care Certificate training.

The course is delivered through a mixture of classroom training sessions, group discussions, workbooks, online learning and practical supervision. This training is led by a qualified trainer and includes a range of modules covering (but not limited to) duty of care, working in a person-centered way, communication, privacy and dignity, fluids and nutrition, dementia, safeguarding, basic life support, health and safety, administering medication, handling information as well as infection prevention and control.

Ongoing assessments are usually arranged by the care provider to supervise live-in carers in your home to ensure they are maintaining the high standards of care that you deserve. Live-in carers are also required to participate in ‘update training’ which ensures that their knowledge and skills are compliant with the latest policies and procedures.

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