What it costs: Priced as a daily or weekly rate rather than a straight hourly multiple, since overnight coverage works differently than a daytime shift.
What 24-hour home care actually covers
This is continuous coverage for situations where safety genuinely can't wait for daytime hours - late-stage dementia, high wandering risk, or a level of need that has simply outgrown part-time hours. There are two structural models, and which one fits depends on your loved one's specific needs.
- 24-hour shift care: rotating awake caregivers providing continuous active supervision
- Live-in care: a caregiver residing in the home with scheduled sleep breaks, for situations with lower overnight activity
- Full daily personal care routine across all shifts
- Overnight wandering and exit-seeking prevention
- Sundowning management during the highest-risk hours
- Continuous safety supervision with no gaps in coverage
24-hour shift care or live-in care: which one fits
24-hour shift care means caregivers rotate in awake shifts around the clock - the right choice when nighttime agitation, wandering, or care needs are frequent and unpredictable. Live-in care means one caregiver resides in the home with a scheduled overnight sleep break, which works well when overnight needs are lower but daytime supervision still needs to be continuous.
We'll help you figure out which structure actually fits your situation during the free matching process - there's no reason to pay for round-the-clock awake shifts if live-in coverage genuinely meets the need, or vice versa.
Who this service is right for
This level of care usually becomes necessary at one of a few clear turning points: a wandering incident (even one is a serious signal), late-stage dementia where full dependence has set in, or simply the point where family caregivers can no longer safely manage nights and days alone. It's rarely the starting point - most families arrive here after scaling up from companion or personal care as needs progressed.
What it costs
24-hour and live-in care is priced differently from hourly care - typically as a daily or weekly rate, since live-in coverage doesn't require the caregiver to be awake and active every hour the way a daytime shift does. This tier represents the highest level of investment in home care, but it's still generally less than the all-in cost of a comparable facility placement for many families, while keeping a loved one in a familiar environment.
What it costs where you live
Live-in care is normally billed as a daily rate rather than hourly, and works out well below the hourly figures below for the same coverage.
The figures below are the going hourly range for in-home dementia care in each city we cover, not for this service alone. They move with local wages more than with anything else, which is why the same care costs half as much again in one city as in another. Each city links to a fuller local guide.
| City | Typical hourly range |
|---|---|
| Baltimore, MD | $24 to $34 |
| Boston, MA | $26 to $40 |
| Buffalo, NY | $20 to $30 |
| Charlotte, NC | $24 to $32 |
| Chicago, IL | $24 to $36 |
| Columbus, OH | $22 to $32 |
| Dallas, TX | $22 to $34 |
| Denver, CO | $24 to $34 |
| Detroit, MI | $22 to $32 |
| Houston, TX | $22 to $34 |
| Los Angeles, CA | $27 to $40 |
| Memphis, TN | $22 to $32 |
| Miami, FL | $35 |
| Milwaukee, WI | $22 to $32 |
| Naples, FL | $35 |
| New York, NY | $28 to $42 |
| Philadelphia, PA | $26 to $34 |
| Phoenix, AZ | $22 to $33 |
| San Antonio, TX | $20 to $30 |
| San Diego, CA | $26 to $38 |
| Seattle, WA | $28 to $40 |
| Tampa, FL | $35 |
| Tucson, AZ | $20 to $30 |
Ranges are what families in each city are currently quoted, and are a guide rather than a price. What you pay depends on hours, the caregiver's experience, and how much notice you can give.
Frequently Asked Questions
What's the real difference between 24-hour care and live-in care, cost-wise?
24-hour shift care (rotating awake caregivers) generally costs more than live-in care (one caregiver with a scheduled sleep break), since it requires more staffing hours overall. We'll help match the right model to your actual overnight needs rather than defaulting to the more expensive option.
Do you provide the same caregiver every day for live-in care?
We aim for consistency - a stable, familiar caregiver matters enormously for someone with dementia. Live-in arrangements typically involve a small, consistent team rather than a large rotating roster.
Is this only for late-stage dementia?
Not necessarily - some families need 24-hour coverage earlier due to a specific safety concern like severe wandering, even if the person is otherwise in an earlier stage. The right level of care depends on the specific risk, not just the stage label.