A Smarter Approach to Full-Time Custodial Care at Home

For Elder Law Attorneys, Legal Guardians, and Financial Planners

When your clients require long-term, non-medical custodial care, they have two options:

1. Relocate to a care facility
2. Receive care at home

Given the choice, 90% of seniors prefer to stay in their own homes, and studies show they fear being placed in a facility more than they fear death. So, how do we help them remain at home while ensuring their care is both high-quality and financially sustainable?

The Problem with Traditional Home Care Agencies

Until 2015, securing full-time custodial care at home was straightforward. Home care agencies provided live-in caregivers who worked 16 hours per day, assisting with Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs), while remaining on-site overnight for emergencies. Agencies also provided RN visits for periodic assessments, ensuring proper care.

However, changes to the Fair Labor Standards Act (FLSA) redefined how home care agencies must compensate live-in caregivers. Under the new regulations, agencies must pay both overtime wages and compensation for overnight hours unless caregivers receive five continuous hours of sleep.

This change made agency-based live-in care financially unsustainable. In 2024, only one-third of home care agencies still offer live-in services, and those that do charge astronomical rates by splitting care into hourly shift rotations with multiple caregivers.

The Financial Reality of Hourly Shift Care

According to Genworth’s 2025 Cost of Care survey, the national average for agency-based home care is $35 per hour. That translates to:

• $840 per day for 24-hour care
• $25,550per month
• $306,600 per year

For many families, this cost is simply unattainable, forcing seniors into facilities they don’t want to enter.

The Direct-Hire Live-In Solution

Thankfully, there’s another option. When Congress amended the FLSA, they maintained overtime exemptions for families who hire caregivers directly. That means a direct-hire live-in caregiver remains the most cost-effective way to secure full-time custodial care at home.

Here’s a breakdown of a direct-hire live-in caregiver’s costs:

💡 Total Cost for Direct-Hire Live-in Care: $174,190 per year
💡 Annual Savings Compared to Agency 24/7 Shift Care: $132,410

Why Direct-Hire Care Works for Your Clients

• Cost Savings: Families save 30-50% compared to agency rates.
• Continuity of Care: One dedicated caregiver instead of rotating shift workers.
• Peace of Mind: 24/7 in-home support without agency scheduling headaches.
• FLSA Compliance: Legally structured employment with proper payroll processing.

At Grandma Joan, we specialize in helping families recruit, vet, and hire the best live-in caregivers nationwide—ensuring a seamless and compliant transition to direct-hire care.

Let’s Partner to Keep Your Clients at Home

Elder law attorneys, legal guardians, and financial planners play a critical role in guiding families toward affordable, high-quality care solutions. Referring your clients to Grandma Joan means giving them an alternative that protects their finances and honors their wish to age in place.