Using Grandma Joan's model, live-in home care is a full-time caregiving arrangement where a professional caregiver moves into the care recipient’s home to provide ongoing, non-medical support. This caregiver typically lives in a furnished guestroom and is available throughout the day to assist with ADLs (Activities of Daily Living) such as bathing, dressing, grooming, toileting, ambulation, and eating, as well as memory care, companionship, light housekeeping, meal preparation, errands, and more.

Unlike hourly or rotating shift-based care—which can involve 4–7 different caregivers each week—live-in care offers continuity, reliability, and peace of mind by having one consistent caregiver. The caregiver is “on-call” overnight in case of emergencies but is given a minimum of 8 hours off each night to sleep, and typically has a weekly break (often covered by family or a local home care agency).

At Grandma Joan, we help families find, screen, and hire top-tier live-in caregivers as household employees. Each match is based on a client-specific nationwide search to ensure the right personality, skill set, and availability. We assist through the hiring process, then step back—so families maintain full control and flexibility without ongoing home care agency overhead costs.

Live-in care can be a great solution for families who want to keep a loved one at home and need consistent, full-time support without the disruptions that come with rotating hourly shifts.

It may be a good fit if:

• Your loved one needs daily help with memory care or Activities of Daily Living (ADLs), such as bathing, dressing, or walking.
• They can safely be left alone for short periods during the day, such as 30–60 minutes.
• They generally sleep through the night or only need occasional overnight assistance.
• You have a furnished guestroom available for the caregiver.
• You're looking for a more affordable and stable alternative to 24-hour agency care.
• You value having one consistent caregiver to build trust and continuity.
• You’re open to hiring a household employee, with support and guidance from professionals such as a live-in care advisor from Grandma Joan, a household payroll specialist, a local care manager, and an elder law attorney.

Live-in care may not be appropriate if your loved one requires around-the-clock supervision, has significant medical needs, or is awake and in need of assistance several times each night.

We’re happy to discuss your situation in more detail. A free consultation can help determine whether live-in care is a strong fit for your family's needs and lifestyle.

Live-in care is ideal for individuals who may require full-time support with daily activities but do not need constant supervision or complex medical care.

Common appropriate care needs include:

• Memory care (Alzheimer’s, dementia, or cognitive decline)
• Assistance with ADLs, including bathing, dressing, toileting, grooming, eating, and ambulation
• Companionship and safety supervision
• Mobility support and fall prevention
• Meal preparation and light housekeeping
• Transportation to appointments, errands, or social outings
• Pet care and household routine help

Live-in care is best suited for:

• Care-recipients who can be safely left alone for short periods (e.g., 30–60 minutes while the caregiver is in another room)
• Individuals who sleep through most of the night or only need minimal overnight assistance (1-2x a night)
• Families who can offer basic oversight or coordinate respite help when needed through their local home care agency

This model is not appropriate for clients who:

• Require hands-on help throughout the night, every night
• Need 24/7 monitoring due to wandering, aggressive behaviors, or high-acuity medical needs

If the care recipient's needs align with this profile, live-in care can be a stable, high-quality, and cost-effective alternative to facility or shift-based care.

To hire a live-in caregiver, the home should have a furnished, private guestroom where the caregiver can sleep and store their belongings. This room should include a comfortable bed, basic furniture (like a dresser and nightstand), and access to a bathroom.

Because live-in caregivers are working long days and staying overnight, a respectful and private living space is essential. They are not expected to share a room with the care recipient or sleep on temporary arrangements like couches or air mattresses.

In most cases, caregivers are also given:

• 8 hours off to sleep each night (they remain “on-call” for emergencies)
• Scheduled breaks or time off each week (typically one full day or 12+ hours, covered by family or a local home care agency)
• Kitchen access and either meals or groceries to prepare meals for the care recipient and themselves.

If the care recipient is open to sharing their home and has a suitable space, live-in care can be a great long-term solution that balances comfort, dignity, and support for both parties.

When a loved one begins to need daily help, most families start by piecing together care informally—relying on a mix of family, friends, and neighbors. It’s understandable. These are people who care deeply and want to help. But they're rarely trained in caregiving, and over time, this approach becomes unsustainable—both for the care recipient and for those trying to provide support.

As care needs escalate—especially for those with memory loss or mobility challenges—the physical, emotional, and logistical strain on informal caregivers grows. People get overwhelmed. Coverage gaps become more frequent. And the quality of care suffers.

The next step many families consider is hiring a local home care agency. While agencies provide trained caregivers and can fill in coverage more reliably, they come with their own challenges. Agency-based care often involves 4 to 7 different caregivers rotating through the home each week, which can be deeply unsettling for someone with memory issues or a strong need for routine. And the cost? It can exceed $25,000 per month for 24/7 care—a price point that’s simply out of reach for most households.

Private-hire live-in care offers a better alternative.

Instead of rotating strangers or burning out loved ones, one carefully selected caregiver moves into the home and becomes a stable, trusted presence. They assist with personal care, memory support, meals, companionship, and are available overnight in case of emergencies. Families hire the caregiver directly—as a household employee—with help from Grandma Joan for recruiting, screening, background checks, and setting up payroll.

There are no ongoing agency fees, and live-in caregivers often provide broader support than agency workers—like driving, pet care, or even traveling with the care recipient.

The Benefits of Private-Hire Live-In Care:

• Consistency: One dedicated caregiver, not a revolving door.

• Affordability: Often 30%–50% less than full-time agency care.

• Peace of Mind: Trained, experienced help is always present.

• Nationwide Talent Pool: We match families with the best caregivers in the country—not just those nearby.

• Better for Everyone: Reduces burnout for families and provides compassionate, professional support to the care recipient.

This model is especially well-suited for those needing full-time memory care or daily assistance with activities of daily living (ADLs)—and who want to stay comfortably in their home, without the chaos of constant staffing changes or the stress of cobbling together care from untrained helpers.

ven live-in caregivers need rest and recovery time. Fortunately, the private-hire model is designed with flexibility to support both the caregiver’s well-being and the care recipient’s needs.

Most live-in care arrangements include:

• A scheduled day off each week (or 12+ hours of respite if working 7 days)
• Breaks during the day, especially when the care recipient is resting or not in need of direct support
• Occasional extended time off, such as a few days every few months or a full week every 6–12 months, which families can plan for in advance

If the caregiver becomes ill or needs unexpected time away:

• Families can coordinate temporary coverage through a local home care agency, an adult day center, or step in themselves if possible.
• Grandma Joan clients also have the option to request a replacement caregiver search, if longer-term coverage is needed or if a permanent change becomes necessary.

While no care setup is entirely interruption-proof, having just one core caregiver makes it much easier to plan and communicate around schedule changes—compared to managing rotating shifts or a revolving door of staff.

Yes, live-in caregivers can assist with medications, but their role is limited to non-medical support.  They shouldn't administer injections, make dosing decisions, or manage prescriptions on their own.

They can:

• Provide reminders to take medications on time
• Hand medications to the care recipient
• Track doses or monitor whether medications have been taken
• Report concerns or changes in behavior to the family

In most live-in care arrangements through Grandma Joan, caregivers support medication routines as part of a broader daily care plan that includes ADLs, companionship, meals, and more—providing peace of mind without overstepping clinical boundaries.

Yes, live-in caregivers typically assist with light household chores as part of their day-to-day support. This often includes:

• Laundry
• Light cleaning (e.g., tidying, dishes, vacuuming common areas)
• Meal preparation and cleanup
• Errands and grocery shopping
• Pet care (feeding, walking, basic supervision)

Their primary role is to support the care recipient’s well-being, so chores are usually focused on maintaining a clean, safe, and comfortable environment for that person. However, live-in caregivers are not housekeepers, and their duties usually stay focused on tasks related to care. Families who need heavier or whole-home cleaning may still want to hire separate housekeeping support as needed.

Yes, many live-in caregivers can drive the care recipient, but it depends on the individual caregiver’s qualifications and the family's preferences.

At Grandma Joan, the majority of caregivers we recruit:

• Have a valid driver’s license
• Have years of experience driving clients safely
• Are comfortable driving either the client’s vehicle or their own, depending on the arrangement

Driving tasks may include:

• Medical appointments
• Grocery shopping or errands
• Social outings or religious services
• General transportation to keep the care recipient active and engaged

Before hiring, families can specify if they want a caregiver who drives. We’ll include that in the nationwide search. If using the caregiver’s personal car, families reimburse for mileage at the IRS declared rate; if using the client’s car, it should be insured and in safe condition.

It's important to note that only a small percentage of live-ins will bring their car with them to work. Why pay care insurance and a car payment on a car when you live at work! Most leave it at home for their families to use, and either drive the clients car, or use a Uber for their day off.

Ultimately, driving is a common and customizable part of many live-in care arrangements.

No you are not required to BUT, most families either provide meals for the live-in caregiver or give a grocery allowance so the caregiver can prepare their own food.

Since the caregiver is living in the home and working long hours, it’s standard to include meals as part of their compensation package. This doesn't mean cooking every meal for them—but rather allowing access to the kitchen, sharing family meals if appropriate, or covering basic groceries.

Common arrangements include:

• Stocking the fridge/pantry with shared or designated food items
• Providing a weekly grocery stipend
• Including the caregiver in family meals when practical

During the hiring process, Grandma Joan helps you set clear expectations around food, dietary needs, and kitchen use—so both sides feel comfortable.

No, live-in care is not covered by Medicare or standard health insurance plans.

Because Grandma Joan’s live-in caregivers provide non-medical, custodial care—such as help with bathing, dressing, memory care, meals, and companionship—this type of support falls outside the scope of what Medicare or traditional health insurance pays for.

Most families pay for live-in care privately using personal savings, retirement income, or help from family members. In some cases, the cost may be partially offset by:

• Long-term care insurance, if the policy includes in-home care and the caregiver meets the policy’s criteria
• Veterans benefits, like Aid and Attendance for qualifying individuals
• Tax deductions for household employment and elder care expenses (consult your tax advisor)

While not insurance-covered, direct-hire live-in care can offer significant cost savings compared to 24/7 agency care—making it a practical long-term option for families who want to keep their loved one at home.