Live‑In Care vs. 24/7 Care in Oregon: What Families Need to Know
When a loved one needs continuous support at home, families in Oregon often choose between Live‑In Care and 24/7 hourly care. Both options provide safety and comfort, but they differ significantly in structure, staffing, and cost. Understanding these differences — especially Oregon’s specific rules for Live‑In Care — helps families make the best decision for their situation.
What Is Live‑In Care?
Live‑In Care means a caregiver stays in the home for a full 24‑hour period, providing daytime support and being present overnight for safety and reassurance. It is one of the most stable and cost‑effective ways to provide continuous care.
How Live‑In Care Works
– One caregiver remains in the home for a 24‑hour period.
– Typically 2–3 caregivers rotate throughout the week.
– Caregivers provide active daytime care: personal care, mobility assistance, meal preparation, companionship, and safety monitoring.
– At night, the caregiver sleeps in the home but is available if the client needs help.
– Families benefit from consistency, because the same small team learns routines and preferences.
Oregon’s Live‑In Care Guidelines
Oregon has specific rules that define how Live‑In Care must be structured. These rules protect both the client and the caregiver and ensure the arrangement is safe, ethical, and sustainable.
1. Caregiver Must Have a Private Sleeping Space
Oregon requires that a live‑in caregiver be provided:
– A private, safe place to sleep,
– A bed with clean bedding,
– Reasonable privacy and access to the home.
2. Caregiver Must Receive Adequate Sleep
For a caregiver to qualify as “live‑in” under Oregon rules:
– The client must sleep through most of the night,
– The caregiver must be able to get at least 5 hours of uninterrupted sleep,
– Total sleep time must be at least 8 hours.
If the caregiver is awakened frequently or cannot sleep, the arrangement is no longer considered Live‑In Care and must transition to awake overnight care (part of 24/7 hourly care).
3. Meal Breaks and Rest Periods
Oregon requires that live‑in caregivers receive:
– Time to eat meals,
– Reasonable rest periods during the day,
– Access to food storage and kitchen facilities.
4. Pay Structure
Oregon allows a reduced overnight rate only if the caregiver is able to sleep.
If the client is awake and requires care, those hours must be paid as active working hours.
This is why Live‑In Care is only appropriate when the client sleeps through the night.
5. When Live‑In Care Must Transition to 24/7 Care
A Live‑In arrangement must be reevaluated if:
– The client begins waking multiple times per night,
– There is wandering, agitation, or nighttime confusion,
– Hands‑on care is needed during sleeping hours,
– Hospice or medical providers recommend awake supervision.
In these cases, Oregon requires awake overnight staffing, which becomes 24/7 hourly care.
What Is 24/7 Hourly Care?
24/7 care is staffed by caregivers working three 8‑hour shifts or two 12‑hour shifts every day. Caregivers are awake and actively working the entire time, including overnight.
How 24/7 Care Works
– Multiple caregivers rotate through the home each day.
– All hours are billed as active working hours.
– Best for clients who are awake frequently at night or require constant supervision.
– Provides the highest level of monitoring and hands‑on support.
Cost Comparison: Why Live‑In Care Is More Affordable
One of the biggest differences between the two models is cost.
Live‑In Care
– Typically the same cost as an 18‑hour shift, even though the caregiver is present for 24 hours.
– Overnight hours are not billed as active care unless the client is awake.
– This structure makes Live‑In Care significantly more affordable.
24/7 Hourly Care
– Requires three full shifts per day.
– All hours are billed at the hourly rate, including overnight.
– Can cost 20–40% more than Live‑In Care.
For many Oregon families, Live‑In Care provides the same level of safety and support at a much lower cost — as long as the client sleeps through the night.
Why Families Choose Live‑In Care
Live‑In Care offers:
– A familiar, consistent caregiver team
– Lower overall cost
– A calm, home‑based environment
– Support with personal care, mobility, meals, and companionship
– Overnight reassurance without the cost of hourly billing
For hospice clients, Live‑In Care often creates a peaceful, dignified environment during a vulnerable time.
