When someone needs help during the night as well as throughout the day, staying at home can become more difficult to manage. They might need help getting to the bathroom, feel unsettled when they wake or need someone nearby to keep them safe.
24-hour live-in care can provide support at home, with carers sharing the work across the day and night. It usually involves a daytime live-in carer and a waking-night carer, so each person has time to rest.
Country Cousins has been introducing live-in carers to people at home since 1959. Here’s how 24-hour care works, what carers can help with and what to think about if you’re considering it for yourself or someone close to you.
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What is 24-hour live-in care?
24-hour live-in care provides support throughout the day and overnight. At least two carers are needed, as one person cannot work around the clock and still get the rest they need.
Usually, the arrangement includes:
- A daytime live-in carer, who helps with daily routines and lives in the home during their placement. They’ll need their own private bedroom to sleep in.
- A waking-night carer, who stays awake overnight and helps whenever support is needed, from trips to the bathroom to offering reassurance after a restless night.
The carers’ hours, breaks and handovers need to be agreed in advance. You’ll also need to arrange cover for times when a carer is taking a break. Our team can talk through these practical details with you, and you’ll agree the arrangements directly with the carers.
Is standard live-in care enough, or is 24-hour care needed?
The main thing to consider is how often someone needs help overnight.
With standard live-in care, the carer sleeps at night and may be able to provide occasional agreed assistance. If someone wakes frequently and needs help each time, or needs support for long periods during the night, a waking-night carer may be more suitable.
It helps to look at the whole day, too. Think about the person’s mobility, the support they need with everyday tasks and whether family members are available to help.
| Standard live-in care | 24-hour live-in care | |
| Carers | One live-in carer | At least two carers sharing daytime and overnight support |
| At night | The carer sleeps and can help occasionally. A waking fee may apply | A waking-night carer stays awake throughout the night |
| Often suits | Daytime support with occasional help overnight | People who regularly need help during the night |
| Cost | Carer and agency fees, plus agreed expenses | Higher overall cost to include waking-night support |
You might want to explore 24-hour care if someone:
- Wakes several times a night and needs help getting settled again
- Needs regular assistance with using the toilet, continence or repositioning in bed
- Becomes confused or anxious at night, or gets up and walks around when they could be at risk of falling
- Needs closer support during palliative or end of life care
If you’re unsure how often help is needed, try keeping a note of what happens overnight for a week or two. This can give you a clearer picture to discuss with the care team.
You can read more about the difference between 24-hour care and live-in care or find out about overnight care at home.
How can 24-hour live-in carers help?
The support will depend on the person’s needs and the way they like to spend their day. It may include help with personal care, everyday tasks and getting out to enjoy familiar activities.
During the day, a carer may help with:
- Washing, dressing and using the toilet, while respecting the person’s privacy
- Moving around the home and getting out for appointments or activities
- Medication reminders and agreed help with medication routines
- Preparing meals, doing laundry and keeping on top of light household tasks
- Companionship, whether that’s chatting over breakfast, walking the dog, visiting friends or going to a local club
At night, a waking-night carer may help with:
- Getting to the bathroom and continence needs
- Repositioning in bed, where they’re trained to do so safely
- Getting a drink or offering reassurance if the person wakes feeling worried or confused
- Noticing changes in the person’s wellbeing and raising concerns with family or the appropriate professionals
Carers provide personal, practical and emotional support. Clinical care, including wound care, injections and medical treatment, remains the responsibility of GPs, nurses and other healthcare professionals.
Who might benefit from 24-hour live-in care?
People need extra support for different reasons, and the amount of help required can change over time. 24-hour care may be suitable in several circumstances.
- Short-term support: A family carer may need a break, or someone may need extra help while recovering from an illness or injury. Find out more about respite care at home.
- Long-term care: Someone who needs regular help throughout the day and night may be able to continue living at home with an ongoing care arrangement.
- Dementia and other complex needs: Someone living with dementia may wake frequently, feel unsettled or need reassurance overnight. Carers with relevant experience can help provide familiar routines and support.
- Palliative and end of life care: Carers can help with everyday needs, offer companionship and give family members practical support. They can work alongside district nurses, hospice teams and the GP. Find out more about palliative care at home.
- Couples: Care at home may help partners continue living together, with support arranged around each person’s needs. Read about care for couples.
- Disability support: Adults of any age may need help with everyday tasks while continuing to live at home and take part in their community. Find out about disability care at home.
- Recovery after a hospital stay: Support at home can help someone settle back into familiar surroundings while recovering from illness, injury or surgery, alongside the plan agreed with their healthcare team. Read about reablement care.
The benefits of 24-hour care at home
For many people, home is where life feels most familiar. They know their surroundings, have their own routines and can keep the small comforts that make each day feel like theirs.
With 24-hour care, support can be arranged around those routines. This might mean having breakfast at the usual time, spending time in the garden, keeping a much-loved pet nearby or having someone to call on during a difficult night.
Other benefits may include:
- Help through the night: A waking-night carer can assist when the person needs help, including with getting to the bathroom or settling back to sleep.
- Familiar carers: Regular carers can get to know the person’s preferences, habits and the little things that help them feel comfortable. Cover for holidays and breaks will still need to be arranged.
- Time together for couples: Partners can continue sharing their home while receiving the help each person needs.
- More time with family: Relatives can spend time together without having to provide every night-time shift themselves.
You can read more about the benefits of live-in care at home.
Arranging 24-hour care with Country Cousins
Country Cousins is an introductory live-in care agency. We introduce families to self-employed carers who have been through our selection process. We consider their experience alongside the person’s care needs, personality, routines and circumstances.
You choose the carers you feel comfortable with, agree the arrangements directly with them and oversee the care day to day. For 24-hour care, you’ll also need to agree how the daytime and waking-night carers will work together, including handovers and cover for breaks and holidays.
Your Care Relationship Executive can help with matching, introductions and administration, and can help you look for a replacement carer when needed, subject to availability.
This approach gives you a say in who comes into the home and how care is arranged. It also means you or someone acting on your behalf will be involved in managing the arrangements.
If you’d prefer a provider to manage the care service and coordinate carers and cover, read our guide to introductory and fully managed live-in care.
How much does 24-hour live-in care cost?
24-hour care usually costs more than standard live-in care because it includes separate daytime and overnight support. The total will depend on the hours required, the fees agreed with each carer and any additional expenses.
With Country Cousins, costs may include:
- A one-off registration fee
- Fees agreed directly with each self-employed carer
- Our agency fee for introductions, matching and ongoing support
- Agreed travel expenses and any bank holiday rates
- Household costs, including food for the live-in carer and additional utility use
We’ll talk through the likely costs once we understand the support needed during the day and overnight.
Our live-in care price comparison gives an idea of starting rates for standard live-in care. For more detail on the cost of waking-night support and how care at home compares with a care home, read the cost of 24-hour care.
How to arrange 24-hour live-in care
If you’re considering care for yourself or someone close to you, our team can talk through the options and help you understand what may be involved.
- Give us a call: Have a free, confidential conversation with our team about the support needed during the day and overnight. There’s no obligation to proceed.
- Talk through your circumstances: We’ll discuss care needs, daily routines, interests and practical details to help identify suitable carers.
- Meet potential carers: We’ll introduce carers who may be a good match. You choose who feels right and agree the arrangements directly with them before care begins.
You can also download our free guide to how live-in care works.
Why choose Country Cousins?
Country Cousins has been helping people arrange live-in care at home since 1959. We know that inviting a carer into your home is a personal decision, especially when support is needed day and night.
Every carer goes through our selection process, including an interview, professional references and a DBS or PVG check. We then look at the person’s needs, routines and circumstances to help find a suitable match.
Jeffrey’s story
Jeffrey, a retired architect, wanted to spend his final days in his cottage in Faversham, Kent, after being diagnosed with terminal cancer. Julie, a live-in carer introduced through Country Cousins, supported him at home while working alongside district nurses and the local hospice team.
Julie paid attention to the things that mattered to Jeffrey. She made his tea the way he liked it, played his favourite classical music and helped him record stories from his career for relatives abroad.
Read Jeffrey’s story.
Reviews from our clients
Choosing care is a personal decision, and it can help to hear from families who have already arranged support.
Read feedback from Country Cousins clients and their families, collected through Feefo.
Frequently Asked Questions
This depends on the support needed, where you live and which carers are available. Finding both a daytime and a waking-night carer may take longer than arranging a single live-in placement.
If care is needed urgently, perhaps after a hospital stay, let us know when you get in touch. We’ll discuss the options and what may be possible.
The daytime live-in carer needs their own private bedroom with a comfortable bed and storage, as well as access to a bathroom and kitchen. Wi-Fi can help them keep in touch with their family.
The waking-night carer will also need access to the kitchen and bathroom, and a suitable place to work from during their shift. Talk through the practical arrangements before care begins.
Yes. At least two carers are needed to share daytime and overnight support, giving each person time to rest and sleep. The additional overnight support is one of the main reasons 24-hour care costs more than standard live-in care.
Read more about the cost of 24-hour care and how much carers cost.
Country Cousins can help look for and introduce a suitable replacement, subject to availability. A written note of the person’s routines, preferences and support needs can help a new carer settle in.
For 24-hour care, you’ll also need to agree how cover will work for both daytime and overnight shifts.
It may be possible. If someone begins needing more help overnight, you can discuss adding a waking-night carer alongside their existing live-in carer.
The arrangements will depend on the person’s needs and which carers are available. Our team can talk through the options with you.
Talk to us about 24-hour live-in care
If you’re wondering whether 24-hour care might suit you or someone close to you, we’re happy to talk through the support needed, how the arrangements work and the likely costs.
Call us on 01293 224 706, Monday to Friday, 8am to 6pm, or Saturday, 10am to 4pm, for a free, no-obligation conversation. You can also send us an enquiry online.
