If your mother needs help at night after a fall, write down each time she wakes and what help she needs before asking for overnight quotes. Guiding Souls Home Care does not provide home health, skilled nursing, assisted living or nursing home care.
What does 24-hour care cost in the Sacramento area?
Start with the formula: hours a week times the hourly rate. CareScout's survey ran from July to November 2025. For this area it found a median of $40 an hour, or $7,627 a month at 44 hours a week.
That monthly figure covers 44 hours a week, not round the clock care. Round the clock care is 168 hours. At $40 an hour, 168 hours is $6,720 a week. At the CareScout median, 24 hours at $40 an hour comes to $960 a day, or $28,800 for 30 days. This is a budgeting estimate, not a ceiling or an agency quote.
For comparison, the same survey listed assisted living in this area at $7,750 a month and a private room in a nursing home at $19,771 a month. Those are facility prices, and they cover a different kind of help.
The median is the middle of many quotes, so some agencies charge less and some charge more.
What changes the price of shift care and live-in care?
Shift care means caregivers work set blocks, such as two 12-hour shifts a day. You pay for every hour, and awake overnight hours usually cost the same as day hours. Live-in care means one caregiver lives in the home, sleeps there and takes breaks. It is meant for someone who sleeps most of the night, so ask how each agency treats a night of repeated waking.
Four things move the price:
- Hours per visit. Many agencies set a minimum visit, so ask what it is.
- Nights, weekends and holidays. Some charge extra, some do not.
- The level of help. Lifting, transfers and dementia supervision may need two caregivers at once.
- Sleep. A caregiver who must stay awake all night is priced differently from one who sleeps.
California's Domestic Worker Bill of Rights FAQ says a personal attendant, someone who mainly supervises, feeds and dresses a person at home, earns overtime after 9 hours in a workday or 45 hours in a workweek. That holds whether a family or an agency is the employer. Ask the agency to show which hours count as paid work and where overtime appears in the live-in quote. Ask how each quote counts sleep, breaks and help during the night. If you hire a caregiver yourself, you are the employer and the payroll is yours. Through an agency, the agency is the employer and handles payroll and overtime.
You can read more about the setup on the 24-Hour Home Care page.
How can you pay for round the clock care in California?
Long-term care insurance
If you or your parent worked for the state, check CalPERS long-term care coverage. Its Spring 2025 newsletter says home care claims need an itemized invoice plus Daily Visit Notes filled out by the provider. Check your policy for the daily limit and the waiting period before care starts.
Medicare
Medicare does not pay for 24-hour care at home, or for personal care when that is the only care needed.
Veterans benefits
The VA's Homemaker and Home Health Aide program can send an aide to a veteran's home. Enrolled veterans qualify if the VA finds a need for the service and it is available where they live. A copay may apply. Talk with a VA social worker about what help you could get. The Sacramento VA Medical Center in Mather is the regional starting point.
IHSS and Medi-Cal waivers
In-Home Supportive Services (IHSS) is a county program that pays for in-home help for people with low income; ask the county about hours and who can be paid. Medi-Cal's Home and Community-Based Alternatives Waiver can help some people who qualify, but it has limited places.
Free local help
The Sacramento County Area Agency on Aging funds caregiver support and respite, senior meals, transportation, legal help and HICAP, which gives free counseling on Medicare questions. Ask which services have fees and whether respite is available for the hours you need.
What should you do next?
Call three agencies. Ask each one for the hourly rate, the minimum visit, the overnight terms and the live-in rate, all in writing. Ask whether a second caregiver is ready for sick days.
Have these ready: a list of daily tasks, the nights your relative wakes, any insurance policy numbers, and who holds power of attorney. If the policy is CalPERS, bring the benefit letter.
Then compare shift and live-in quotes for the same week. Check whether each quote covers the waking hours you recorded and what happens when the caregiver needs a break.
What happens if you call Guiding Souls Home Care?
A person answers (916) 229-8120 at any hour, including weekends and holidays. The first visit to the house is free and carries no obligation. Mereani Blanton does it herself on most new cases, looks at the routine and the layout, and puts a plan and a clear cost in writing before anything begins. There is no contract. You can also reach the office through the free assessment page, and see the areas we cover.
