Choosing round-the-clock care at home is a big decision—emotionally and financially. Families in Texas often ask what to realistically budget for 24/7 in-home care and how those costs compare with other care options. Here’s a clear, practical guide to what 24/7 care looks like in Texas, how to estimate monthly costs, and smart ways to manage the expense, including how Clara can help families find caregivers, employ them legally, and handle payroll, taxes, and compliance.

What “24/7 in-home care” typically means

When families say “24/7,” they’re usually describing one of two models:

• Continuous hourly coverage: Caregivers are scheduled in shifts to cover all 24 hours (for example, 2–3 caregivers rotating 8–12-hour shifts each day).

• Live-in coverage: A caregiver resides in the home and provides daytime support with agreed overnight arrangements; separate overnight coverage may be needed if awake care is required throughout the night. You can read more about live-in coverage here.

Hourly coverage is more common for true “awake” overnight needs, while live-in arrangements can be more cost-effective if the nighttime needs are minimal or intermittent.

The building blocks of the cost

• Texas hourly rates for non-medical home care generally fall in the mid-$20s, with common ranges cited between $24–$31/hour in 2025 statewide, and a Houston median of $28–$30/hour based on recent surveys.

• Nationally, the 2025 median is about $33/hour for non-medical home care, which places Texas below the U.S. average and helps explain why 24/7 home care can be relatively more affordable here than in many states.

• A 24/7 schedule requires roughly 720 hours per month (24 hours × 30 days), so multiplying hourly rates by 720 gives a realistic monthly estimate for shift-based coverage.

Texas estimates: 24/7 hourly coverage

Using the 720-hour benchmark:

• At $24/hour: about $17,280/month.

• At $29/hour (Texas 2025 median): about $20,880/month.

• At $31/hour: about $22,320/month.

How this compares to other care settings

Context helps. Recent data show:

• Assisted living in Texas often runs around the mid-$5,000s/month, varying by city and amenities.

• Home care at standard full-time levels (about 44 hours/week) typically totals around $5,000–$5,300/month statewide, which is why 24/7 coverage is a major step up in budget—it’s more than 4× the hours of typical “full-time” home care.

• Nursing home averages vary widely by state; nationally the 2024 median for semi-private rooms was $9,277/month and $10,646/month for private rooms, making 24/7 in-home care generally more expensive than facility care unless using a cost-efficient live-in model with modest night needs. Costs in Texas specifically average $5,475/month for a semi-private room, to over $7,000/month for a private room.

Key factors that raise or lower the price

• Care intensity and nighttime needs: Specialized dementia care, transfers, or frequent overnight assistance tend to push families toward hourly shifts and increase total cost.

• Local market: Major metros like Houston, Dallas, and Austin often sit at or slightly above statewide medians due to demand and wages.

• Staffing model: Two or three caregivers working 8–12-hour shifts costs more than a single live-in caregiver if overnight needs are light.

• Overtime and compliance: When hiring directly, federal overtime (over 40 hours/week) and Texas payroll rules can impact cost; budgeting correctly avoids surprises.

Sample monthly budgets (Texas)

These examples illustrate typical Texas math, not quotes:

• Shift-based, awake nights (24/7): $25/hour×720 hours ≈ $18,000/month.

• Shift-based with slightly higher rate (metropolitan or complex care): $29/hour×720 hours ≈ $20,880/month.

Local Houston sources describing “24/7” commonly cite $14,000–$25,000/month for shift-based coverage, consistent with the hourly calculations above.

Paying for 24/7 home care in Texas

Most families pay privately, but it’s worth exploring:

• Long-term care insurance benefits for in-home services if the policy allows.

• VA benefits for eligible veterans and surviving spouses.

• Texas Medicaid programs for those who qualify (availability and scope vary).

Because 24/7 is a high-hour scenario, even small differences in hourly rates, overtime planning, and scheduling efficiency make a big difference to the monthly total.

How Clara helps families lower friction and stay compliant

Clara is a facilitator of in-home care that helps families:

• Discover vetted caregivers who fit skills, schedule, and budget goals.

• Employ caregivers legally with correct pay practices and documentation.

• Manage payroll, taxes, FICA, and Texas unemployment insurance, reducing error risk and administrative burden. You can read more about payroll and taxes for care in Texas in our blog from Attorney at Law, Ke Ma.

Clara’s approach can be especially valuable when organizing complex schedules (like 24/7) and ensuring compliance with overtime and pay-stub requirements—areas that frequently impact cost and caregiver retention in high-hour care plans.

Tips to optimize a 24/7 plan

• Right-size overnight support: If nights are mostly quiet, evaluate a live-in model with defined sleep periods; shift to awake nights only if safety truly requires it.

• Mix schedules strategically: Combine consistent daytime coverage with targeted overnight support on riskier nights (post-hospital discharge, new medication regimens).

• Compare metro vs nearby suburbs: Slight rate differences can add up over 720 hours/month; even $1/hour matters at 24/7 scale.

• Keep compliance tight: Avoid unexpected overtime costs and penalties by setting a compliant schedule from the start—Clara can help structure this and run payroll accurately in Texas.

Bottom line: What to budget in Texas

For true 24/7 hourly coverage, most Texas families should plan around $17,000–$22,000/month depending on local rates and care complexity, with Houston-area guidance often citing $14,000–$25,000/month for full awake coverage.

If the goal is to keep a loved one at home safely with continual support, the right plan—and the right facilitator—can help balance budget, quality, and caregiver continuity.

Clara can help families discover great caregivers, employ them legally, and handle payroll, taxes, and compliance in Texas. To get started, reach out to Clara to outline care needs, review budget options (including 24/7, live-in, or hybrid schedules), and build a compliant plan that supports both family and caregiver for the long term.

Reach out to the Clara team today to learn more.