24-hour care: Clarify presence, working hours and total cost
24-hour care often refers to a live-in arrangement where a support worker lives in the household. It does not mean uninterrupted active work by that person. A workable arrangement defines tasks, night needs and cover during breaks and absences.
Distinguish support and nursing
Companionship, meals, housework and everyday assistance can form a support assignment. Nursing tasks need separate professional assessment and suitable staff; living in the home does not provide a nursing qualification.
| Requirement | Record in the staffing plan |
|---|---|
| Active everyday help | Tasks and planned time |
| Night support | On-call cover, interventions or awake night duty |
| Nursing | Qualified staff and handover to nursing services |
Presence is not continuous work
One person cannot provide continuous active care. Establish who covers breaks, rest periods and staff changes.
A rotation over several weeks does not explain availability within each day or night. Check both levels. If relatives cover gaps, their agreement and practical availability must be explicit.
Describe night requirements clearly
Distinguish occasional on-call cover, planned short assistance and continuously awake night duty. These require different staffing plans. Initial enquiries need only the type of support, without diagnoses or health diaries.
If requirements are undecided, arrange assessment. Regular night work should not be hidden under the word on-call. Agree when the plan and price will be reviewed as workload changes.
Clarify the employer role
Direct household employment, placement and staff leasing are different models. Ask who employs the worker and handles pay, social insurance, time records and cover. A placement service does not automatically assume those responsibilities.
Swiss rules distinguish employment models. Ask for an explanation of applicable working and rest arrangements and necessary permissions. A low package price does not replace this check.
Prepare accommodation and daily routines
Check that suitable separate accommodation and agreed meals are available. Discuss privacy, household rules and key handling. If accommodation needs preparing, include that in the start plan.
Communication and mutual expectations matter too. Discuss language needs, introductions and staff changes without putting private personal circumstances in the initial enquiry.
Compare total costs rather than package prices
Request an itemised total for the same support plan. On-call cover, night duty, coordination, travel, rotation, food and accommodation may add to active help. Check inclusions and amounts payable separately or directly to the worker.
| Item | Clarify before agreeing |
|---|---|
| Staffing and cover | Covered times and absence cover |
| Accommodation and travel | Provision, costs and payment arrangements |
| Additional nursing | Separate assignment and billing |
| Ending the arrangement | Minimum term, notice and final settlement |
Arrange the start and review
Enquiry is followed by assessment, role clarification and a practical staffing plan. Agree tasks, contacts, cover and secure exchanges between services before starting. Health or insurance documents belong in subsequent protected professional discussions.
Arrange an early review: do routines work, are there gaps and does billing match the agreed scope? Clear change procedures prevent extra duties becoming unagreed permanent on-call work.
Frequently asked questions
Does one worker actually work 24 hours?
No. Clarify active work, on-call cover, rest and additional staffing in the plan.
Does support automatically include clinical nursing?
No. Nursing tasks need professional assessment and a separate agreement with suitable services.
Can I request short-term cover?
Yes. State the planned duration and check minimum terms, availability and cover. Partial weeks can be specified.
Does a live-in worker need a room?
Suitable accommodation must be agreed for a live-in arrangement. If it is unavailable, clarify alternatives before committing.
Are direct employment and staff leasing the same?
No. Employer roles and applicable rules differ. Obtain written clarification of responsibilities for your arrangement.
Does insurance pay for all support?
There is no such guarantee. Support, housework and separately arranged nursing differ; clarify individual funding before relying on a net cost.
