24-Hour Home Care in Richmond, VA
Continuous, around-the-clock non-skilled personal care, attentive monitoring, and companionship delivered by a dedicated team of alert caregivers across coordinated shifts — under ongoing Registered Nurse oversight.
Is this the right fit for your family?
- Individuals living with advanced Alzheimer's disease, dementia, or cognitive impairment requiring constant awake supervision to prevent wandering, elopement, and confusion
- Seniors recovering from major orthopedic surgery, stroke, cardiac events, or severe illness who need hands-on assistance day and night during acute rehabilitation
- Aging adults at extreme risk for falls, disorientation, or balance instability who cannot safely be left unattended at any hour of the day or night
- Individuals with severe mobility impairment, progressive neuromuscular conditions, or bed-bound status requiring scheduled repositioning and personal care
- Families seeking compassionate non-medical presence and comfort support around the clock alongside hospice care during a loved one's final journey
- Exhausted family caregivers facing physical collapse from providing 24/7 care who need a professional, coordinated care team to take over
When families usually reach out.
Care tailored to every stage of need.
Explore how our support adapts to different care requirements, ensuring complete clarity without confusion.
Daytime Assistance + Awake Overnight Vigilance
Targeted support for daytime tasks with dedicated nighttime safety monitoringDesigned for seniors who are relatively stable during the day but face severe nocturnal fall risks, nighttime disorientation, sundowning restlessness, or need hands-on assistance getting to the bathroom at night. A daytime caregiver assists with morning hygiene, meals, and mobility, while an awake overnight caregiver monitors the home from 10:00 PM to 6:00 AM.
- Assistance with morning bathing, dressing, and breakfast preparation
- Midday companionship, hydration tracking, and scheduled medication reminders
- Evening bedtime routine, transfer into bed, and locking all exterior doors
- Awake overnight supervision with 30-minute safety checks
- Immediate physical support for midnight bathroom visits or commode use
- Soothing reassurance during moments of nighttime confusion or restlessness
Two 12-Hour Continuous Coordinated Shifts
Comprehensive 24/7 coverage with two dedicated caregivers dailyIdeal for post-surgical rehabilitation, acute illness recovery, or moderate-to-advanced mobility limitations. Two alert caregivers split the 24-hour cycle (e.g., 7:00 AM to 7:00 PM and 7:00 PM to 7:00 AM), ensuring someone is alert and attentive at all hours. Caregivers conduct a standardized shift transition to maintain unbroken routine consistency.
- Complete physical assistance with bathing, dressing, grooming, and skin hydration
- Transfer assistance using gait belts between bed, lift chairs, wheelchairs, and commodes
- Preparation of three fresh, nutritious meals plus snacks and hydration cueing
- Timed medication reminders synchronized with discharge physician orders
- Scheduled turning and repositioning every 2 hours for bed-bound clients
- Continuous shift handoff documentation reviewed daily by our supervising RN
Three 8-Hour Specialized Shift Rotation
High-acuity, intensive 24/7 care with peak alert staffingRecommended for high-acuity situations such as advanced dementia with wandering and severe elopement risks, complex multiple chronic conditions, or end-of-life comfort care. Three coordinated 8-hour shifts (6:00 AM–2:00 PM, 2:00 PM–10:00 PM, 10:00 PM–6:00 AM) ensure caregivers remain at peak mental and physical alertness throughout every hour of the day and night.
- Continuous visual monitoring to prevent exit-seeking, elopement, or falls
- Gentle de-escalation, validation communication, and sensory redirection
- Incontinence care and meticulous skin barrier protection across all shifts
- Coordination with visiting home health nurses, physical therapists, or hospice teams
- Daily shift audits and weekly clinical reviews conducted by our Registered Nurse
- Total peace of mind for family members who cannot be physically present
Detailed breakdown of care activities.
Everything you need to know about the daily tasks, assistance, and support covered under this service.
Daytime Care & Morning Routines (6:00 AM – 2:00 PM)
Focuses on launching the day with dignity, warmth, and safe physical assistance. Caregivers help seniors transition smoothly out of bed, complete personal hygiene, enjoy wholesome nutrition, and engage in meaningful activities.
- Safe bed-to-standing transfers and gentle morning mobility stretching
- Hands-on assistance with showering, tub bathing, hair care, and shaving
- Assisting with wardrobe selection, buttoning, compression stockings, and footwear
- Cooking fresh breakfast and lunch aligned with dietary guidelines and chewing needs
- Morning medication reminders and fluid intake tracking
- Accompaniment on gentle walks in the garden or living room mobility exercises
Afternoon & Evening Care (2:00 PM – 10:00 PM)
Focuses on maintaining momentum, managing late-afternoon energy dips and sundowning agitation, preparing dinner, and establishing a relaxing, secure bedtime routine.
- Nutritious dinner preparation, table companionship, and kitchen sanitization
- Engaging cognitive activities, listening to music, reminiscing, or folding laundry
- Managing sundowning anxiety with soft lighting, calm music, and warm herbal tea
- Evening personal hygiene, dental/denture cleaning, and changing into sleepwear
- Evening medication reminders and logging daily nutritional totals
- Assisting into bed with proper pillow positioning and ensuring call bell access
Awake Overnight Vigilance (10:00 PM – 6:00 AM)
A dedicated awake night caregiver remains alert throughout the nocturnal hours to provide immediate assistance, prevent falls, and give family members restorative sleep.
- Quiet, non-intrusive safety checks conducted every 30 to 60 minutes
- Immediate physical hands-on support for midnight bathroom visits or commode use
- Managing incontinence hygiene promptly to protect skin integrity and comfort
- Gentle repositioning in bed to relieve pressure points and optimize breathing
- Securing exterior doors, windows, and checking home security perimeters
- Preparing morning coffee and providing a verbal shift handoff to the incoming caregiver
RN Clinical Oversight & Shift Coordination
Our Registered Nurse leads the 24-hour care team, ensuring that every shift adheres to Virginia Department of Health regulations and clinical best practices.
- Initial comprehensive in-home nursing assessment and customized Plan of Care creation
- Standardized shift handoff logs audited daily to detect subtle health changes
- Regular supervisory home visits conducted during daytime, evening, and night hours
- Direct communication with family members, primary physicians, and hospice teams
- Immediate care plan updates whenever mobility or cognitive needs change
Everything covered under this service.
- Continuous 24-hour awake coverage structured across coordinated daytime, evening, and overnight shifts
- Dedicated small team of familiar Certified Nursing Assistants (CNAs) and Personal Care Aides (PCAs) assigned for continuity
- Full assistance with morning, afternoon, and bedtime personal hygiene, bathing, dressing, and grooming
- Discreet toileting assistance, commode support, and scheduled incontinence management throughout day and night
- Safe transferring support, ambulation guidance, and scheduled turning/repositioning for bed-bound clients
- Nutritious meal preparation, dietary adherence, hydration prompting, and pleasant mealtime accompaniment
- Timely medication reminders according to physician schedules and pre-filled organizers across all shifts
- Light household upkeep, kitchen sanitization, client laundry, bed linen changes, and keeping clear pathways
- Structured shift handoffs with detailed daily documentation logs reviewed continuously by our supervising RN
- Comprehensive Registered Nurse oversight, ongoing care plan audits, and 24/7 on-call clinical escalation support
How this service compares to other care levels.
24-Hour Shift Care vs. Live-In Care
In 24-Hour Shift Care, alert caregivers rotate in 8-hour or 12-hour shifts so someone is awake and actively watching all night. In Live-In Care, a single caregiver resides in the home and sleeps 8 hours overnight. 24-Hour Care is essential for frequent nighttime waking, wandering, or high medical acuity.
24-Hour In-Home Care vs. Facility Placement
24-Hour home care provides dedicated one-on-one attention in familiar home surroundings, whereas assisted living and memory facilities often have staffing ratios of 1 caregiver to 8–15 residents at night. Home care preserves personal routines and eliminates the trauma of relocation.
Non-Skilled 24-Hour Care vs. Skilled Home Health
Skilled home health provides intermittent, brief visits (30–60 minutes) by visiting nurses or physical therapists ordered by a doctor. Archangels provides continuous, hands-on personal care, transferring, meals, and supervision for 24 hours a day between those medical visits.
A realistic look at a visit.
A Full 24-Hour Cycle of Coordinated, Attentive Support
At 7:00 AM, the daytime CNA arrives, receiving a verbal handoff from the overnight caregiver regarding sleep quality and 3:00 AM bathroom assistance. The daytime caregiver assists the client with a warm shower, prepares oatmeal and fruit, offers morning medication reminders, and engages him in a crossword puzzle before taking a guided garden walk. At 3:00 PM, the evening caregiver arrives, taking over dinner preparation, assisting with evening hygiene, and establishing a calm bedtime routine with soothing music. At 11:00 PM, the awake overnight caregiver begins her shift, conducting quiet safety checks every thirty minutes, assisting immediately when the client wakes to use the commode at 2:30 AM, and ensuring he returns to bed safely without a fall. The supervising RN audits the full 24-hour log each morning to ensure flawless continuity.
Getting started, step by step.
Urgent or Planned 24-Hour Consultation
Call 804-903-8133 to speak with our care coordinator. We assess your loved one's 24-hour care requirements, discharge timelines, shift preferences, and immediate safety concerns.
Comprehensive In-Home RN Assessment
Our Registered Nurse completes an in-depth evaluation of physical mobility, cognitive status, nocturnal habits, fall risks, and bathroom layouts to design a 24-hour Plan of Care.
Assembly of a Dedicated Care Team
We hand-select a small, cohesive team of 3 to 5 credentialed CNAs and PCAs matched to your loved one's personality and trained on the specific requirements of the care plan.
Coordinated Shift Implementation
Care begins on a structured shift schedule (such as three 8-hour or two 12-hour shifts). Every shift transition includes standardized handoff notes to maintain unbroken continuity.
Continuous RN Oversight & Plan Optimization
Our Registered Nurse regularly reviews shift logs, conducts supervisory visits across day and night shifts, and adjusts care levels as recovery or health conditions evolve.
How we deliver this service.
When an aging loved one requires around-the-clock attention due to advanced dementia, severe fall risks, post-surgical recovery, or acute physical frailty, family caregivers often find themselves pushed past the point of physical exhaustion. Attempting to manage nighttime wakefulness alongside daytime caregiving is unsustainable and dangerous for both the senior and the family. At Archangels Personal Care LLC, our 24-Hour Home Care service provides a complete, professional care solution that keeps seniors safe and comfortable in their own homes 24 hours a day, 365 days a year.
The defining advantage of our 24-hour care model is our awake, shift-based structure. Rather than relying on a single 'live-in' caregiver who must sleep at night, our 24-hour care is delivered by a coordinated rotation of caregivers working structured shifts—typically two 12-hour shifts or three 8-hour shifts. This ensures that the caregiver in your home is always rested, mentally alert, and actively monitoring your loved one's safety, whether it is 2:00 PM on a Tuesday or 3:00 AM on a Sunday.
Continuity of care is paramount when establishing around-the-clock support. We recognize that having unfamiliar strangers rotating through the house creates anxiety, especially for seniors with cognitive decline. We carefully assemble a small, dedicated core team of 3 to 5 Certified Nursing Assistants (CNAs) and Personal Care Aides (PCAs) who are specifically assigned to your family. Over days and weeks, these caregivers build deep rapport, learn your loved one's subtle non-verbal cues, and understand their unique daily preferences.
A seamless handoff protocol connects every shift. At each transition, the outgoing caregiver briefs the incoming caregiver on the client's mood, meals consumed, hydration, medication reminders, personal hygiene completed, and any physical or behavioral changes observed. Every shift maintains detailed care logs that document vital daily metrics. This rigorous communication ensures that no detail slips through the cracks between day and night.
Under the leadership of our Registered Nurse, 24-hour care plans receive continuous clinical oversight in full compliance with Virginia Department of Health regulations. The RN analyzes shift documentation daily, looking for subtle patterns such as increased nighttime restlessness, reduced fluid intake, or changes in transfer stability. The RN conducts regular in-person supervisory visits, audits caregiver performance across different shift windows, and serves as the primary liaison to family members and treating physicians.
Our 24-hour care plans are designed to be flexible and adaptive. Many clients begin 24-hour care following a major orthopedic surgery, stroke, or prolonged hospitalization. As rehabilitation therapies progress and physical independence is regained, our RN reassesses the client and collaborates with the family to gradually step down coverage to 12-hour day shifts or morning/evening visits. Conversely, for progressive conditions, our team provides the reliable long-term safety net families need to keep their loved ones comfortably at home for life.
What sets our care apart.
Alert, Rested Caregivers at All Hours
By utilizing rotating shifts rather than an exhausted single caregiver, our team remains fully awake, energetic, and vigilant throughout the night.
Consistent Team of Familiar Faces
We assign a small, dedicated core team of caregivers to your loved one's schedule, ensuring familiarity, comfort, and deep understanding of personal habits.
Flawless Shift Handoff Protocols
Standardized shift documentation and verbal transitions ensure that every detail—from appetite to nighttime bathroom trips—is accurately communicated.
Scalable as Recovery Progresses
Start with 24-hour care after a hospital discharge and scale down to 12-hour or daytime visits as strength returns, with no rigid long-term contract penalties.
24-Hour Home Care in Richmond, VA FAQ
What is the difference between 24-Hour Care and Live-In Care?
24-Hour Care utilizes rotating shifts of awake caregivers (such as two 12-hour or three 8-hour shifts) so that an alert caregiver is actively monitoring the client at all times, including through the night. Live-In Care involves a single caregiver who resides in the home and requires a private bedroom and 8 hours of uninterrupted sleep each night. 24-Hour Care is recommended for clients with high overnight care needs, frequent nighttime waking, or severe wandering risks.
Does the overnight caregiver stay awake all night?
Yes. In our 24-Hour Care model, the overnight caregiver is an awake shift worker whose sole responsibility is to remain attentive, conduct quiet regular safety checks, assist with midnight toileting, and respond immediately if the client wakes or calls for help.
How many different caregivers will be assigned to my loved one's 24-hour team?
We intentionally build a small, consistent team of 3 to 5 primary caregivers who rotate across the weekly schedule. This maintains high continuity and familiarity while preventing caregiver fatigue and ensuring reliable coverage for sick days and holidays.
How quickly can 24-hour care be arranged for an unexpected hospital discharge?
We specialize in rapid-response transitions. In many cases, we can complete an RN assessment and mobilize a 24-hour care team within 24 to 48 hours of your call—often coordinating directly with hospital discharge planners to have caregivers ready the moment your loved one arrives home.
How do caregivers communicate information between shifts?
Our caregivers participate in a verbal shift handoff and maintain standardized written care logs documenting personal hygiene, meals, hydration, mobility, and medication reminders. The supervising RN reviews these logs regularly to maintain total clinical alignment.
Can we start with 24-hour care and reduce hours as my loved one recovers?
Absolutely. Our care plans are completely flexible. Many clients require 24-hour care during the first two to four weeks post-surgery and then step down to 8 or 12 hours of daytime care as strength improves, with no cancellation fees or contract penalties.
Can 24-hour care support a loved one receiving hospice care at home?
Yes. We frequently provide 24-hour non-skilled comfort care and continuous presence alongside licensed hospice teams. Our caregivers manage around-the-clock personal hygiene, gentle repositioning, and companionship, allowing family members to focus on being loving family during final days.
What tasks are included in overnight 24-hour care?
Overnight tasks include assisting with bedtime routines, preparing the client for sleep, repositioning in bed to prevent pressure points, providing immediate physical support for bathroom trips or commode use, managing incontinence care, monitoring breathing and comfort, and preparing breakfast when morning arrives.
Is 24-hour care covered by Medicare or standard health insurance?
Non-skilled 24-hour home care is typically paid privately or through Long-Term Care Insurance (LTCI) policies and VA Aid & Attendance benefits. Medicare generally does not cover continuous non-skilled custodial home care. We provide itemized documentation to assist with LTCI claims.
How does the Registered Nurse oversee a 24-hour care case?
Our RN conducts the initial in-home assessment, writes the comprehensive 24-hour Plan of Care, trains the assigned caregiver team, performs regular in-person supervisory visits during various shift times, audits daily shift logs, and communicates regularly with family and physicians.
Other ways we can help.
You Don't Have to Navigate Care Alone
Our team is available 24 hours a day to answer your questions and help you explore a care plan built around your family's needs.