Live-In Caregivers in Spearfish, SD: 24-Hour Home Care

Local figures

Live-In Caregivers in Spearfish, SD: the local picture

421

residents 85 or older (3.3% of all residents)

1,002

households headed by someone 65+ own their home (57%)

52%

of Spearfish homes have 3 or more bedrooms (59% in Lawrence County)

$11.85

South Dakota minimum wage per hour

About 421 Spearfish residents are 85 or older. Live-in care is most often arranged for this age group, when help is needed through the day and someone should be close at night.

A live-in caregiver needs a private room. 52% of homes in Spearfish have three or more bedrooms (59% in Lawrence County), while 18% have one bedroom or none, where live-in care rarely works; the median home has 5.1 rooms.

Of Spearfish households headed by someone 65 or older, 1,002 own their home and 760 rent; among householders 85 and older it is 247 owners and 85 renters. Renters should check that the lease allows another adult to live in before anyone moves in.

Spearfish compared with Lawrence County and South Dakota

Census figure	Spearfish	Lawrence County	South Dakota
Residents 85 or older	3.3%	2.7%	2.1%
Residents 65+ in households who live alone	35%	28%	30%
Residents 65+ with a disability	30%	33%	31%
Residents 65+ below the poverty line (approx.)	12%	12%	10%
Residents 65 or older	21%	25%	18%
Residents 5+ who speak a language other than English at home	4.3%	4.7%	7.1%
Median income, households headed by someone 65+	$57,813	$58,472	—

Older residents in towns around Spearfish

Town	Distance	Residents 65+	Residents 85+
Lead, SD	9.9 mi	818	102
Belle Fourche, SD	12 mi	1,117	149
Sturgis, SD	17 mi	1,375	187
Summerset, SD	31 mi	248	29
Blackhawk, SD	33 mi	550	26
Colonial Pine Hills, SD	41 mi	793	13

Emergency hospitals near Spearfish

Hospital with an emergency department	Town	Distance	CMS overall rating	Phone
Monument Health Spearfish Hospital	Spearfish, SD	2.4 mi	4 of 5	(605) 644-4000
Monument Health Lead-Deadwood Hospital	Deadwood, SD	9.0 mi	not rated	(605) 717-6000
Va Black Hills Healthcare System	Fort Meade, SD	19 mi	5 of 5	(605) 347-2511

Straight-line miles from the center of Spearfish. Medicare (CMS) data, October 2026; call ahead to confirm. We are not affiliated with these providers.

What it covers

What a live-in caregiver can help with

Help across the day: meals, housekeeping, personal care
Someone in the home overnight if help is needed
Medication reminders and appointment rides
Companionship and a steady routine

Cost

What live-in care costs in Spearfish

Live-in pay is often agreed by the day or week, but every hour worked counts toward minimum wage. At $18.15 an hour (the South Dakota median aide wage), a live-in caregiver paid for 50 hours a week costs about $3,932 a month (82% of the $4,818 monthly median income of Spearfish households headed by someone 65+). Round-the-clock shift care, 168 paid hours a week across two or three caregivers, comes to about $13,213 a month (274% of the $4,818 monthly median income of Spearfish households headed by someone 65+). Private rates are agreed with the caregiver, and overtime rules can add to both. South Dakota's minimum wage is $11.85 an hour (U.S. Department of Labor table, updated July 1, 2026).

Hiring directly, you agree the rate with the caregiver and usually become the household employer (U.S. Department of Labor rules). Some families qualify for programs that pay for care at home; see Medicaid programs for family caregivers: who can be paid, and the rules in 12 states.

Before you hire

What to know before hiring a live-in caregiver

Put the arrangement in writing: hours on duty, sleep time, days off, the room and pay (federal rules: DOL Fact Sheet 79B).

Questions worth asking: Have you lived in with a client before, and for how long? What days off and sleep time do you need? How do you handle being woken at night? More in our live-in caregivers guide.

CaregiverConnect does not run background checks. Check identity, references and any certification yourself before anyone starts. The Safety Center explains how.

Questions

Live-In Caregivers in Spearfish: common questions

Where is the nearest emergency hospital to Spearfish?

Monument Health Spearfish Hospital in Spearfish, about 2.4 mi in a straight line from the center of Spearfish (Medicare hospital file). Its listed phone number is (605) 644-4000. In an emergency, call 911.

How much does live-in care cost in Spearfish?

Live-in pay is often agreed by the day or week, but every hour worked counts toward minimum wage. At $18.15 an hour (the South Dakota median aide wage), a live-in caregiver paid for 50 hours a week costs about $3,932 a month (82% of the $4,818 monthly median income of Spearfish households headed by someone 65+). Round-the-clock shift care, 168 paid hours a week across two or three caregivers, comes to about $13,213 a month (274% of the $4,818 monthly median income of Spearfish households headed by someone 65+). Private rates are agreed with the caregiver, and overtime rules can add to both. South Dakota's minimum wage is $11.85 an hour (U.S. Department of Labor table, updated July 1, 2026).

Live-in or 24-hour care in Spearfish?

A live-in caregiver sleeps in the home and has protected sleep and break time. 24-hour care uses two or three caregivers in shifts so someone is always awake; in Spearfish it costs more than three times as much a month (see the cost section above). Choose shifts if help is needed several times a night.

More near Spearfish

More senior care near Spearfish

Live-In Caregivers in nearby cities

Other care in Spearfish

More for Spearfish families

Sources

Census ACS 2020–2024 5-year; CMS provider data (October 25, 2026); U.S. DOL state minimum wages (July 1, 2026); BLS OEWS May 2025 aide wages, which cover employed aides rather than private rates.

Live-In Caregivers in Spearfish, SD