What do you for night time care when parent wants to live at home?

There are several options depending on the available resources.

My great-aunt lived to 99 with all her cognitive functions completely intact but grew physically frail. Her younger sisters (in their late 80s to mid 90s) could be counted on to visit and phone during the day. In my college years, I visited 1-2 afternoons a week for family stories. Her younger brother (my paternal grandfather) died before I was born; so I enjoyed seeing her photo albums and hearing about my great-grandparents and their household with 10 children. My aunt's three daughters daughter rotated bringing or cooking a supper and spending the night with their mother from about age 97; occasionally another family member would stay a night or two when someone was on vacation or ill.

Two of her younger sisters also lived to 99 (6 of 7 girls lived to at least 93, one died in a car accident at 53, boys died at ages 63-78). One only had a single surviving son by the time she needed some overnight help, but she had provided a home for dozens of diminished capacity adults (brain injury or downs syndrome) over 4 decades and had 2 women still living with her who could help her or call someone if more help was needed than they could provide. In home help was hired for the third sister to serve a supper, assist in bedtime routine and remain in the house overnight.

So three basic in home options are:
1) family rotates to provide overnight care;
2) roommate or guest lives in to provide overnight care; or
3) hired care giver is engaged for overnight care.

Unless extraordinary financial resources are available, at some point AL or MC becomes a more affordable way to provide assistance on demand in something as close to a home like setting as possible.

The OP added some additional helpful info which I will post here:
"I live an hour away and drive up 3 times a week. My sister helps me the rest of the week. We do have private care and they are employees. I have used agencies and they tend to just send a warm body. Our employees are great. My dad has been recovering from brain injury and in the beginning we had an RN and an HHA with him 24/7. He is now at a point where I don't believe he needs an RN (only for meds, which I can have an employee give him) at night anymore. I do feel that he needs someone there overnight though. He has is does have much of his mind and I have approached him about assisted living but he will have no part of it. This has been the hardest thing I have every done but I love him and feel it is something I need to do for him. I am so happy to have found this forum where I can talk to people in the same situation."

dmoc, are you managing his care long-distance? How old is your father? Does he have dementia/ALZ, or Parkinsons? I am not in your situation but I'm asking those other questions because if he has all or much of his mind, he may get more socialization at a care community, plus all the medical attention he needs, for less money. Are you hiring the caregivers privately, or through an agency? If privately then you probably already know that this makes you an employer and responsible for a contract, and anything else FL requires when you have employees. If an agency, then you may or may not know that 24/7 care can (and usually does) exceed the costs of a good facility. I totally understand that parents rarely want to leave their homes, but what is he gaining by being by himself there? And, as his PoA (I'm assuming), is this arrangement acceptable to you? The arrangement has to work for both of you, especially if you are still working and have a partner and family in the home. There isn't necessarily a right answer, just one that works for the both of you, to the best of your ability to make that judgment. May you gain peace in your heart and a clear answer to your question!