A woman holding some papers and sitting on a couch is talking to an older adult man and woman who are seated in the foreground with their backs to the camera.
Before hiring a home care agency, it’s important to ask the right questions. Here’s what families should know to make a confident, informed decision. Photo Credit: iStock.com/Ridofranz

The realization that an older loved one is having trouble caring for themselves and needs help can be upsetting. In these stressful moments, it’s difficult to know how to proceed. Hiring a home care agency helps families ensure their loved one will be cared for while living in their home, surrounded by their own familiar and much-loved belongings. 

Knowing you need to find good home care and knowing how to go about that task are quite different things. A good place to start is to think about your loved one’s most important needs and how they and you would like them to be met. You’ll likely talk with several agencies, so having a list of your most important questions at hand will help you learn about and compare them to find the best fit. We’ll get you started with a list of ideas for what to ask.

If possible, involve your loved one in the interview. This not only helps them feel respected, but it can also reveal priorities you hadn’t considered. 

1. What experience, qualifications, and training do caregivers have?

Home care agencies often provide their own initial and ongoing or periodic training. Ask what their training includes. Good things to look for are:

Certifications like HHA (home health aide) or CNA (certified nursing assistant) also indicate a dedication by both the caregiver and the agency to caring for their clients.

2. How are caregivers screened and vetted? Is screening done only at first hiring, or is it repeated periodically?

Ask the agency if they perform the following as well as what would disqualify a caregiver:

  • State and federal background checks.
  • Employment history and references.
  • Driving records if they provide transportation.
  • Health screening or certification.
  • Abuse and neglect registry checks.
  • Does the agency have a fidelity or honesty bond (a type of insurance that protects against theft or dishonest acts) in place?

3. How does the home care agency supervise and support the caregivers?

The home care agency should supervise caregivers regularly and review input from caregivers, clients, and families. Ask about the following:

  • Do supervisors conduct impromptu home visits to observe caregivers and clients in the home setting?
  • Does the agency check in with caregivers on a regular basis?
  • Do caregivers provide a summary of each home care visit with detailed notes on anything significant or of concern?
  • Are agency supervisors readily available for caregivers to consult if questions arise about a client’s care?

4. What happens if there’s an emergency?

If your loved one has a fall, injury, or other medical emergency, the caregiver should have a defined protocol for providing immediate aid and summoning emergency help. Find out what the agency’s procedures are for emergency situations.

  • Are caregivers trained to recognize emergencies and respond quickly?
  • What steps should caregivers take if the client falls or suddenly feels ill?
  • Does the agency require caregivers to call 911 immediately in life-threatening situations?
  • Are caregivers equipped with emergency contact information and medical history?
  • How does the agency notify family members in an emergency?

5. How does the home care agency communicate with the family?

Clear, timely communication is key to ensuring everyone stays informed and involved in your loved one’s care.

  • Will caregivers check in with family members regularly or only when there’s a concern?
  • What methods do they use for communication (phone calls, texts, emails, or an online portal)?
  • How is client and family feedback handled?
  • How quickly can you expect a response if you reach out with concerns?

6. How does the agency match caregivers to clients?

A good personality match can make a world of difference in how your loved one feels about accepting help. Ask how the agency learns about your loved one’s personality, preferences, and routines and how they use that information to match them with a caregiver.

  • Does the agency send the caregiver to meet the client before regular visits begin?
  • Will they change caregivers if the personalities don’t mesh?
  • Do they try to keep the same caregiver for consistency and trust?

7. What services are included (and excluded) in the care plan?

Not every agency offers the same scope of services, and “full service” can mean different things. Ask for a clear list of what the caregiver will and will not do, including:

  • Personal care (bathing, dressing, grooming).
  • Meal preparation and feeding assistance.
  • Transportation to appointments or errands.
  • Light housekeeping or laundry.
  • Medication reminders. (Note: Administering meds may require special licensing.)

By specifically asking about the services that are not included in your loved one’s care, you can create a personal to-do list ahead of time. For example, when you talk about medication, the agency may tell you that the caregiver is allowed to verbally remind your loved one that it’s time to take their medication, but they aren’t allowed to dispense the meds. Knowing that you need to set up pillboxes with the day of the week and time of day is helpful.

8. How flexible is the scheduling?

Your loved one’s needs may change. Flexibility in hours, frequency, and duration of visits can help avoid care gaps.

  • Can hours be increased or decreased without penalties?
  • Is there a minimum number of hours per visit or per week?
  • Can the agency provide temporary extra help after surgery or illness?

9. What should I know about costs and contracts?

Understanding the financial side up front can help prevent surprises later, especially since Medicare typically does not cover home care except under very specific circumstances and only for a short time.

  • What are the agency’s hourly rates? Are there different rates for nights, weekends, or holidays?
  • Are there any fees for cancellations or changes in schedule?
  • What services are included in the contract, and what might cost extra?
  • What is the agency’s policy on payment methods and billing frequency?

10. How are the client’s preferences and routines respected?

The best care honors the way your loved one has lived their life. Ask how caregivers adapt their approach to fit the client’s daily habits and comfort level.

  • Do they learn preferred meal times, hobbies, and social activities?
  • Can they adapt to cultural, dietary, or religious preferences?
  • Will they involve the client in small decisions whenever possible?

Even with the right questions in hand, the process can feel overwhelming, especially if your loved one resists the idea of home care. Staying calm, listening closely, and observing both verbal and nonverbal cues from the agency representative can help you spot a good fit.

Once you have answers to these and other questions you may have, you’ll feel more confident in making the important and loving decision to hire a home care agency.