After you’ve made the decision to bring in additional in-home caregiving support, and researched the various kinds of home care or home health professionals that may be appropriate to your situation, the next step is actually finding that help! This process can be very bewildering. Here are our recommendations for finding reputable help.
Word of Mouth
Your family, friends, neighbors, associates, and existing healthcare providers are great sources of recommendations for in-home caregiving support. Your inner circle has already earned your trust and will have had firsthand experience to speak to reliability and competency.
If the patient has been in the hospital, the facility’s discharge planner can also be useful.
Remember that if you choose to hire a word-of-mouth-recommended caregiver directly – not through an agency – you will want to do a background check and get multiple references.
The importance of background checks and references
Facebook, Nextdoor, and similar sites often contain posts or community groups offering caregiving. In our opinion, social media can range from a valuable resource to the wild west. Unfortunately, social media is an avenue for online scammers, and even people who aren’t technically scammers may not necessarily be safe.
The person you are hiring to be an in-home caregiver will be in your home, taking care of a vulnerable person you love, and potentially have access to private and sensitive information. We’ve provided some guidance on how to search from local resources, but we still stand by our advice in getting a thorough background check and verifying all references.
Local Senior Centers and Aging Services Organizations
Community resources such as local health departments, senior centers, and Area Agencies on Aging (specifically their Aging and Disability Resource Centers) can be very helpful in connecting you with reputable caregivers. Many local agencies have extensive networks and can recommend qualified professionals. Also, Centers for Independent Living (CIL) usually maintain a directory of caregivers and personal care attendants. You can find your local CIL here.
The Family Caregiver Alliance has a lot of very useful information, including a state by state listing of available resources, centers, and organizations.
Online Caregiver Matching Platforms
Websites like Care.com, Caregivers.com, and AgingCare.com function as matchmaking services for people seeking carers and home health service providers. You can specify your location, job description, and qualifications. Sometimes these services have conducted background checks, but be sure to verify. Be aware that they will ask you for your contact information, including phone number and email. AgingCare.com is owned by A Place for Mom, and shares your information in the same way, so reviewing any services privacy policy before you provide your personal information is the right idea.
Online Searches for Agencies
For home care agencies in your area providing in-home care, the trusty internet search is always an option. You will find not only local agencies, but also local franchises of the national chains such as Right at Home, Home Instead, BrightStar Care, Senior Helpers, and more. Some of the agencies provide personal caregivers only, others provide home health care, and some provide a combination of the two.
When contacting a home care (or home health) care agency you find via search, be sure to ask
- About the qualifications of the caregivers they list
- Whether they have done background checks
- If the carers are licensed and bonded
- If the agency is the employer of record or if you will be
- If they are Medicare or Medicaid certified
Additionally, it is a very good idea to use “word of mouth” here and ask for references from patients and families that have used the agency. While the franchises may carry a national name, they are still run locally, and the quality of service may vary.
Information on Medicare- or Medicaid-certified agencies
Any home care agency that is Medicare or Medicaid certified is held to strict federal regulations regarding caregiver qualifications, standards of practice, and record keeping. The Center for Medicare & Medicaid Services (CMS) requires that agencies maintain documentation that each of the Medicare certification standards have been met.
Some states have little to no regulation over non-medical home care providers. Many states require that a home care organization fulfill certain requirements and be licensed by that state.
Any agency that is CMS certified will also be required to be licensed in the state(s) it operates. Generally, you can find information about your state’s requirements (which for aides include things like a clean background check, a valid driver’s license, and certification of skills) on your state’s Department of Health website; often you will find a directory of licensed home care organizations there as well. In the absence of state licensing or CMS certification, agencies themselves determine qualifications, training, and services.
If you anticipate Medicare or Medicaid paying for any part of the in-home care, you must use an agency certified by the Center for Medicare & Medicaid Services.
Use Medicare-Certified Home Health Aide Requirements as a Starting Place for Questions
Even if the home health care agency you choose is not CMS certified, it may be helpful to use the requirements for Medicare-certified home health aides so you can ask what qualifications the agency requires and what training it provides.
To be Medicare-Certified, a home health aide must:
- Have completed at least 75 hours of training, including a minimum of 16 hours of classroom training followed by a minimum of 16 hours of supervised practical training
- Have passed a competency evaluation
- Be in good standing in the nurse-aide registry
- Have 12 hours of in-service training during each 12-month period.
- Participate in training programs that focus on the skills necessary to provide quality care and train aides to observe, communicate, and report information about the patient’s status to the family, the agency and fellow caregivers.
It is important to inquire about qualifications, specialized skills, and responsibilities at each agency to understand what standards they are adhering to. The Medicare-certified requirements give you a list of questions to start your research with.
Learn more about the duties of home health aides and other types of home care professionals.
Geriatric Care Managers
You may also have access to a professional whose role it is to evaluate and arrange for the right type of care at home and help create plans of care with you. These professionals can help remove some of the weight from your shoulders in stressful times.
This wonderful service has many names: Certified Senior Advisor, Geriatric Care Manager, Gerontologist, or Aging Life Care Professional. We will call them “geriatric care managers” for simplicity.
A geriatric care manager may assess needs and coordinate care, find, interview, and conduct background checks on caregivers, make referrals to other providers, identify programs that patients or families may qualify for, answer questions, serve as a liaison to far-flung family members, and provide general advocacy and counseling. For busy caregivers, particularly children living away from the parents they are caring for, geriatric care managers can be truly sanity-saving. This article from AARP provides more information.
Geriatric care managers may be found through word of mouth, the local resources that we described, or through their professional association directory — Aging Life Care.
Geriatric care managers often embrace this role as a second career phase, having begun as a healthcare professional or social worker. and They often maintain certifications in their original field.
Three nonprofit organizations — the Commission for Case Manager Certification in Mount Laurel, New Jersey; the National Academy of Certified Care Managers in Tucson, Arizona; and the National Association of Social Workers in Washington, DC — offer certification programs. All require specialized degrees, experience, and successful completion of an examination.
Neither Medicare, Medicaid, Medigap, or Medicare Advantage plans pay for geriatric care managers. Some long-term care insurance plans may pay, as may some employee assistance programs. Geriatric care managers charge by the hour and their services can become expensive. Get references, check their credentials, and talk about estimated costs up front.
Summary of the Ways to Find In-Home Care
| Source of finding paid in-home care | Examples | Services | Pros/Cons | Source’s responsibility | Your responsibility |
|---|---|---|---|---|---|
| Word of mouth | Friends and family | Recommend caregivers | Personal recommendation, not systematic | None | Background check, carer contract, payroll and taxes |
| Recommendations from local sources | Area Agency on Aging Senior Center Local Center for Independent Living | May recommend individual carers or agencies | Know the local landscape | None | Background check, carer contract, payroll and taxes |
| Apps/websites | Care.com, Caregivers.com | Connect with available caregivers May offer payroll service: Homepay.com | Carers available, may have references/must create account, share personal information | Usually perform background check | Carer contract, payroll and taxes |
| Professional in field | Geriatric Care Manager, Aging Life Care Manager, Aging Life Care Professional, Gerontologist | Advise on care plan. Services may include advertising for and screening carers, background checks, onboarding with payroll company, scheduling caregivers, and ongoing consultations as needs change | Personalized care plan, more control, ongoing input, can directly hire carers if choose with knowledge they have been verified/pay professional in addition to carers | Agreed upon tasks, including caregiving contract with each carer, keeping records of their activities, communicating with carers and you | Determining who is employer of carers, communicating clearly with professional |
| Agencies—companion and personal care Agencies—Home Health Agencies—Both Personal and Home Health | Right at Home Home Instead BrightStar Care Senior Helpers | Provide carers in home. Some provide in-home consultation and care planning | Carers verified, often bonded, may offer training, agency responsible for compliance with state law and taxes/expensive, agency takes as much as 50% of hourly fee, not as much control over who comes | Background check, Credential verification, may be employer of record, responsible for taxes and reporting | Specifying what you want/need, instructing carer, paying agency Verify that agency is Medicare or Medicaid certified if those programs will be paying for home care. Verifying employment status of carers—you or the agency? |
| Provider associations | The National Alliance for Care at Home | Provide a directory of member agencies | Providers included in directory attest to high-quality care; directory is not comprehensive and some providers in your area may not be listed | Members of National Alliance for Care at Home | Finding a provider in your area, confirming they offer the type of home care you need, and contacting the provider to determine eligibility for care, if applicable. |
The Alliance can help you find the help you need
The National Alliance for Care at Home (the Alliance) is the largest professional association representing care-at-home providers. We maintain a searchable directory of our members called Find a Provider. This database includes private duty home care, Medicaid HCBS, home health, palliative, and hospice care providers, all of which have attested to high-quality care provision. Use Find a Provider to filter by care type and search for a provider in your area.
Understanding the costs and how to pay for a home care agency or independent professional can feel as daunting as finding that help. There are many options to pay for care, including Medicare and Medicaid. Learn more about how in-home care can be paid for.
