How to Choose a Home Care Agency

If you’re looking for information on how to choose a home care agency, you’ve come to the right place. 

Sometimes you have to move quickly to find a senior home care agency due to a medical emergency. Other times, you can plan ahead and thoroughly research different agencies to find the best fit for your particular situation. 

Regardless of your situation, among one of the most important care decisions will be choosing the best caregiver agency, as it impacts everyone involved, both emotionally and financially. But finding senior care that meets your needs is often easier said than done, as there are so many factors to consider.

For instance, you’ll want to know if the senior care agency you hire follows all legal requirements, from a business perspective to ensure they’re liable for their caregivers as their employees and you are not.

If your Caregiver works for you directly as an independent contractor, they may be able to sue you if they experience a physical injury on the job or if they feel they experienced other types of abuse on the job. As you are not set up as a business, you are not able to deliver legal protections created for employees through Worker's Compensation insurance and payroll benefits.


Senior home care agencies and all home health care providers, on the other hand, must hire caregivers as employees and pay their payroll taxes and worker’s compensation insurance for any injuries that occur on the job.


This is why it can be helpful to hire through a third-party assisted home care agency. It ensures you get the help you need, while also protecting you legally, as an individual. In addition, you have an experienced, professional company to manage the caregivers and the care. When you are working and perhaps living far away from a senior loved one, you are not going to be available to drop everything at 8:00 a.m. in the morning if a caregiver calls off sick. Your home care agency has the management staff and caregivers to continue to provide care, even if your main caregiver needs off at the last minute. This is especially important for seniors with memory loss, to have the benefit, for no extra cost, of an entire support care team.


Choosing a Home Care Agency Checklist

Determining how to choose a home care agency is complicated. So we’ve created this checklist to help you weed out low-quality home care agencies from the top senior home care companies in your area. Remember, the senior home care agencies provide private pay home care, as Medicare does not pay for longterm care. Home Health agencies, on the other hand, provide skilled care by R.N.'s, Speech Therapists, Physical Therapists, Occupational Therapists and is covered by Medicare for short-term care visits. 


The information below will help you properly vet the list of home care agencies you’re considering for you or your loved one. It’s essentially a checklist of all the items you’ll want to address with them.

Care Needs

First off, elderly care companies need a full rundown of all of the specific care needs you or your loved one will require. Write out a list of items that need to be provided and be ready to give an example of a typical day for the care recipient, from the moment they wake up until they go to bed.

Also include a timeline of when they prefer meals, naps, and other activities. You’ll want to ask about time minimums as well, as many agencies set a minimum hourly requirement for home visits.  Usually a 3-hour care visit is required and really you need this much time to connect with the senior and make sure everything for their daily activities is on track.

Hands-On Care vs. Companion Care

The type of care your loved one needs is also very important. Do they need hands-on care, like bathing assistance and medication management? Or, do they need more of a companion — someone to listen to them and be with them during the day? If companion care is needed, make a list of possible activities. Think about what they enjoy doing when they feel good.


Does the Caregiver Need to Help with Transportation?

Do you need a caregiver who can escort you or your loved one to doctor’s appointments and social activities? If so, what mode of transportation will they use? Does the caregiver have their own car? If so, you’ll need to ask about their insurance policy. And if they’ll need access to your or your loved one’s car, you’ll need to make sure the car insurance policy on your loved one’s car applies to other drivers.

If you’re in a city or urban area, the caregiver may be able to rely solely on public transportation. This is probably the best method to avoid any issues associated with car insurance. Some cities also provide special transportation privileges for seniors, so you may want to contact your local Department of Aging. Ride-sharing companies now also provide transportation for seniors and will even provide drivers who have specific training and understanding of senior transportation needs.

Is Memory Loss Care Needed?

The top-rated home care services will be able to meet all your needs, including providing specialized care for Alzheimer's disease and other types of memory loss. Many states even now mandate that caregivers are trained in memory loss care. If memory loss is present, make sure to inform the agency of the particular memory loss diagnosis — Alzheimer's Disease, Huntington’s Disease, Pick’s Disease, Frontal Lobe Dementia, Frontotemporal Dementia, Lewy Body Disease, Normal Pressure Hydrocephalus, Vascular Dementia, Parkinson’s Disease or any forgetfulness as some medications may have side-effects that cause sleepiness or temporary brain fog. Blood clots and brain tumors may also cause dementia. 

Providing a specific diagnosis can help the agency better understand the care needs of you or your loved one and assign a caregiver who’s properly trained and qualified to handle those needs.

Specific training for caregivers who specialize in areas like Dementia has been required to be provided in most states, so it’s important you ask specific questions like, “what kind of experience do you have caring for those with dementia?” “What safety precautions do you take?” and “How will your care differ knowing memory loss is present?”


Language Requirements

Wondering how to find a good caregiver for the elderly whose first language isn’t English? Sometimes those who speak English as a second language will feel more comfortable speaking in their native tongue when memory loss develops or when they are retired and perhaps spending more time speaking with family members who speak their first language. Senior care companies do staff to provide caregivers who are fluent in a variety of languages such as Spanish. If another language will be best, you’ll want to ask the agency if they have any bi-lingual caregivers available. If a second language is a must, you’ll also want to ask how the caregivers know their second language and their level of fluency in it.


Hours of Home Care Required

Whichever agency you opt to hire, they’ll need to know the number of hours of service to assign a Caregiver. To start, you’ll need to at least know whether you or your loved one requires part-time or 24-hour home care. Part-time care works best for those who need help only during the day. Around-the-clock, or 24-hour care has an option for a Live-in Caregiver who will stay with the senior for a few days in a row and sleep at night and 24-hour home care where two caregivers rotate on day or night shifts as the care needs require a caregiver who can be awake at night. Live-in care meets the needs when caregivers can sleep at night. Caregivers do not actually move in with the senior for live-in care, the term just means the caregiver lives with the senior for a few days and sleeps at night vs. the 24-hour care where caregivers must be awake and is best for those who need help both day and night for safety purposes. 

Even if you or your loved one does not require 24-hour care, you’ll still need to determine how many hours of care per day you or your loved one will need to receive care. Sometimes, too, you will plan for care hours to increase over time, especially if hospice care will be needed. You can calculate care hours needed by reviewing the list of services you or your loved one will require on a daily basis — more services require more time. The senior care companies care manager will also be able to present the best option for the right amount of care hours as they develop the senior's care plan.

Senior home care agencies will always be able to adjust the care hours once care services begin. They will also be able to add more hours for respite care, for example, if family members provide care for part of the time and need to be away for a weekend and need more caregiving hours.

Dietary Restrictions or Food Allergies

You’ll want to ask the elderly care agencies you consider if their caregivers are able to cook and what they can cook. Senior home care agencies are able to provide caregivers who have experience cooking different foods and who will provide meal preparation services. Make sure you also communicate any food allergies or specific cooking requests to the caregiver agency as sometimes seniors do not feel comfortable sharing their specific tastes. Think through what requirements are needed for food or water or avoiding food for a period of time in order to meet the requirements of their medications. For instance, maybe the care recipient has a dairy allergy or needs help watching their diet for health reasons. Another benefit a senior home care agency will provide is grocery shopping services. Groceries can be ordered and delivered if the care recipient is unable to shop for groceries on their own and you will just need to think through what the grocery shopping list should be.

Additional Care Skills Required

Are there any skilled care requirements, such as taking blood pressure, blood sugar testing, wound care or a feeding tube? Communicate if these specialized services will need to be performed or monitored. Also think through the daily routine that will be best. Do they like to watch a television show, such as Jeopardy, every day? Remember to communicate this.


Medication Management

You also need to know the care recipient's method for managing their medication, as well as whether or not their medications are currently being taken correctly. In fact, you should be able to provide a list of medications and the method of monitoring them so the agency will be aware of potential side effects and any other requirements, such as taking pills with or without food. You can also ask them questions like, “what is your prior experience with dealing with this kind of medication?” “How do you usually help patients with possible side effects?” And, “what is your protocol for medication-related emergencies?” Artificial intelligence tools are now available to help monitor medications and may be an added service to consider.


Will Care Management be Required?

To find a home care agency, you’ll want to be thorough in laying out exactly what you or your loved one needs. For instance, will you need overall care management? While caregivers are responsible for providing hands-on care, day-to-day, they usually don’t have time for the overall care of the patient

But a trained care manager can supervise all care needs, from organizing medications in a pillbox and obtaining refills (note, however, that due to insurance purposes, medication refills must be provided by a Supervisor or R.N., depending on state laws), to arranging doctor’s appointments and other services.

A Geriatric Care Manager will work with family members to take on a wide variety of responsibilities and provide professional expertise in guiding all long-term care decisions. Click here to read about CaregiverList’s quality standards for participating senior home care agencies.

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