How to Choose the Best Home Caregiver Agency: 5 Tips

Certified Care Manager, Aging Life Care Professional, and National Master Guardian Emeritus

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No matter what your situation is, there comes a time when you are looking to hire a caregiver. You could have caregiver burnout, or your other obligations and responsibilities have become too great to continue caregiving. Or, your loved one can no longer continue to function safely without some help in the home. In these circumstances, you may be unsure where to look for help--which is when a caregiver agency steps in.

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Home care is typically privately paid unless you have long-term care insurance. If you are looking to find ways to supplement care or to help a loved one safely, it helps to do research on what caregiver agency will fulfill you and your loved one’s needs. Choosing the best agency will take some work, but we have steps to follow for a successful decision.

Steps for Choosing the Right Caregiver Agency

Depending on where you live, you might have many choices of an agency or just a few. Most home care agencies are part of national franchises. Each location will be independently owned and operated with the structure and support of the national company. Other home care agencies will not be part of a franchise and may have a local owner.

It also matters where you live regionally. Some major urban centers could have over a hundred options, but a more rural community a couple of hours away may only have a few. Since caregiver agencies are private pay, there is no federal oversight and therefore no online ratings for these agencies.

Choosing the right caregiver agency will take some time and effort, but you want to be as confident as you can that you have selected a reliable agency to care for your loved one. All agencies will make mistakes. The best ones accept responsibility for those mistakes and correct them immediately.

1. Talk to other healthcare providers and friends

Sometimes the best referral is personal. If your loved one sees a physician or home health provider, ask about their experience with caregiver agencies. Get details on what they liked best and least about any referral. If your loved one is already receiving home health, the agency might have a good recommendation of a company that they have worked well with in the past.

2. Do an online search

In a community where there are lots of choices, the only way you might be able to find out what companies are available is to search.

When you search you will likely end up getting a mix of caregiver agencies and home health agencies. Make sure the company you have an interest in is a caregiver agency. It is rare to find a company that does both home health and home care. Companies usually do one or the other.

3. Evaluate the care that you require

Since caregiver tasks vary state by state, you need to make sure that the care you need for your loved one can be done. If you need someone to do insulin injections and your state does not allow for that, you might need to hire a nurse. Having a plan in place before hiring an agency will make the process go more smoothly. Consider evaluating care needs first before reaching out to an agency.

You will definitely want to identify what tasks your loved one may need help with. Here are some tasks to consider:

  • Bathing
  • Grooming
  • Toileting
  • Transportation
  • Shopping
  • Cooking

Take a look at how many hours a day you want a caregiver to help and what times of day are most important. It might be helpful to put together a caregiver schedule that includes family caregiving time as well. Consider starting with minimal hours first and then increasing later to help your loved one transition into professional caregiving.

4. Find out who owns the agency

If you can, find out who the company’s owner is and how long they have had ownership. Since most home care agencies are franchises, each one will be individually owned and operated.

See if you can get any information online about the integrity of the owner and any experience they have in this industry.

5. Talk to your loved one

Sometimes in all of the chaos of getting home care started, you might forget that you have to get your family member’s permission to begin services. Plunging into the idea of home care, without discussing the idea first, might create increased resistance. 

Broach the subject with honesty and respect. Let your family member know why home care is needed. Talk about caregiver duties and the reasons that you might need some relief. You might find yourself in the position of giving up your life to care for an aging parent, and the imbalance is causing a lot of stress for you and your loved one.

While your parent or loved one may think that caring for them is easy, they may not be aware of how time-consuming it can be. Share your thoughts with compassion and honesty. If possible, make the decision together about how and when to start with a professional caregiver. Negotiate hours and keep an open mind.

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Questions to Ask When Hiring a Caregiver Agency

You will want to have a list of detailed questions to ask any caregiver agency, and the agency should be happy and prepared to answer your questions. If possible, address your questions to the owner. In the end, you are hiring a caregiver for in-home help through the agency they work for.

1. Is the agency licensed, bonded, and insured?

Ask to see proof and inquire about criminal background checks and drug screening. Don’t assume that an agency is licensed, bonded, and insured, even if required by the state.

If there were to be a problem with a caregiver, theft, or accusations of abuse, you want an agency that has liability insurance to handle these issues.

2. What are your rates?

At most agencies, the more consecutive hours you contract for, the lower the hourly rate. Even though you may not need it, ask about live-in, 24-hour care, and overnight rates, to plan for any possible changes to the care schedule.

Ask about the option of augmenting a caregiver’s hourly rate if you find someone you really like and want to do what you can to retain them. It is against most company policies to provide monetary compensation for a caregiver outside the agency payroll.

3. What is your current staffing?

The turnover rate for the home care industry is about 82 percent. Staff turnover is a significant problem because it affects staff availability and consistency of care.

You will want to know if the agency has the staff to fill in should a caregiver call in sick or leave the agency. Ask about retention and how long staff have been with the agency.

4. What is your compensation for care staff?

Most people don’t think to ask this question, but you will want an agency that treats their staff well.

Ask not only about the hourly rate but bonuses, health insurance, and other perks. If consumers show an interest in how companies treat their employees, more might be willing to make that a priority. 

5. What training do you provide for your staff?

As part of this question, ask how many of the care staff are certified nursing assistants. A certified nursing assistant is allowed to provide more medically oriented tasks. Other unlicensed staff can help with daily living activities like bathing, dressing, cooking, transportation, and companionship. 

Even unlicensed care staff should have a training schedule—especially when working with people who have dementia. The states dictate the number of training hours, but a good agency will go above and beyond those requirements. Ask to see the training schedule and what incentives there are for staff to attend. 

6. What is the process of pairing a caregiver with a client?

Each agency will have a process of pairing a caregiver with a client. It is impossible to know whether your loved one will be compatible with a particular caregiver, but the introduction process is critical to the success of the relationship. 

For most people, an introduction before the first shift is preferable. That way the caregiver and your family member can get to know one another first and develop a comfort level. An introduction gives your loved one a sense of control and involvement in the process. 

Also, if a caregiver doesn’t work out, how does the agency handle a change? Sometimes clients are reluctant to let anyone know that they are unhappy with a caregiver because they don’t want it to reflect badly on the care provider. A good agency will handle replacing a caregiver with sensitivity.

7. How is documentation to the family provided?

Most agencies develop a care plan with the family that includes basic demographic information, emergency contacts, likes and dislikes, and tasks that the caregiver performs. The caregiver then documents what happened on their shift. Sometimes this is done in writing in a book kept at the client’s house, or it is done online, and the family is given access to a portal to read the notes. 

If there are multiple caregivers coming into the home, it can be helpful for them to communicate with one another. Ask the agency how communication between caregivers and the family is handled. 

8. Who is the main point of contact?

There are few things more frustrating than getting passed from person to person when you have a problem or need to discuss a change. Find out who does the scheduling and who handles caregiver issues. If something comes up in the middle of the night, is there a 24-hour emergency on-call person to talk to?

Choosing the Best Home Caregiver Agency for Your Loved One

The most important point to remember in choosing a home caregiver agency is that as the consumer, you are in control. You want the absolute best care for your loved one, and the way to ensure that is to ask the right questions.

If the agency you choose doesn’t work out, then move on to another one. Be the best advocate you can so that your loved one gets the care they deserve.

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