What Is Companion Care for Aging Adults?


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

Companion care for an aging adult can be a really valuable and positive option for many families. When people think of care, they tend to think of skilled needs, such as help with bathing, dressing, or mobility. However, just as critical is the need for human connection and companionship.

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For many older adults, isolation and loneliness are serious problems. Perhaps your loved one has dementia or is no longer able to drive due to medical issues. Even short-term illness or accidents can leave an aging adult isolated and alone. 

Finding good reliable companion care is possible with effort and flexibility. When you find a good care companion, it can be a real boon for both you and your loved one.

What’s Companion Care?

Companion care can be defined as non-medical care by a personal care aide or what is sometimes called a “homemaker.” Companion care is an excellent addition to an aging adult’s life because it can help someone age in place at home. These are some of the tasks that a companion care aide can do:

  • Provide emotional support. For aging adults who are isolated due to driving restrictions, being quarantined, or other mental or physical problems, loneliness can be a real problem. Having the company of an aide can boost mood and improve an older adult’s quality of life. 
  • Cognitive support. Mental stimulation is an important component of managing cognitive impairment. A companion can play games, help with connecting someone to technology, and offer conversation.
  • Household tasks. Companions can assist with light housekeeping, organizing, laundry, preparing meals, providing transportation, and any other non-medical tasks. These duties can also help take the pressure off of other family members. 
  • Assistance with appointments. As a family caregiver, you may not be able to attend all of your loved one’s medical appointments. A companion can take your place and help your family member into the appointment and stay with them.
  • Supervision for people who wander. Wandering for people with dementia is a serious safety concern. A companion can help to manage and monitor someone who tends to wander.
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Difference between a companion and a caregiver

The main difference between a companion and a caregiver is the type of tasks they can and are able to perform legally. Each state regulates what certified caregivers can and can’t do.

For example, some states will allow a caregiver to do blood sugar checks, administer medications, take blood pressure, and perform other approved medical tasks. It is essential to know what a Certified Nursing Assistant (CNA) can do in your state before you decide on care. These are the main differences between a certified caregiver and companion.

One specific way that you can tell the difference is that your state of residence will certify a caregiver. A certification includes hours of hands-on training and a test. As a result, caregivers can assist and are qualified to help with daily living activities such as dressing, bathing, hygiene, toileting, and any transfers. 

A caregiver can also assist with medication management, which might be reminders only depending on state requirements. This also applies to being able to measure one’s pulse, take their blood pressure, logging fluid, and food intake along with other state-mandated tasks. 

A companion can help with a lot of the other interpersonal skills required for daily living. They can be valuable aides when it comes to transporting your loved one to and from appointments, and help them run errands such as picking up prescriptions. 

Companion care can also include things like laundry, light housekeeping, and cooking -- things which may become more difficult as your loved one ages. They can also help by keeping your loved one company, as is referenced by the title, with conversation and by playing games.

How Much Does Companion Care Cost? 

Companion care costs will vary widely depending on where you live, how many hours you require, and other variables that are not readily apparent.

If you have not done long-term care planning with companion care in mind, here are some of the following things that can affect cost:

  • Where you live affects pricing for companion care. For example, if you live in California, companion care costs might be higher than in Kansas, and if you live in an urban versus rural area. Genworth estimates the median hourly cost for companionship services in 2019 to be $22.50.
  • Another factor in cost of care is whether you contract with an agency or hire on your own. An agency factors in the price of background checks, liability insurance, training, and other costs associated with running a brick and mortar agency.
  • As a consumer, you will probably pay less per hour if you hire yourself or through one of the online caregiver companies.
  • How many hours of care you or your loved one requires. Some agencies have a minimum number of hours a day or week. Other agencies will reduce your hourly rate depending on the number of hours per visit. For example, if the cost is $35 an hour for one hour, it might be $20 an hour for five or more hours. Or, 24-hour or overnight care could be a flat rate.

Who Usually Benefits From Companion Care?

Almost anyone can benefit from companion care, but many families wait until there is a compelling need due to companion care costs.

Isolated and lonely older adults. Loneliness can have serious mental health and medical consequences. Older adults who cannot access other people, family, or social events can become very lonely. Everyone needs the comfort and emotional support of other people. Companion care can help by providing socialization.

People with dementia or other mental health problems. A loved one with dementia or other mental health problems can present challenges for a family caregiver. Wandering, agitation, boredom, depression, and anxiety are not uncommon for people with cognitive impairment. A companion can help to minimize these problems by distracting and re-directing towards other activities. 

Burned out caregivers. Family caregivers often take on the brunt of companionship duties for an older adult. The time and effort this takes, along with all of their other responsibilities, can lead to caregiver burnout. Hiring a companion can take the pressure off of having to be available for your loved one all of the time.

How Do You Find the Best Companion Care?

As a family, you want the best companion you can find for your loved one. A good fit can be hard to predict, but starting with the basics will help.

You may have to go through more than one or two companions before you find the best one for your loved one. Although it might seem that certified nursing assistants have a higher skill level, companion care takes a compassionate and caring person, skills that are harder to identify.  Finding the best companion care can be challenging, but your chances will be improved if you follow these tips.

Check with your Area Agency on Aging

Your local Area Agency on Aging may have companion services or referrals to other non-profit programs that offer companion services.

These programs might be available for a nominal fee. Some faith-based organizations provide companionship services.

Decide if you will go through an agency or hire privately

Depending on where and how you choose to hire, don’t underestimate the time and effort it takes to manage care. If you go through an agency, make sure to talk to several agencies before making up your mind. Find out about their hiring practices and staff availability to fill in if your companion can’t make it. Ask how long the companion has worked for the company and if there have been any problems. 

If you hire privately, such as a family friend,  church member, or someone off the internet, you are responsible for any sudden changes that may come up. For example, if your companion doesn’t show up for a shift, you will have to replace that person yourself. 

You will also be responsible for payroll and background checks. Ask to talk with several other families that the companion has worked with. Be prepared with a list of questions about their working style and personality.

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Interview with two or three possible companions

Ask to meet two or three recommended companions and focus on asking questions that give you a good idea of how they work and manage care.

Here are some things to remember when you interview them:

  • Professionalism. This includes appearance, appropriate language, pride in their work, and being on time.
  • Integrity. You want a companion that is honest and trustworthy.
  • Empathy. Empathy is an essential quality for any caregiver, but very important for a companion. The ability to connect emotionally is critical for a good relationship with your loved one.
  • Responsibility. A responsible companion knows when to talk with a supervisor about issues and concerns. 
  • Patience. Dealing with people who have dementia or mental health problems can get frustrating. A good companion is patient and calm.
  • Optimism. A positive attitude helps your loved one’s mood, which in turn promotes healthier outcomes. 

Ask for a change if it isn’t working out

Don’t be afraid to find a different companion if your loved one is not satisfied with the selected person. It is more important to find the right person than to avoid making a change. Check-in with your loved one to see how things are going and if there are any problems or concerns. 

Sometimes people are reluctant to change because they are concerned that the companion will take it personally. Asking for another companion is not necessarily a reflection on the skills of the person, as it may just not be a good fit.

Also, consider the possibility that the companion you love will leave the job. Don’t panic if that happens. Be confident, start the process again,  and have faith that you will find a suitable replacement.

Companion Care for an Aging Adult

Companion care for an aging adult has many positive benefits. This option can help keep your loved one happier and healthier while also giving the family caregiver support.

If you focus on hiring someone who can work well with your loved one while also providing valuable support, know that it can take time and dedication. In the end, the time spent on finding the right person can be worth it.

If you're looking for more help planning care for a loved one, read our guides on living with aging parents, what you can do when siblings don't help with aging parents, and how to hire a caregiver for in-home help.


  1. “Cost of Care Survey.” Genworth, www.genworth.com/aging-and-you/finances/cost-of-care.html 

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