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Hiring a Home Care Aide

Finding, vetting, and managing in-home help for your aging parent

Agency vs. Private Hire

Know your options first

Home Care Agency

Agency employs the aides and handles everything.

Pros:

Background checks done
Backup if aide is sick
Handles taxes, insurance, liability
Supervision and training
Easier to switch aides

Cons:

More expensive ($25-40/hr)
Less control over who comes
May have different aides

Private/Independent Hire

You hire the aide directly as an employee.

Pros:

Lower cost ($15-25/hr)
More control and consistency
Can build closer relationship
More flexibility in duties

Cons:

You must run background check
You're the employer (taxes, insurance)
No backup if they're sick
Less oversight

If You Hire Privately: Legal Requirements

You may be a "household employer", must pay payroll taxes
May need workers' compensation insurance
Should have a written agreement
Consider umbrella liability insurance

Consult an accountant or use a payroll service like Care.com HomePay.

Type of Care	Typical Hourly Rate	What They Do
Companion/Homemaker	$15-25	Companionship, light housekeeping, errands, meal prep
Personal Care Aide (PCA)	$18-30	Above + bathing, dressing, toileting, transfers
Certified Nursing Assistant (CNA)	$20-35	Above + more medical tasks, vital signs
Home Health Aide (via agency)	$25-40	All personal care, some medical, often through agency

Medicare Doesn't Pay for Custodial Care

Medicare only covers home health aides as part of skilled care (after hospitalization, with PT/OT). Long-term custodial care (help with bathing, dressing, meals) is private pay, Medicaid, or long-term care insurance.

Finding & Vetting Candidates

Protect your parent

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Where to Find Aides

Home care agencies (search "home care agency [your city]")
Care.com, Indeed, or Craigslist (private hire)
Word of mouth, ask friends, neighbors, church
Hospital social workers often have referrals
Area Agency on Aging (local senior services)
Nursing schools, students seeking experience

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Vetting Checklist

Background check: Criminal, sex offender registry (use Checkr, GoodHire)
Reference check: Call at least 2-3 previous employers
Verify certifications: CNA license if claimed
Driving record: If they'll drive your parent
In-person interview: Chemistry matters
Trial period: Start with a paid trial shift

Interview Questions to Ask

"Tell me about your experience caring for seniors."
"Have you cared for someone with [dementia/mobility issues/etc.]?"
"What would you do if my parent fell?"
"How do you handle it when a client is resistant to care?"
"What do you enjoy about this work?"
"Why did you leave your last position?"
"Are you comfortable with [specific tasks: bathing, transfers, cooking]?"
"What's your availability? Any upcoming time off?"
"Do you have reliable transportation?"
"Can you provide 2-3 references I can call?"

Reference Check Questions

"How long did [name] work for you?"
"What were their primary responsibilities?"
"Were they reliable and punctual?"
"How did they interact with your loved one?"
"Were there any concerns or issues?"
"Would you hire them again?"

Red Flags to Watch For

Gaps in employment they can't explain
Unwilling to provide references
Resistant to background check
Overly focused on money or hours
Speaks negatively about former clients
Late to interview without good reason
Can't explain how they'd handle emergencies

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Setting Expectations

Create a written care plan covering:

Specific duties and daily schedule
What they should NOT do (medications? driving?)
Communication expectations (daily log? texts?)
Emergency procedures
Pay rate, schedule, and overtime policy
Time off and cancellation policy
House rules (no phone use, no visitors, etc.)