Keeping your loved one at home 

Taking care of a spouse, relative, or friend is a demanding role. It’s also one that many family caregivers manage on their own. Approximately two-thirds (2/3) of family caregivers don’t have paid help.¹

Sometimes, the suggestion to hire professional caregiving help can be met with resistance from the person who needs it. Your loved one may consider it a sign that they’re losing even more independence. They might also feel uncomfortable having personal needs tended to by a stranger, or have some other objection, whether they voice it or not. 

You—and those you share caregiving responsibilities with—may have complicated reactions to seeking outside help. You may feel like you should be able to manage caregiving on your own, especially if you already get help from family and friends. You may worry that hiring someone will upset your loved one, or that you’ve let your loved one down.

If the goal is to have your loved one at home for as long as possible, bringing in outside help may be the key. Caregiver burnout is real. Taking advantage of available home care resources can support your caregiving efforts, help you continue to provide care effectively, and keep your loved one at home. As a result, it may also have positive effects on your relationship with your loved one.

Types of home care

People often refer to “home care” as a general term. However, there are different types of caregiving help available, depending on a person’s needs (medical and/or non-medical) and available resources. 

• Personal care/companionship provided by a homemaker or a home health aide
• Helps with bathing and dressing, meal preparation, household tasks, and other everyday activities
• Includes non-medical care, home health aide services, homemakers, or companion care
  
  
• Private-duty home nursing prescribed by a health care provider
• Helps someone with a chronic illness, injury, or disability
• Includes home-based skilled nursing, long-term nursing care, catastrophic care, tracheostomy, or ventilator care
  
  
• Home health care prescribed and directed by a physician
• Helps a patient from—or prevent—an illness, injury, or hospitalization
• Includes Medicare-certified home health care, visiting nurse services, physical therapy, and intermittent skilled care

Choosing a home care agency

Taking the time to choose the home care agency that’s right for you is important. When you’re looking for an agency to provide any type of home care, don’t sign on the dotted line until you take these important steps:

1. Know your loved ones needs. Understanding what the essential medical and non-medical needs are will direct you to the type of agency that can provide you with support.


2. Find out what your loved one’s insurance coverage includes. Health insurance plans—including Medicare plans—may require copays or another type of cost-sharing, or they may have limits on the types and duration of services allowed.


3. Ask for references from people you know and trust. Word of mouth is the best way to get a good sense of the care and service a home health agency offers. Talk to friends, acquaintances, your loved one’s doctor’s office or a local senior center. These are the folks who can give you an insider’s view of the quality of care and level of respect your loved one will receive from an agency’s personal care attendants and nursing staff. They can also be a good source of information on what it’s like to deal with agency’s management. Ask them about scheduling, billing and reliability.


4. Interview the agencies. Ask questions similar to those you ask your word-of-mouth sources. Also, find out if the agency is licensed and insured. Other questions to consider:
• Will I be able to reach staff and management 24/7?
• How will your staff communicate with me about care updates?
• How does the agency screen employees?
• How are complaints managed?
• Under what circumstances can I request a different caregiver?
• Have you undergone a quality review, and can I see the results?


5. Review ratings for the agencies you’re considering. You can check out Medicare-certified agencies in your area on Medicare’s Care Compare website at medicare.gov/care-compare/. The site includes patient survey results and Medicare ratings for home health agencies that are approved by Medicare and meet specific federal health and safety requirements. Agencies that accept Medicare and MassHealth must follow federal guidelines. However, in Massachusetts, the state doesn’t regulate agencies unless they provide services under MassHealth or another state contract.

Finding the right agency and the right care providers can take some time, but don’t be discouraged. It’s worth the effort. With extra support in place, you’ll be better able to support your loved one’s goal of living at home.

Originally posted: August 2017
Last updated: September 2025

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