Questions to Ask Before Hiring a Home Care Agency
The questions that actually separate agencies, including the uncomfortable ones about consistency, cost and what happens when something goes wrong.
Most families choose a home care agency in a hurry, from a shortlist they assembled in an afternoon, at a point when they are already stretched. The questions below are the ones that actually separate agencies, and several of them are uncomfortable to ask, which is exactly why they are worth asking.
Bring this list to the call. A good agency will not mind.
About the caregivers
“Will the same person come every time?”
This is the single most important question, and the answers vary enormously. Consistency is most of what makes home care work: a familiar person notices what has changed, and personal care is far more tolerable from someone you know. Ask what happens during holidays and sickness, the honest answer is that cover is sometimes necessary, and the follow-up question is whether the cover is someone who has met your relative before.
“What screening and training do they have?”
Background checks, references, and what training is required before a caregiver enters a home. Ask specifically whether training is refreshed, and how often. “Experienced” is not a credential.
“Are caregivers employed by you or self-employed?”
This determines who carries insurance, who covers a no-show, and who is responsible if something goes wrong. Introduction agencies and employing agencies are different businesses with different obligations.
“Can we meet them before we commit?”
Most good agencies will arrange this. Watch how they talk to your relative, directly, or over their head to you.
About the care itself
“Who writes the care plan, and can we change it?”
It should be built with the family, describe how this particular person likes things done, and be revisited as things change. A generic checklist is a warning sign.
“What is the minimum visit length?”
Short visits are a false economy. Fifteen or thirty minutes is enough to complete tasks and nothing else, no conversation, no noticing, no relationship.
“What happens if needs increase?”
Ask what they can and cannot do as things progress, and at what point they would say a situation has moved beyond them. An agency that claims no limits either has not thought about it or is not being straight with you.
“How do you confirm visits happened?”
Electronic visit verification means arrivals and departures are recorded rather than assumed. Ask whether families can see it.
“What would make you tell us we should be looking at something other than home care?” An agency willing to describe the point at which it would refer you elsewhere is one that will be honest with you later, when it is harder.
About money
“What is the hourly rate, and what changes it?”
Weekends, evenings, holidays and short-notice visits often carry different rates. Get the whole schedule in writing.
“Are there minimum hours or a minimum contract?”
Some agencies require a weekly minimum. That may be fine, just know before you commit.
“What is the notice period, on both sides?”
Including what happens if your relative goes into the hospital, and whether you keep paying to hold the slot.
“Is travel time or mileage charged?”
Ask specifically about accompanied trips and errands.
“What are the funding routes, and do you help with them?”
In Pennsylvania this usually means Community HealthChoices, veterans’ benefits, or long-term care insurance. An agency that can explain the landscape plainly, including where you may qualify for support that does not go through them, is worth more than one that only quotes a private rate. We have written about how this works in Pennsylvania separately.
About what happens when something goes wrong
This is the section families skip, and the one that matters at 6am on a Sunday.
- “If a caregiver cannot come, what happens, and how quickly will we know?” Ask about the process, not the promise.
- “Who do we call outside office hours?” Establish whether that is a real person, an answering service or a voicemail.
- “How do we raise a concern, and what happens then?” There should be a named person and a timescale.
- “What is your process if we are unhappy with a caregiver?” Requesting a change should be normal and unawkward, a mismatch of personality is nobody’s fault.
Things to notice that nobody says out loud
Alongside the answers, pay attention to:
- Who they address. During the assessment, do they talk to your relative or about them? This predicts a great deal.
- Whether they ask more than they tell. An assessment that is mostly a sales presentation is a sales presentation.
- Whether they ever say no. Yes to everything means either inexperience or dishonesty.
- How fast they want a decision. Pressure to sign quickly is a reason to slow down.
- Whether they mention the person’s preferences at all. Good agencies ask what someone likes, not only what they need.
You are not shopping for a service. You are choosing who comes into your parent’s home, sees them undressed, and is trusted to tell you the truth about how they are doing.
A reasonable process
Speak to two or three agencies. Ask the same questions and compare the answers rather than the brochures. Have the assessment done with your relative present and involved. Start with fewer hours than you think you need, and review after a month.
And if an agency’s answers are vague on consistency, unclear on cost, or evasive about limits. That is your answer. There are others.
If you want to put these questions to us, call or send a message. We would rather answer all of them now than have you find out later.
