How to Select an In-Home Aide

Studies show that older Americans want to remain in their homes for as long as possible – even when they are struggling. For growing numbers of elders – and concerned family members – the solution to their struggle is a home aide.

If your family is considering hiring an aide, the first decision is what type of aide you need. 

There are two basic choices: a home health aide or a home care aide. 

  • Home health care aides provide personal care (bathing, grooming, etc.); assist with range-of-motion exercises and provide some medically-related care (empty colostomy bags, dress dry wounds, check blood pressure, etc.); and provide assistance with housekeeping and errands.  They are often referred to as personal care assistants.
  • Home care aides provide companionship and socialization and assist with meal preparation, housecleaning, laundry, shopping and errands.  They are also called homemaker or chore aides.

“The level of care the person requires determines who should be providing the home care and what it will cost,” says Mary Hujer, MSN, a gerontological clinical nurse specialist in Cleveland, Ohio.

Getting Started

With an agency, the aide has been screened and trained, and they will be supervised, explains Byron Cordes, LCSW, a certified care manager and the current president of the Aging Life Care Association. But, Cordes adds, there are other benefits of hiring through an agency: “Clients have access to all the resources the agency has.  They have back-up if the scheduled caregiver can’t be there and the agency handles all the administrative responsibilities – reimbursement forms, payroll, taxes, workers’ compensation, insurance, and background checks and bonding of the employee.”

Hiring independently means you will be doing the screening and interviewing, supervision, coordination of care and all administrative paperwork.  But, says Hujer, it also means you are able to hire someone – a friend or relative—who may already know the person, “so the trust factor is higher…and you will usually be paying less, too.”  (Learn more on making this choice.)

To locate potential candidates, “cast a wide net,” says Hujer.  Get suggestions from the older person’s primary care physician or nurse; the local hospital’s social work department; local social service and/or disease-specific organizations; your community’s office on aging or senior center; the older person’s minister or rabbi; and/or friends and neighbors who have previously used a home aide. 

See also: 12 Interview Questions to Ask an In-Home Aide

Additional Resources



  • ElderCare 911: The Caregiver’s Complete Handbook for Making Decisions, S. Beerman, MS, MSW and J. Rappaport-Musson, CSA (2008, Prometheus Books)
  • How to Care for Aging Parents, Virginia Morris (2004, Workman Publishing)