Best Home Care Companies for 2023

Staying at home is not without its challenges, however. As we age, even familiar surroundings can become difficult to navigate due to mobility and health issues. Friends and family can begin to drift apart, leading to isolation and loneliness. And some health concerns—especially neurological issues like Alzheimer’s and dementia—can leave loved ones with seemingly no alternative to taking the senior out of the house and placing them in a facility.

Fortunately, home care agencies can extend a senior’s ability to live independently, and can make aging in place a viable alternative through every stage of the aging process. Not only can home caregivers provide physical assistance for a variety of everyday activities, they can also boost a senior’s well being by providing transportation, housekeeping help, and essential companionship.

The home care field can seem bewildering at first glance, however, with many agencies operating franchises across the country, and many more local choices available almost anywhere you live. To help you get started finding the home care you need, we’ve surveyed most of the leading national home care agencies and come up with a list of those we recommend.

How to Shop for Home Care

Before You Start

Before you shop for home care, you should take time to decide exactly what kind of care you or your loved one needs. Without some detailed knowledge of the client’s care needs, you may be setting yourself up for friction with your home care agency over what needs to be done. Fortunately, describing the your needs, or your loved one’s needs, is relatively simple: ask yourself what kind of help the client is receiving now. As you make a list, you should also familiarize yourself with terms that home care agencies use for different types of care. Get to know the difference between activities of daily living (ADL) and instrumental activities of daily living (IADL), and look at a couple of agency websites to familiarize yourself with the way they define personal care and companion care. Finally, home care is very much about companionship, and before you speak to a company, you should get a sense of how much time you or the prospective client spends alone, and whether you want a companion for some or all of that time.

Comparing Agencies

Do a little window shopping—a smart move is to look at 4-5 companies in your area, and as you search, take note of how they present themselves and whether they advertise any areas of specialization. You may be able to narrow down your choices after spending a little time online.

If you’re seeking care for yourself, talk to your doctor and other health care providers and ask for recommendations; if you’re seeking care for someone else, do the same with their health care providers. Also speak to your friends or your loved one’s peers and see if they have any suggestions. This is important because one of the biggest influences on the quality of your caregiver is the skill and commitment of the local franchise owner, and word of mouth is one of the best ways to assess the local office.

When you do approach a home care agency, you will generally have a preliminary meeting or assessment, either over the phone or in person. When you have this meeting, be sure to ask the local owner or the care manager the following questions:

• How do you screen caregivers?
• Will my caregiver have any special training to address our particular care needs?
• What will you do if we feel our assigned caregiver isn’t a good fit?
• How do you handle no-shows or caregivers who must cancel an assignment?
• What amount of care do you recommend?
• What financial obligations will I take on to start care? Will I have/contracts/prepayments?
• Can you give me references? Can I talk to any current clients?

If you can get references or current clients to talk to, the most important thing is to get a read on the reliability, quality of care, and the professionalism of the caregivers and office staff. Whether you’re the client or just a loved one, you’re going to want to be sure that you’re entering this care partnership with someone you can rely on and who will treat you well.

Pricing

Because the cost of care often tracks the client’s condition, how much a home care agency charges will likely depend on the type of care you need. For this reason, most locations won’t set an hourly rate until they’ve spoken to you, and often, paid you a visit. When they’ve had a chance to talk to you, however, they should offer a quote based on the care needs you’ve outlined.

There are some useful tools for assessing the rates the company is offering, including the Genworth Cost of Care calculator. But if you’ve done your research and find that a company quoting higher rates than you were expecting, be sure to ask what’s going into their price: it may be that they’re more selective when they hire caregivers, or plan to provide caregivers specially trained to deal with the client’s condition, and it’s important to know this if you’re comparing the rates offered by other companies who might not have the same concerns about quality.

If the cost still seems too high for the care needed, you can always turn to another agency. If, on the other hand, you’d prefer to work with this agency in particular, a local office will sometimes renegotiate if you let them know that cost is an obstacle. You can also reevaluate your care needs and, possibly, ask for less intensive help or for fewer hours than originally planned.

What If Things Don’t Work Out?

You’re going to want quality care above everything else. So if there’s a problem with a caregiver, ask the agency to address it. Even if the caregiver is simply a bad fit for you or your loved one in terms of personality, let your agency know. A good agency will usually understand that it can take a couple of trial runs with different caregivers before they find one that “clicks” with a client.

If you’re not the one receiving the care, be sure to monitor the quality of the care that’s being provided. Ask direct questions about the care your loved one is receiving, and keep note of any problems, even if they’re just related to punctuality or personality.

If you decide that the caregivers aren’t the problem, but the agency is, don’t hesitate to change. It can seem like a lot of hassle to have to look into other agencies, especially if you’ve already gone through the selection process. Still, it’s crucial to get the right fit, and the hassle will pay off in added peace of mind.

Finding home care for you or a loved one can be a complex process, but it can also pay off in terms of better health, a better quality of life, and peace of mind for everyone who cares about the senior being looked after. What’s more, a glance at the companies above is enough to see that home care can fulfill a variety of needs, and can often do so in just a few hours of care a week. If you or someone you love is hoping to age in place, be sure to consider home care as you explore your options.