choosing a home care agency

It can be a challenge coming up with questions to ask a home care agency if you’ve never needed their services before. Especially if you’re starting from, “What is Home Care?”

I remember when I was looking for home care for my mother, Emily, in the Adirondacks area near Glens Falls, NY. Literally hundreds of home care agencies came up when I typed “Home Care Warren County NY” into Google search.

home care search


I thought, “My gosh, where do I start? How can I tell the good agencies from the bad ones? Is there some site where I can read reviews, rank them and create a short call list?”


From this experience, and after three years of talking to families about home care, we’ve developed a process to help families make a decision regarding home or elderly care.

This, of course, assumes that you or your loved one not only need help (see our self-assessment tool) but also that you or your love one will accept help.

These two issues are typically big hurdles to clear before many people select a home care agency. Let’s assume home care is needed and accepted.

How do I choose the best in-home care? Before evaluating the costs and services, the first thing to consider is what’s really important to you.

What do you want home care to provide?

The typical answers include:

  • Consistency – Families want a reliable caregiver that performs their duties well and is there for the loved one when needed.
  • Passion/Love/Great Care – The caregiver loves what they do and it shows. They share that love with your loved one.
  • Reliable and Dependable – Families would like to work with an agency that can be relied upon for consistently great care, in good and bad times.  Nobody is perfect, but great agencies create caregiver teams with suitable replacements and they never miss shifts. When there is a problem, they proactively fix it and are forthcoming about it.

We stand behind our caregivers and our goal of exceptional care. If our clients are not satisfied, we will make it right or refer the family to somebody who will.

‘Price’ is absent from the above, if you didn’t notice.

“You get what you pay for”

This is especially true in the home care industry.

Our services are priced slightly above the industry average and our caregiving team is compensated in the upper 90th percentile based on industry research from Home Care Pulse.

Our approach is similar to the one that is behind the success of Southwest Airlines: Take care of the people who take care of you. Aware Senior Care prioritizes our caregivers.  If they feel loved and we have their back, they can focus their love and care on our families. A simple formula, but one that can be overlooked by many of the agencies out there.

What separates the good home care companies from the below average ones?  Wouldn’t it be nice to have a portal like or where you could type in your zip code and ask for all the home care agencies to be displayed based on reviews?

To help you in this important decision, we have created this short list.

Home Care Evaluation Points

1. What are their ratings and how are they reviewed?

If a home care agency is not reviewed online, we’d recommend putting them aside to revisit later. You should look for agencies that have been reviewed by families. The more reviews, the better. Of course, the highest rated tend to be better.

Here are some of the industry-leading review sites in elder care:

  • – Home Care Pulse forms relationships with agencies and independently call and survey the agencies’ clients and caregivers. They create very detailed monthly reports on these surveys for their clients. They recognize the top-performing companies with awards.
  • – The largest consumer ratings and reviews site for senior living communities and home care providers across the United States and Canada. The site features reviews and advice from community residents and their loved ones.
  • – A leading senior care resource for family caregivers seeking information and support as they care for aging parents, spouses, and other loved ones.

The agency’s website – Check out the agency website to see if they are posting reviews.

2. What awards or recognition have they earned and what national memberships or associations in senior care do they take part?

Gina and I started Aware Senior Care in 2014. Within our first year in operation we were privileged to have one of the most successful home care companies in North Carolina, Partners in Care, spend a day looking at what we had achieved.

They emphasized the importance of earning awards.

Awards demonstrate to people that you are delivering great care. Awards take time and extraordinary effort to achieve, so not only do they help distinguish your business from your peers but they let families know what companies can be relied upon to deliver quality care.

Examples of awards and recognition:

Recognition from their local Chamber of Commerce
Awards from the major senior care industry review and rating sites mentioned above such as:

National Senior Care Memberships or Associations:

  • The Senior’s Choice (TSC) is the world’s largest membership network of senior care providers.  Home care agencies associated with The Senior’s Choice are among the top performers in their respective markets when it comes to overall client satisfaction. TSC is a wonderful organization and taught us the fundamentals of being a great home care agency.  What we enjoy most is our membership where we talk to other members and meet in conferences to share experiences and great ideas to keep raising the bar for exceptional home care. In 2016 we were fortunate to be selected to become part of the TSC Champions which is a subset of highly rated and performing home care agencies through the United States and Canada in the 150+ TSC membership network.

3. Is the home care business personal for them?

You are trusting a complete stranger to care for you or your loved one. You should know the people providing care.  Why did they want to work in home care?

What are their values? We share a lot about our personal lives and why we started Aware on our web site and our Blog.

Why?  Establishing trust with families is absolutely vital to us. We want you to get to know us and know that we truly care. We frequently receive calls from clients of other agencies frustrated that they rarely hear from them, much less know them.

They called some agencies “faceless.” From Gina, myself, and the staff to the caregivers, we want you to know, like, and trust us.

4. What additional services do they provide?

You certainly want to be satisfied the agency can provide the services you need now and in the future. The minimum requirements from a home care agency should include companion care and personal care.

You may not be looking for personal care at the start, but it’s good to pick an agency that you can grow with that is licensed for personal care. You never know what can happen. It may be wise to check if the agency has additional experience and competency in complex illness cases that could include cases with clients suffering from:

  • Dementia
  • Alzheimer’s
  • Multiple Sclerosis (MS)
  • Aphasia
  • Recovery from a stroke
  • Client has limited vision or is blind

It’s certainly an asset when you can verify the agency has experience in these cases and a staff that can provide care. Again, it’s good to work with an experienced agency that you can grow with.

5. Are they a “team player?”

It takes a village to provide care for a client and their family. We feel as much joy referring clients to members of our partners in the circle of support as we do when we provide the care ourselves.’

We want to give you solutions, not sell you on services and/or products we don’t trust.

Since 2014, we’ve met and worked side by side with great people and organizations that provide services, products, or consulting focused on living well in the home.

The list is extensive and includes home health, hospice, meal delivery, pharmacy delivery, home renovation and security, estate planning, veteran’s assistance, counseling, resources for seniors, etc.

Look to see if the agency has this kind of “It takes a village” approach with links and mentions about complimentary home care services.

6. How often do they communicate with you?

We’ve had a number of clients come to us for services from other agencies because they virtually never heard back from the office after their care plan was put in place.   Frequent check-in visits are an important part of our services. Our staff makes frequent unannounced visits to clients just to see how the caregiver is performing.

A plan of care will likely change over time and it’s important to establish communication in case adjustments need to be made. Ask your potential agency how often they visit their clients once service begins.

Additionally, we always personally introduce a new caregiver. We don’t feel it’s appropriate to assign a new caregiver without an in-person introduction. It’s an uncomfortable situation not only for the client, but also for our caregiver.

This includes new caregivers taking over the services of a previous caregiver. We are frequently told by clients how much they appreciate this small, but important detail.

7. How do they screen and hire professional caregivers?

As part of our initial call with families we always ask: “What’s most important to you?” 

In almost every case the top answer is: “We want the best caregiver.” Clients usually follow-up and inquire about our hiring and screening process. Clients ask “Do you do background checks?  Do you check their driving records, etc.?”

You will find, per requirements from the North Carolina Department of Health and Social Services, that home care agencies must perform background checks and we do.

We go the extra mile to ensure we’re hiring a reliable home care professional when screening applicants. We review DMV records, we check the NC Criminal Offender database, and we test for drugs randomly.

For our agency, we have a detailed online application that’s very helpful as well during the screening process. After applicants complete and pass our application, the next step is a personal call from the office.

If the candidate screens well on the phone, the next step is a personal interview in the office. If they pass the personal interview, they are then invited to orientation.

Orientation doesn’t guarantee employment, however.  We’ve designed orientation as a final step to see how our potential caregivers interact with colleagues during training and how they embrace what we call “The Aware Way.”

Are they a team player? Do they act and dress professionally? Are they easy to interact with and exude kindness?

We’ve had applicants go through orientation but not get hired. Our advice is to ask your potential home care agency a number of questions about screening and hiring to get a feel for how an agency hires a caregiver and the emphasis they put on finding good people.

8. How do you retain and take care of good caregivers?

This is an excellent question for you to ask your potential agency.

Home care industry research leaders like HomeCarePulse track caregiver retention ratios nationally and we rank in the upper 10th percentile for excellent caregiver retention. The success of a home care provider rests on the quality and strength of their caregivers. The higher retention is a good indicator that the caregivers like working for the agency.

Happy caregivers in turn pass on their love to the families. We also have a comprehensive caregiver benefits and perks program. Based on industry benchmark data on caregiver compensation, we are in the upper 10th percentile.

Our caregivers tell us what they value most is verbal and written expressions of gratitude from clients. When clients call us about something they can do to acknowledge their caregiver’s love and care, we simply say you just did.

We track every time a client calls us and expresses appreciation for one of our caregivers. Client recognition and reliability are the two major things we look at in annual reviews of our caregivers. 

Ask your potential agency what they do for their caregivers. A weak answer to this question should concern you because caregivers are, or they should be, the most important thing to a home care agency.

9. How much do your services cost?

Home care can be costly and when you’re considering it, I imagine you’re trying to see just how cost effective it can be compared to the various senior living options. Look for a crisp answer.

Typically, home care agencies offer companion care and personal care. Ask them what the hourly price starts at for both categories. Do they have different pricing for weekdays and weekends? (We do not, by the way).

Ask them about other complex cases such as care for patients with Alzheimer’s, dementia, MS etc.? Is there a higher charge to take care of a couple? Do they have any other services such as nurse care (we do).  Get the complete picture.

10. What are their caregivers saying?

You can tell a lot about an organization by what their employees are saying about them. How do we provide exceptional care? The answer is simple. Our exceptional caregivers and office staff. Taking care of caregivers and office staff is priority one. Check out what employees are saying by checking the agency web site or popular employment portals and elder care review sites such as, and

11. How do they answer the phone?

This is a wonderful first test of the company you may trust for the care of your loved one. They say first impressions are important and it’s true. We get so many compliments from our circle of support referral partners and potential clients, which includes the sons and the daughters, on not only how we answer the phone but how we connect and establish rapport.

Is the person you’re talking to listening and giving feedback on your situation or just selling services? Frequently after listening to the situation, we guide callers to other resources that can be more appropriate and helpful.  The caller is a bit stunned we did that and asked nothing in return. We want to give you the best possible solution and another organization may be better suited.

Consider the following when you call:

  • Are they good listeners?
  • Did they understand your needs?
  • Did you feel comfortable with them?

12. Do they have professional references?

What do professionals in the senior care industry say about them?

This could be doctors with whom they work, senior living community directors, Home Health and Hospice organizations, geriatric care managers, and others. If you can find positive reviews from the professional network, it’s definitely a positive and reflects well on the agency. It’s what is called a “proof point” in the sales world and demonstrates that the agency is very good at what they do and is good to work with.

13. Do they have case studies?

It’s always reassuring when you can find some case studies that validate the service description provided in brochures.

If the agency says they are experienced in cases with clients with MS, it’s nice to see a documented case study that discusses the case and what the outcome was.  It also helps you identify with the agency if there is a case study that matches your loved one’s situation.

14. How involved is the agency in the community and in giving back?

It speaks volumes about the owners and staff of the agency when they are deeply involved in their community, donating time and educating people in home care. It’s all about being accessible and approachable.  We want to provide as much information as we can so you make the best decision regarding care.

Ask your potential agency if they are frequent speakers in the community and/or to whom they donate their time.

15. Do they provide veteran’s assistance?

Gina and I have a soft spot in our hearts for our veterans. Gina’s father Andy served in World War II in the Army as a scientist working on the Manhattan project. My Dad served briefly in the Air Force post WWII and my Step-Dad Jack Doyle was a naval officer during WWII. I served in the US Navy as a submarine officer on the USS Groton Nuclear Submarine SSN-694. In 2017, we were honored to be approved for the Veteran Administration Veterans’ Choice Program. We can provide care to veterans directly or under contract from the VA.

Ask your potential agency if they provide services for veterans and if they are under contract with the VA for home care.
We hope this list is helpful for those trying to navigate the waters of caring for a loved one.  If you’ve been through the process, what has your experience been like? What other questions would you add to this list?

And as always, feel free to give us a call at (919) 436-1871 if you have any further questions. It’d be great to hear from you!