Hiring a home care aide — what to look for and what to ask

This article is for informational purposes only and does not constitute medical, legal, or financial advice. Please consult appropriate professionals for guidance specific to your situation.

Hiring a home care aide is like matchmaking. You're trying to find someone who will be trustworthy, skilled, kind, and compatible with your parent. Someone who will help your parent stay clean and fed and safe. Someone your parent will feel comfortable with in intimate moments like bathing. Someone who will be reliable, show up on time, and actually do the work. Someone whose presence makes your parent's life better, not more stressful.

The person doesn't have to be perfect. But they have to be trustworthy. This is someone who will be in your parent's home when you're not there. This is someone your parent will be vulnerable with. This is someone handling your parent's belongings, their personal care, their safety. Get this wrong and you've introduced a risk instead of preventing one. Get this right and you've added a real person who cares about your parent to the support network.

What to look for in a home care aide

Trustworthiness is non-negotiable. This is someone being let into your parent's home unsupervised. They have access to valuables, medications, financial information. You need to know they're not going to steal or cause harm. Background check is the minimum. References are good. But the truth is you're also making a judgment call about character. Does this person feel trustworthy? There's an instinct piece here that matters.

Competence with the specific tasks your parent needs matters. If your parent needs help bathing, you want someone who knows how to help someone get in and out of the shower safely. If your parent uses a walker, you want someone who understands mobility. If your parent has specific medical things like a catheter or feeding tube, you want someone trained to handle those. Basic competence means fewer problems and your parent is safer.

Physical capability matters. If your parent is large or has significant mobility issues, you need an aide with the physical strength to help. A small person might struggle to help someone transfer from chair to walker. This isn't about size, it's about whether the aide can do the work. Ask about their physical capabilities and be honest about what your parent needs.

Personality compatibility is huge. Your parent has to be comfortable with this person. They're going to see them multiple times a week. They're going to help with intimate things. If your parent is a quiet person and the aide is constantly chatty, that's annoying. If your parent wants company and the aide does the work silently, that's also a mismatch. The aide doesn't have to be your parent's best friend. But they have to be someone your parent is comfortable around.

Reliability means they show up on time, they do the work, they don't take random days off. A reliable aide makes your life easier. An unreliable aide creates constant stress because you don't know if they're showing up and you have to make backup plans constantly.

Experience with older adults is valuable. Someone who's done home care before understands how to work with aging bodies, how to be patient with cognitive issues, how to handle the physical demands. Someone without experience but willing to learn can work, but there's a learning curve.

Languages matter. If your parent speaks English and your aide speaks only Spanish, that's a serious problem. You need to communicate. Your parent needs to communicate. This is more important than you might think.

The hiring process

You hire through an agency or you hire privately. An agency does background checks, handles liability, handles taxes and employment stuff. The agency is responsible if something goes wrong. You pay more. A private hire is cheaper but you handle all the logistics.

If you go through an agency, they'll ask what your parent needs help with and they'll send candidates. You interview the candidates. You talk about what the job entails. You see if it seems like a good fit. You arrange a trial period. The agency handles everything else.

If you hire privately, you're responsible for vetting. You advertise, you interview, you check references thoroughly, you do background checks, you handle employment taxes and requirements. It's more work but cheaper. The problem is if the aide does something wrong, you're liable because you're the employer. You also have to manage what is actually an employment relationship, which has legal and financial requirements.

The interview is where you get a sense of the person. Ask about their experience. Ask why they do home care work. Ask how they handle difficult situations. Ask about their approach to personal care, to medicine reminders, to housework. Ask what they would do if your parent was upset or confused. Listen to how they answer. Someone who's been doing this has clear answers and they're thoughtful about the work.

Call their references. Ask the previous employers about reliability, honesty, how they handled specific situations. Ask about problems. Ask how long they worked for them and why the work ended. Real references matter. Anyone can be polite in an interview. References tell you how they actually work.

Background check is essential. Criminal history matters. Abuse history is disqualifying. Financial crimes suggest dishonesty. This is someone with access to your parent and your parent's home.

Trial period is important. Don't hire someone to come three days a week forever without having them come a few times and seeing if it actually works. The aide might be perfect in interview and terrible in practice. Your parent might decide the aide is not someone they want in their home. Better to find this out quickly.

Start with smaller tasks. Don't hire someone and immediately have them managing your parent's medications and doing all personal care. Have them do housework or cooking first. See how they work. Build trust gradually.

Building a good working relationship

Clear expectations matter. Your parent and the aide both need to know what the job is. What tasks are included? What time does the aide arrive and leave? What happens if the aide is sick? How much is the aide responsible for versus how much is your parent's responsibility? If expectations aren't clear, resentment builds.

Communication between you and the aide is important. How do you stay updated? Do they report to you daily or weekly? What kinds of problems do they tell you about immediately versus what can wait? Some families use a communication notebook that travels with the aide. Some text daily. Some have a weekly call. Figure out what works for your family.

Personality conflicts happen. Maybe your parent and the aide don't click. Maybe the aide does the work but your parent resents having them in their home. Maybe the aide is reliable but also kind of rude. If the relationship isn't working and it's affecting your parent's quality of life, change it. This is one situation where you don't have to make a relationship work if it's not working. Try a different aide.

But also give it time. New relationships are awkward at first. Your parent might warm up to someone they were initially resistant to. An aide might become more comfortable as they understand your parent's routines. Some issues resolve themselves with time. Some don't. Be willing to try, but also be willing to make a change if it's clearly not working.

Compensation and appreciation matter. Home care is hard work and the pay is not great. If you can, pay fairly and on time. Appreciate the work they do. Small bonuses on holidays. Acknowledgment when they do a good job. This isn't required, but it affects reliability and how much the aide cares about your parent. People who feel valued and treated well tend to work harder.

Remember that a good home care aide is becoming increasingly essential to your parent's ability to stay home. They're not just someone doing a job. They're part of your parent's team. Invest in finding the right person and in the relationship once you have them. It matters.

How To Help Your Elders provides educational content for family caregivers. This is not a substitute for professional medical, legal, or financial advice. Every family situation is different — what works for one may not work for another.