Finding a caregiver starts with knowing what type of help you need, then choosing the right hiring path and vetting candidates carefully. The process looks different depending on whether your loved one needs hands-on medical support or help with everyday tasks like cooking, bathing, and getting around the house. Here’s how to work through each step.
Decide What Level of Care You Need
Caregivers fall into two broad categories, and understanding the difference saves you from hiring the wrong person. Home health aides work under the direction of a nurse or other clinician. They can check vital signs, give medications, change bandages, help with prescribed exercises, and in some cases operate medical equipment like ventilators. Personal care aides handle nonmedical tasks: companionship, cooking, cleaning, bathing, dressing, and driving to appointments.
If your loved one has a chronic condition that requires monitoring, wound care, or medication management, you’re looking for a home health aide. If the main concern is that they can’t safely manage daily life on their own, a personal care aide is the right fit. Some families need both, or find that needs shift over time from one category to the other.
Certified nursing assistants (CNAs) sit a step above home health aides in training. They complete a state-approved program and pass a competency exam. Home health aides typically need only a high school diploma and a shorter training course, though those working for certified home health or hospice agencies must complete formal training and pass a standardized test. State requirements vary, so check whether your state requires licensing or certification for the type of aide you’re hiring.
Agency Hire vs. Independent Hire
You have two main paths: hire through a home care agency or find a caregiver independently. Each comes with real trade-offs in cost, control, and responsibility.
An agency handles recruiting, background checks, credential verification, scheduling, payroll, and taxes. If a caregiver doesn’t work out or there’s a conflict, the agency has a process for resolving the issue and can send a replacement. Most states require agencies to carry insurance and may impose licensing standards on individual caregivers. You pay more per hour for this convenience, but the administrative burden is minimal.
Hiring independently gives you more control over who provides care and often costs less per hour. But you take on everything: finding candidates, running background checks, verifying training, managing schedules, and handling payroll. Critically, an independent caregiver is typically your household employee. That means you’re responsible for withholding and paying employment taxes. For 2025, Social Security and Medicare taxes apply once you pay a household worker $2,800 or more in cash wages during the year. You’ll need to file Schedule H with your tax return. Some families also purchase additional liability insurance to cover potential injuries or theft, since independent caregivers aren’t required to carry their own insurance in all states.
Where to Search for Candidates
Several resources can connect you with caregivers, depending on your situation and budget.
The Eldercare Locator, a free service run by the federal Administration for Community Living, is one of the best starting points. You can search by location at eldercare.acl.gov or call 1-800-677-1116 to speak with trained staff. They connect you with your local Area Agency on Aging, which can point you toward vetted home care agencies, subsidized programs, and community services in your area.
Online caregiver matching platforms work like registries. Providers create profiles listing their training, experience, and availability. You search the registry, review profiles, then contact candidates directly to set up interviews, request background checks, and negotiate rates. These platforms are connectors, not employers. They don’t typically verify the information providers list, so the screening responsibility falls entirely on you.
Word of mouth remains one of the most reliable channels. Ask your loved one’s doctor, hospital social worker, or discharge planner for referrals. Other families dealing with similar care needs, whether through local support groups or online communities, often know which agencies and individual caregivers are worth contacting. Faith communities and senior centers can also be good sources.
What It Costs
According to the Genworth Cost of Care Survey, the national median hourly rate for home health aide services in 2024 is about $34, while homemaker services (nonmedical help) average around $31 per hour. Rates vary significantly by state and metro area. If your loved one needs 20 hours of care per week at $33 an hour, that’s roughly $2,640 a month out of pocket.
Medicare covers home health services under specific conditions: a healthcare provider must assess your loved one face-to-face and certify that they need part-time or intermittent skilled care, your loved one must be considered homebound, and a Medicare-certified agency must provide the services. Medicare does not cover full-time home care or personal care aides who only help with daily tasks. Medicaid coverage for home care varies by state but is generally broader for people who qualify financially. Long-term care insurance, veterans’ benefits, and some state waiver programs can also offset costs.
How to Screen and Vet Candidates
Whether you hire through an agency or on your own, thorough vetting matters. Agencies handle this step for you, but if you’re hiring independently, you need to run your own background checks and verify credentials.
A fingerprint-based background check that searches both state and federal criminal databases typically costs $75 to $100. This level of screening is standard for jobs involving vulnerable adults. A simpler name-based state check runs around $24, and a basic name-only check costs $8 to $20, though these are less thorough since they don’t include fingerprint verification. Many states require the more comprehensive check for caregivers working with elderly or disabled individuals.
Beyond the background check, verify any certifications the candidate claims. Confirm CPR and first aid training is current. Call references and ask specifically about reliability, communication, and how the caregiver handled difficult situations.
Questions to Ask in the Interview
The interview is where you assess both competence and personality fit. A caregiver might have perfect credentials but not connect well with your loved one. Plan to have your family member present for at least part of the conversation if possible.
- Experience and training: Ask them to walk you through their education and hands-on caregiving experience. If your loved one has dementia, mobility issues, or another specific condition, ask about their experience with that situation in particular.
- Emergency response: Ask what steps they would take if your loved one needed to go to the hospital, or if they found an open bottle they suspected was poison. You want someone who can think clearly under pressure and knows when to call 911 versus when to call you.
- Medical skills: Find out whether they have CPR certification, first aid training, and any experience administering medications. If your loved one needs help with medical equipment or exercises, ask the candidate to describe how they’ve handled that before.
- Respite and flexibility: Discuss their availability, how they handle schedule changes, and whether they’ve worked in respite care (short-term relief for primary family caregivers).
- Daily routines: Describe a typical day for your loved one and ask how they would approach it. Their answer reveals whether they’re adaptable and attentive to individual preferences.
Making the Transition Smooth
Once you’ve chosen a caregiver, start with a trial period of one to two weeks. This gives everyone time to adjust and lets you see how the caregiver interacts with your loved one in real situations. Write out a clear care plan that covers daily routines, dietary needs, medications, emergency contacts, and any behavioral patterns the caregiver should know about.
Check in frequently during the first month, both with the caregiver and with your loved one. Look for signs that the relationship is working: your family member seems comfortable, their needs are being met consistently, and communication with you is open. If something feels off, address it early. Switching caregivers is far easier in the first few weeks than after months of settling into a routine that isn’t quite right.