How to Find a Home Care Agency

Your loved one needs help and you need respite. But a nursing home is not the right answer

Quincy, Mass. June 2012 – Are you caring for a loved one, juggling work and family and wondering how much longer you can continue without help? You're far from alone: one in five adults, or 43.5 million Americans, now live this reality.

As primary decision makers and caregivers for their parents and elderly relatives, women share a disproportionate burden of the emotional and economic stress: National studies show that women who care for their elders often decrease their wage earning hours, pass up a job promotion, training or assignment, take a leave of absence, switch to part-time employment, quit their jobs or retire early.

“When you start looking for options, all you think is that you should have been more prepared,” said Lisa Gazzaniga, a Martha's Vineyard resident whose mother, Stoughton resident Margaret Feinberg, had a heart attack and a stroke last year, then suffered complications from an artery stenting procedure.

“First you're waiting in the hospital hoping she will survive. Then you bring her to your home because she needs support to convalesce. Mom stayed with us for seven months and while she received valuable stimulation with our family, the experience was draining. Because we live three hours and a ferry ride from mom's condo, we really needed someone who could be our eyes, ears, legs and hearts once she moved back home,” Gazzaniga added.

Taking care of one or more aging relatives is “the new normal” (CNN Living, 4.9.12). What's more, family caregivers form a workforce that provides an astounding $306 billion worth of unpaid care each year, according to the Family Caregiver Alliance.

While many elderly or recovering patients may require a nursing home level of care,  today's elders and their families prefer to remain in their own homes. More than 70 percent of AARP members in a recent survey said they will choose home care services for a themselves or a loved one.

“Everyone's situation is different. But I felt keeping mom in a familiar environment would be crucial during her recovery. We wanted a home care agency that could offer trained professionals who would listen to her, observe and appropriately react to her condition and be an advocate for her care,” said Gazzaniga. “Keeping mom in her condo with someone we trusted seemed a better alternative than putting her in a nursing home or assisted living facility, where she'd be alone and receive limited attention,” she added.

“Whether your loved one requires full service nursing support, a home health aid, a homemaker/companion or specialized rehab or psychiatric services, you have the right to thoroughly screen the agencies and the people that will serve him or her,” said Kevin Smith, vice president of Quincy, Mass.-based Best of Care Inc..

“While it's easy to find home care workers online or by word of mouth, the real challenge is selecting a qualified provider with high standards, trained and experienced staff and the ability to match a caregiver with your loved one's personality, lifestyle and expectations.”

“We did a lot of research to determine our options,” said Gazzaniga. We spoke with the owners of the health care agency we chose and felt they were talking about mom as one of their family members. I've learned that they also pay attention to detail and logistics and don't leave anything to chance. I've recently increased the time my caregiver is with mom from 6 to 12 hours per day; the agency quickly accommodated our needs. Mom's condo, which she shared with her late husband, is now way too big for her. But regardless of how her living environment changes, we want the agency – and the wonderful caregiver they brought us — to continue caring for her in her new home.”

AARP's web site   and MIT's Family Caregiver Handbook are among the many credible resources that offer advice for families to choose a home care provider. But ultimately, it's about personally verifying the agency's reputation, processes, track record, people and outcomes before choosing who will care for mom, dad, uncle, aunt or grandma.

How do you find a qualified homecare agency?

In Massachusetts, there are several ways to get a list of qualified agencies. Places to start include your family doctor, a family member or friend that hired an agency, town senior services, the aging councils, hospital or nurse care managers, or you can search online. Then, once you've assembled a short list of prospective home care providers, go to their web sites to learn about how they work and operate. Call the Better Business Bureau to see how they are rated. Find out if they are certified or accredited and by what organizations.

Then, schedule a face-to-face meeting with the owner or a key manager of each agency. During each meeting, ask these questions:


  • Will your agency conduct a needs assessment to determine care plans…and revisit this periodically to make any adjustments that may be needed?
  • How does your agency protect confidentiality of my loved one and my family?
  • If I ask for a different caregiver, ask to review your care logs for my loved one or cancel your services, will you honor these requests?
  • Do I need a doctor's order for home care?
  • How does your agency handle emergencies?


  • How do you screen, train and supervise your agency's caregivers?
  • How will you a match a caregiver to my loved one's needs?
  • How will my loved one's course of treatment and services documented?
  • Who do we contact with questions or complaints?


  • Are there any limits on the services you provided, e.g. number of hours per day or week?
  • If necessary, is the care plan overseen by a registered nurse?
  • Do you provide a written schedule of services?
  • Can you help us find additional services, eg. Meals on Wheels, etc.?

Payment and Financials

  • Is your agency certified to take Medicaid and/or Medicare?
  • Does your agency partner with state funded Elder service programs that provide subsidized funding for qualified candidates?
  • Do you take commercial or long term care insurance?
  • Do you have payment agreement plans?
  • Do you provide detailed explanations of the costs associated with your services?
  • Does your agency provide guidance to help us better understand any options that may be available for financial assistance to help in my loved one's home care?

By using this checklist as you review each agency, said Smith, you'll be able to hone in on home care providers that will truly serve your loved one's specific care needs.

“I've missed a lot of work over the past few years arranging for mother's care and schedule. While I continue to manage the financial, scheduling and overall care details of my mom's life, I work with a home care agency I trust that has provide us with caregivers who adore her and communicate well with me,” said Gazzaniga.  

For more information, contact:

Home Care Alliance of Massachusetts Online

Mass Home Care

The Family Caregiver Handbook: Finding Elder Care Resources in Massachusetts




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