Hiring In-Home Help for a 90+ Parent: Questions to Ask First

When a parent in their 90s needs more help than family can give, in-home care is often the next step. The hard part is knowing what to ask. This checklist covers the questions worth asking any agency or independent caregiver before they start.

First, be clear about what kind of help you need

• Non-medical (personal care or companion) help: bathing, dressing, meals, light housekeeping, rides, supervision.

• Home health care: skilled services such as nursing or physical therapy, usually ordered by a doctor. Medicare may cover home health in some situations; it generally does not cover ongoing non-medical help. Check Medicare.gov for the current rules.

Write down the tasks and hours you need before you call anyone.

Questions for an agency

1. Are you licensed in this state? Requirements vary by state; ask what license applies and check it.
2. Are caregivers employees or contractors? Who handles taxes, insurance and workers' compensation?
3. What background checks do you run, and how often are they repeated?
4. What training do caregivers have, especially for fall prevention, transfers, and dementia if relevant?
5. What happens if the caregiver is sick or doesn't show up? Is a backup guaranteed?
6. Can we meet the caregiver first, and request a change if it's not a good fit?
7. How is care supervised? Is there a care plan, and who reviews it and how often?
8. What are the rates, minimum hours per visit, and charges for nights, weekends and holidays?
9. What's the cancellation policy?

Questions for an independent caregiver

• References from recent families, and permission to call them.

• Consent to a background check.

• Who pays payroll taxes. Hiring someone directly may make you a household employer; see IRS Publication 926.

• A written agreement covering duties, hours, pay, and time off.

Red flags

• Pressure to sign a long contract on the spot.

• Vague answers about backup coverage or background checks.

• Requests for cash only or for access to your parent's bank accounts.

Free help finding services

• Eldercare Locator (a public service of the U.S. Administration for Community Living): eldercare.acl.gov or 1-800-677-1116. It connects you to your local Area Agency on Aging.

• Your parent's doctor or hospital discharge planner can also point you to local options.

Sources

• Eldercare Locator: https://eldercare.acl.gov

• Medicare, Home health services: https://www.medicare.gov/coverage/home-health-services

• IRS Publication 926, Household Employer's Tax Guide: https://www.irs.gov/publications/p926

General information only, not legal, tax or medical advice. Affiliate disclosure: we may earn a commission on purchases through links on this site, at no cost to you.

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