Most families call three agencies in an afternoon and come away unable to tell them apart. Everybody sounds kind. Everybody says their caregivers are wonderful.
The differences are real, but they aren't in the brochure. They show up in how an agency answers specific questions, and in what happens six weeks later on a Tuesday when something goes wrong.
Here are the ones worth asking, and what a straight answer sounds like.
Are you licensed, and what's your license number?
California has required home care organizations to be licensed since January 2016, and the state keeps a public registry of home care aides who have passed a criminal background check.
Any agency should give you its license number without hesitating. Ours is HCO #344700040. You can check a license with the California Department of Social Services.
If an agency is vague about this, that tells you most of what you need to know and you can stop there.
Are your caregivers employees or contractors?
This sounds like paperwork. It isn't.
If caregivers are employees, the agency carries payroll, taxes, workers' compensation and liability insurance. If somebody is hurt in your parent's home, that sits with the agency.
If caregivers are contractors, some of that can land back on your family. Ask directly and ask them to say it plainly. Our article on hiring through an agency or privately goes through what actually changes.
What happens when my caregiver can't come?
This is the question that matters most and the one families forget to ask.
Caregivers get sick. They take vacations. Sometimes they leave. The question is what happens on that day, not whether it will happen.
A good answer is specific. Somebody else comes, here's how we arrange it, here's how much notice you get. A vague answer means the answer is you.
Who supervises the care, and how often will they visit?
A caregiver working alone with no oversight is a different service from a caregiver working to a documented plan that somebody reviews.
Ask who writes the care plan, who checks on it, and how often they actually come to the house. Ask what happens when your parent's needs change, because they will.
Can I meet the caregiver before care begins?
The answer should be yes.
A first meeting with a family member present makes an enormous difference, particularly in dementia care, where arriving as a stranger on day one and starting in on tasks is the fastest way to be refused at the door.
What happens if the fit is wrong?
Not if the caregiver is bad. If they're perfectly good and simply not right for your mother.
You want to hear that you make one phone call and the agency changes the match. You don't want to be in a position where fixing it means firing somebody yourself.
Ask how long that takes and whether there's any charge for the changeover.
How does scheduling actually work?
Ask about the minimum, how far ahead you need to book, and how much flexibility there is week to week.
Then ask what happens if you need to increase hours quickly. After a fall or a hospital stay, families often go from a few hours a week to needing 24 hour home care within days. An agency that can't do that leaves you starting over at the worst possible moment.
What training do caregivers have for dementia?
If memory loss is part of your situation, ask specifically rather than generally.
Alzheimer's care at home isn't the same work as helping somebody who is physically frail and mentally sharp. Ask what the training covers. Ask how they handle somebody who's anxious in the late afternoon, or who refuses help with washing, or who doesn't recognize the caregiver on a given day.
The answers will tell you quickly whether the agency has thought about it or is reading from a list.
What's in the agreement, and how do I end it?
Read it before you sign it, and ask two things.
How much notice do I need to give? And is there anything I'm committing to beyond the hours I'm booking?
An agency confident in its own service doesn't need to lock families in.
A question to ask yourself
After all of that, there's one more, and it isn't about the agency.
Did the person on the phone ask about your mother, or did they talk about themselves?
The agencies worth using spend the first ten minutes asking what an ordinary day looks like, what has gotten difficult, and what you're actually worried about. The rest is a sales call.
Where to start
A free in-home assessment is the straightforward way to find out. Somebody comes to the house, looks at the real situation, and tells you what would genuinely help. Nothing to sign, no obligation.
Ask us every question on this page while they're there.
Call (916) 333-0383 in Greater Sacramento or (619) 430-4443 in San Diego County.
This article is general information for families and is not medical, legal, financial or insurance advice.
How Golden Years helps
Golden Years Home Care is family owned and has been caring for California families since 1996, from a few hours a week to round-the-clock support.
Book a free in-home assessment and put these questions to us directly. We'll look at your situation and tell you honestly whether a few hours of help, dementia care, Alzheimer's care at home or 24 hour home care is the right fit. Licensed Home Care Organization #344700040.
