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finding and screening an in-home care provider

Key points

  • Start your search early, before you are in crisis. Contact your loved one's doctor and your local Area Agency on Aging first.
  • Always conduct an in-home interview with a third person present. Prepare specific questions about dementia training and experience.
  • Check references and ask about background checks. Do not skip this step, even if the caregiver seems wonderful.
  • Share a detailed 'About My Loved One' sheet with the caregiver to help them connect and provide personalized care.
  • Start with a trial period while you are still home. Observe how the caregiver interacts and trust your instincts.
  • Consider your own need for respite care. You cannot care for your loved one well if you are exhausted and overwhelmed.

General caregiving information, not medical advice. Check medications and major care changes with your clinician.

Step-by-step

  1. Start by talking to your loved one's primary care physician or neurologist. Ask specifically: 'Do you know any home care agencies or independent caregivers who have experience caring for someone with dementia?' Doctors often have a list of trusted providers they have worked with. This is one of the most reliable starting points because the recommendation comes from a professional who knows your loved one's health needs.

  2. Contact your local Area Agency on Aging (AAA). You can find yours by calling the Eldercare Locator at 1-800-677-1116 or visiting eldercare.acl.gov. The AAA can give you a list of licensed home care agencies in your area, tell you about any state-funded programs that help with costs (like respite vouchers or PACE programs), and connect you with a counselor who can help you understand your benefits. This is a free service and one of the most underused resources.

  3. Use Medicare's online tool 'Home Health Compare' at medicare.gov/care-compare to find and compare Medicare-certified home health agencies in your area. Even if you are looking for non-medical home care, this tool can give you a starting list of agencies that are regulated and inspected. You can also search the Alzheimer's Association Community Resource Finder at alz.org for local home care services that specialize in dementia.

  4. Once you have a list of 2-3 agencies or independent caregivers, schedule an in-home interview with each one. Have the interview in your loved one's home, not over the phone. This lets you see how the provider interacts with the environment and with your loved one. Bring a third person with you — a friend, another family member, or a social worker — so you can compare impressions afterward. Prepare a list of questions beforehand and take notes.

  5. During the interview, ask specific questions about dementia training and experience. For example: 'How many clients with dementia have you cared for in the last year?', 'What do you do when a client becomes agitated or refuses care?', 'Do you have training in validation therapy or positive approach to care?', and 'How do you handle wandering or sundowning?' Listen for answers that show they understand the person is not being difficult — they are having a difficult time.

  6. Ask about the agency's hiring and screening process. Do they conduct criminal background checks? Do they check references? Do they provide ongoing dementia-specific training? Some agencies will conduct background checks, but not all do. You have the right to ask for proof. Also ask about their backup plan: what happens if the regular caregiver is sick or quits? Will they send a substitute who also has dementia training?

  7. Check references. Ask the agency for the names and phone numbers of at least two current or past clients who have a family member with dementia. Call those families and ask: 'How long have you used this agency?', 'Has the same caregiver come consistently?', 'How did the caregiver handle difficult moments?', and 'Would you hire them again?' If you are hiring an independent caregiver, ask for personal references and follow up.

  8. After the interview, share detailed information about your loved one with the provider. Write down their daily routine, favorite foods, preferred activities, meaningful memories from their past (like their childhood home or their wedding day), and any triggers that upset them. The more the caregiver knows, the better they can connect and provide care that feels familiar and safe. Even with memory loss, people with dementia maintain strong memories from periods of their past, and using those can build trust.

  9. Start with a trial period. Arrange for the caregiver to come for a few short shifts (2-4 hours) while you are still in the home. Observe how they interact. Does your loved one seem comfortable? Does the caregiver speak calmly and respectfully? Do they ask questions or try to take over? Trust your gut. If something feels off, it is okay to try someone else. You are not being picky — you are being protective.

  10. Once you decide on a provider, put everything in writing. This includes the schedule, services provided, hourly rate, payment terms, cancellation policy, and a clear process for giving feedback or ending the arrangement. If you use an agency, they will have a contract. Read it carefully. If you hire independently, write a simple agreement. This protects both of you and prevents misunderstandings later.

What not to do

  • Do not wait until you are in crisis to start looking. Many families wait until a major incident — like a fall, wandering, or hospitalization — before they seek help. By then, you are exhausted and making decisions under pressure. Start exploring options early, even if you are not sure you need help yet. It is much easier to hire someone when you have the time to interview and observe.

  • Do not hire the first person you find without checking references or doing a background check. It is easy to be charmed by a warm personality, but dementia care requires specific skills and trustworthiness. Skipping this step can lead to theft, neglect, or a caregiver who does not know how to handle behaviors. Always verify. If an agency refuses to share references, cross them off your list.

  • Do not assume that a caregiver with general senior care experience is automatically good for dementia care. Caring for someone who is physically frail but cognitively intact is very different from caring for someone with dementia. A caregiver who does not understand dementia may argue, correct, or take things personally, which can cause distress and escalate behaviors. Ask specifically about dementia training and experience.

  • Do not keep your concerns to yourself after the caregiver starts. If you notice something that bothers you — a missed task, a dismissive tone, or your loved one seeming more anxious — speak up immediately. Most good providers want to fix problems. If you stay silent, resentment builds, and your loved one may suffer. You have the right to request a different caregiver or to end the arrangement.

  • Do not forget to consider your own needs as a caregiver. You might be so focused on finding someone for your loved one that you forget to ask about respite for yourself. Many agencies offer respite care — a few hours or days of professional care so you can rest, run errands, or just have a break. Some state programs even offer vouchers to help pay for respite. You cannot pour from an empty cup. Taking care of yourself is part of taking care of your loved one.

Practical tools

  • The Pre-Interview Question Checklist

    Before the in-home interview, write down these exact questions to ask the agency or caregiver: (1) 'How many clients with dementia have you cared for in the past year?' (2) 'What specific dementia training does your staff receive?' (3) 'How do you handle a client who refuses to bathe or take medication?' (4) 'What is your policy on background checks?' (5) 'Do you have a backup caregiver if the regular one is unavailable?' (6) 'How do you communicate with the family about changes in the client's condition?' (7) 'Can you provide two references from families caring for someone with dementia?' Keep this list with you during the interview and take notes.

  • The 'Share This Sheet' Template

    Create a one-page document to give to every caregiver on their first day. Include: your loved one's preferred name, their daily routine (wake-up time, meal times, favorite activities), foods they like and dislike, any allergies or medical conditions, a list of meaningful memories or stories they enjoy (e.g., 'She loves to talk about growing up on a farm'), triggers to avoid (e.g., 'Do not rush him in the morning'), and calming strategies that work (e.g., 'If she gets upset, offer her a cup of tea and put on big band music'). This tool helps the caregiver connect quickly and reduces confusion for your loved one.

  • The Trial Period Observation Log

    During the first few shifts, use a simple log to track what you observe. Write down: (1) Did the caregiver arrive on time? (2) Did they greet your loved one by name and with a smile? (3) Did they ask questions or try to take over? (4) How did your loved one react — calm, anxious, happy? (5) Did the caregiver handle any challenges calmly? (6) Did they respect your home and your loved one's belongings? After the shift, ask your loved one (if they can communicate) how they felt. Trust your gut. If something feels off, it is okay to try someone else.

  • The Area Agency on Aging Contact Script

    When you call your local Area Agency on Aging, say: 'I am caring for my [mother/father/spouse] who has dementia, and I am looking for in-home care options. Can you help me find licensed home care agencies in my area? Do you have any programs that help with the cost of respite care or home care? Are there any grants or vouchers available for dementia care?' Write down the name of the person you speak with and any reference numbers. This call is free and can save you hours of searching.

  • The 'What to Look For' Observation Guide

    During the interview and trial period, watch for these signs of a good dementia caregiver: They speak slowly and calmly, use simple sentences, and give your loved one time to respond. They do not argue or correct. They redirect gently (e.g., 'Let's go look at the garden' instead of 'No, that's not right'). They make eye contact and smile. They ask your loved one questions about their past. They are patient when your loved one repeats themselves. They do not take frustration personally. They are willing to learn from you about your loved one's preferences.

  • The 'Veterans Benefit Check' Tool

    If your loved one is a veteran, contact the Veterans Administration (VA) at 1-800-827-1000 or visit va.gov. Ask about the Aid and Attendance benefit, which can help pay for in-home care. You can also ask about the Veteran-Directed Care program, which gives you a budget to hire your own caregivers. This benefit is often underused. A local Veterans Service Officer can help you apply for free.

Discuss with your clinician

Ask your loved one's doctor: 'Given my loved one's specific type of dementia and current health, what level of supervision or care do you recommend? Do they need 24-hour supervision, or is part-time care sufficient?'

Ask the doctor: 'Are there any medications or medical conditions that the caregiver should be trained to handle, such as insulin injections, feeding tube care, or seizure management?'

Ask the pharmacist: 'Can you review my loved one's medications and let me know if any need to be given at specific times, or if any can be crushed or given in liquid form? This will help the caregiver avoid errors.'

If your loved one has a history of falls, ask the doctor: 'What specific fall prevention strategies should the caregiver use, and should we consider a medical alert system?'

Ask the doctor or social worker: 'Are there any local home care agencies that you have worked with and trust for dementia care? Can you give me a referral?'

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