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Elder Care/Companionship Services FAQs

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What is Elder Care?

Elder care is a relatively new and growing concept that combines domestic services and limited health care services for the rapidly growing, aging population (most often persons 65 and older). The primary focus of elder care companionship services is to enable otherwise physically healthy elderly adults to remain independent in their own homes as long as possible. Elder care can evolve into providing limited health care services to recovering, disabled, chronically or terminally ill adults who would ordinarily be cared for in a nursing home, not hospital, environment. Families find that elders suffering from Alzheimer's Disease and related dementias can remain in their home environment, especially with other family members, with the services of Home Health Aides, a type of elder caregiver.

Generally, elder care is appropriate whenever an individual prefers to stay at home but needs ongoing care that cannot be readily provided solely by family members. Elder care helps seniors live independently for as long as possible, given the limits of their medical condition. It covers a wide range of services and can often delay the need for long-term nursing home care. Families may acquire elder care services either through a Home Health Care Agency (HCA) or by hiring directly. Direct hires are most common for companionship services, and for private-pay home health care when the senior's condition is expected to remain substantially the same for a long period of time.


4HomeHelp.com provides families an economical means to recruit and directly hire companions and home health aides. The Search Eldercare Help Wanted  Help Wanted area allows families to preview available candidates, advertise their specific job, and to hire directly without utilizing a Staffing Agency. 4HomeHelp.com also provides a data base of staffing agencies who, for a referral fee, will assist families in hiring elder caregivers. Locate Eldercare Staffing Agencies  Search Staffing Agencies for agencies near you.


When hiring elder care givers directly (instead of through a staffing agency), it is important that the responsible adult screen the person thoroughly. One should prepare for the interview by making a list of any special needs the senior might have. Prepare a list of what you anticipate the required duties and hours will be in advance. Armed with this you can then interview the elder care giver to make sure that he or she is qualified for the job. Require references and check them thoroughly. Professional reference checking services may be utilized. Appropriate pre-employment screening includes conducting a pre-employment criminal background check and sex offender registry checks. In addition to screening for criminal records, families should consider checking DMV records when the care giver will be driving. Many families find that they need two or more care givers. This is of particular importance when medical care is required. This provides the family with the coverage and backup care to accommodate employee vacations, illness and other personal needs.

Companions, home health aides, and elder care givers who are paid directly by the family become employees of the family. Families often find direct employment is more economical, even after added expenses of employment taxes and workers compensation insurance are factored in. Families are encouraged to familiarize themselves with Eldercare Payroll and Employment Tax Rules and Regulations.

Elder caregivers may live in or live out. Companionship services are generally, but not exclusively, provided on a live-in basis. Home Health Aides typically come and go on a pre-established schedule.

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