Guide to Choosing Home Nursing Care

Guide to Choosing Home Nursing Care

When our parents or other loved ones begin to experience declining health, or are recovering from an injury or surgery, they may require medical assistance to live their daily lives. Often the person would prefer to remain in his or her own home, but is unable to care for themselves as well as they need to.  Home nursing care may be a possible option. Before you hire a home nursing care professional, it is best to take some time to research and review your options. The process of finding a caregiver is less difficult when you follow the guidelines in this informational guide.

Each person has unique requirements and those needs may change over time. The ideal nursing care provider is one that is available to meet the ongoing needs of the patient. You certainly want a qualified individual caring for your loved one, but you must also balance this need with the costs of care. You must make sure that the patient has the qualified assistance needed to stay safe while living at home.

Determine Your Needs

The main reason for hiring a home nursing care professional is to provide services such as health monitoring (blood pressure, glucose levels, etc.), medical care (wound treatment, managing IV’s, etc.), physical therapy, speech therapy or skilled nursing care under the direction of a physician, while allowing the patient to remain at home. Educating the patient’s family caregivers is also a part of the services provided, so that loved ones know how to help care for the patient when the nurse  is not there. The patient’s physician will decide what type of care is needed, and how often care is required. Some patients may need care daily, while others only need care a few days a week or once a week. Sometimes the patient is recovering from surgery or an injury, and will need help on a short-term basis, while others may need help long-term due to declining health. It’s important to keep in mind that a home health care professional offers medical-related help, while home care services focus specifically on the household chores. If your loved one requires both medical care and help with their home, you will need to consider hiring two separate individuals or services.

Choosing a Home Nursing Care Professional

It is essential to choose a home nursing care professional who provides high-quality care. Caregivers are often Registered Nurses (RN) or Licensed Practical Nurses (LPN), or specially trained therapists. To locate a home nursing care professional near you, you can search online for “home nursing care (your city and state)”. The search results will provide you with the names of agencies, their location, specialties and reviews.

The National Association for Home Care & Hospice is a non-profit organization that “advocates for the more than two million nurses, therapists, aides and other caregivers employed by such organizations to provide in-home services to some 12 million Americans each year who are infirm, chronically ill, and disabled”. They are a great resource and have a lot of information to share on their website at They also have a “Home Care & Hospice Locator” on their website, to help you locate professionals in your area that they support.

There are many other resources to help locate a home nursing care professional.  For example, The Visiting Nurse Association of America is a nationwide home healthcare provider and can be found online at The Department of Health and Human Services offers an eldercare locator online through the Administration on Aging. Your doctor or hospital may have a list of local resources that they trust. If the care is covered by insurance, such as Medicare, they may offer a list of providers. Friends or family members may also have recommendations for caregivers in your area that they trust.

Home Nursing Care Providers

There are probably several different options available in your area, so it is necessary to narrow your choices down to just a few and focus your research efforts on those. Review each of the providers. Much of the information you need may be supplied online or you may place phone calls to learn more. Important considerations include:

  • How long has the company been in business?
  • Is the company licensed and accredited?
  • Is the agency Medicare-certified/approved?
  • Does the company provide a care plan?
  • Will the company communicate with and take direction from our physician?
  • How are caregivers supervised?
  • Home many caregivers are available?
  • What hours do caregivers provide service?
  • What services are provided?
  • How are problems resolved if they occur?
  • If there is a conflict in personality, are there other professionals available?
  • Is the company bonded and insured?
  • How are the backgrounds of caregivers checked for crimes or past abuse?
  • Are payment plan options available?

Home nursing care providers typically have printed materials, such as brochures or pamphlets, which explain their services in detail. Review this information as well as their websites to learn more about the providers. You should also obtain and check references from other clients/patients to see how they rate the company’s services.

Home Nursing Care Costs

Costs of home nursing care may vary greatly depending on the specific services required. Part of the decision process in selecting a provider must include the coverages and payment options available, and whether it is financially feasible for you to hire that provider given your resources.

Generally, Medicare only covers home nursing care for a short period of time and only under certain conditions. More information regarding what Medicare covers can be found online at: If you are going to rely on Medicare to pay for the home care services, you will need to make sure that the provider you have chosen is “Medicare-certified”. Home care may also be partially or fully covered under a supplemental insurance plan.

Interview the Caregiver

Once you have located potential providers and have done some preliminary research, you can schedule interviews. The interview allows you to ask questions and get to know the provider. Here are some suggested interview questions to ask each provider during the meetings:

  • What are your credentials?
  • Where have you worked throughout the course of your career?
  • How long have you been providing in-home care?
  • Are you familiar with the particular illness or needs of the patient?
  • Are there any areas of healthcare that you specialize in?
  • Are you prepared for emergency situations? If so, how would you handle different situations?
  • What certifications do you carry?
  • Are you willing to communicate with and take direction from our physician?
  • How are your vacations and sick days covered?
  • What are our options if we need help when you are not here? Can we call you?

An important and often overlooked part of hiring a caregiver is to have the provider meet with the patient. Your loved one needs to spend time on a daily basis with the caregiver and should feel comfortable with the choice. There is much to be said for the trust and general approval of the care provider and this will go a long way towards making sure that the situation works well. Make sure that your loved one knows that he or she has a voice in the decision-making process, if they are able to do so.

Once you have chosen a caregiver, you will likely need to sign a contract. The contract protects both you and the provider by ensuring an agreement to service options and prices. If the needs of your loved one change, you will need to make the necessary changes to the contract.

Spend the First Day with Caregiver

It is helpful to spend the first full day of care with the patient and caregiver at the home. This gives you the opportunity to observe the care and to provide and receive helpful information throughout the day. If there are any problems or you have any reservations following this experience, you can discontinue service and find a different provider.

Be sure to provide your contact information and the circumstances for which you should be called. For example, when there has been a problem or a change with the patient, you must be notified immediately. Make a list of local emergency phone numbers and leave it by the phone.

Review and Update Ongoing Care Services

Once a provider is in place, there is still work to be done. It is necessary to evaluate and oversee the care that is being given. Our elderly relatives may not always provide feedback on the services that are provided. You should be sure to visit your loved one every now and then while the caregiver is present. Also, be certain to discuss care with your relative to ensure they are being treated properly and that they are receiving the type of care that you are paying for. If the needs of your loved one change, be sure to make the necessary changes with the caregiver. If any concerns or problems occur, you need to bring them immediately to the provider’s manager. Most home nursing caregivers are able to get along well with all types of individuals and know how to work through difficult situations. However, sometimes a caregiver and a patient are not a good fit. If they are not, it may be necessary to make a change. Discuss the problem with the provider’s manager to determine the best solution. Continue to monitor your loved one’s care to make sure they remain happy and healthy.

DISCLAIMER: This guide is provided only for informational purposes and is not intended to be a substitute for legal or other professional advice. This guide does not contain nor is it intended to provide legal or other professional advice for any specific situation and readers should not take action or refrain from taking action, based only on the information provided in this guide. Goldberg & Osborne has attempted to provide accurate and current information in this guide, but cannot and does not guarantee that the information is accurate, complete, or up to date. This guide may contain links and/or search terms that will lead to external websites as a convenience to the reader, but Goldberg & Osborne is not responsible for the content or operation of any website other than its own website. The presence of a link or a search term does not imply and is not an endorsement by Goldberg & Osborne of the website provider or the information contained on any linked website or on any website contained in search results from a search term provided in the guide.