Angie's LIST Guide to
In-Home Elder Care Services

Many elderly people forgo long-term care facilities for the comfort of home. Home health care aides and nurses have become commonplace, helping with activities of daily life.


elderly woman sits at a table with a man who is writing.
Several types of senior care are available to help fit every individual's and family's needs.

Elder Care Options

When exploring care options for your loved one, you’re bound to run across a dizzying array of terms. Because many seniors bristle at the mere mention of the words nursing home, facilities and staff often resort to euphemisms in an effort to put families more at ease. In her book, Eldercare for Dummies, Dr. Rachelle Zukerman lists several of these synonyms: “old folks home, rest home, convalescent home, health center, rehabilitation center, home for the aged, living center, nursing center, care center.”

More directly, types of elder care generally fall into these categories:

Nursing Home. These facilities have with live-in residents who require constant care by licensed health care professionals.

Assisted Living. Usually apartment- or condo-type settings, seniors can live more independently than at a nursing home but still have access to care. They’re still seen on an as-needed basis by a network of providers and receive help managing medications and grooming. Many nursing homes also have independent living residences.

Independent Living. More like a retirement community, these facilities are for seniors who don’t need special care, just opportunities to socialize. Some also offer meals and transportation.

In-Home Elder Care Services. Services can consist of assistance at a senior’s own home with health care, meals preparation and transportation from a network of doctors or nurses. Care can range from round-the-clock in shifts to periodic checkups.

Adult day care. Programs provide supervision and activities during daytime hours to give the caregiver a break and peace of mind while at work or running errands.

The first three types follow a scale from a low to high level of independence for the senior. Nursing homes and assisted living facilities aren’t exclusive to the elderly, but often include younger people with other disabilities.

Elder Care at Home

Often, elderly people struggle with the decision of whether to enter a residential care facility where they can receive skilled nursing support. For those who wish to stay in their homes but with needed personal support, in-home care might be the solution.

With attention to protecting the individual's dignity, elder care in the home fulfills a niche health need that ensures help for the elderly in their time of greatest need. Centered specifically around late adulthood, care providers consider the elderly person's holistic needs, not just his or her health care needs.

While skilled nursing care may be an aspect of elder care, providers typically help with other activities, such as food preparation and light cleaning. In-home care for the elderly provides assistance for six basic categories of daily life: bathing, dressing, eating, sleeping, transferring and walking. Sometimes care in the home provides for more than just the activities of daily life. Therapists also perform advanced skills, which include physical therapy, occupational therapy and speech therapy.

Many companies offer services targeting the needs of the elderly community and market services to those who wish to stay in their home. Specializing companies often have training programs and accountability checks in place.

Who Provides Elder Care?

Qualified practical nurses (PNs) and nursing assistants (NAs) provide care in the individual's home. While training programs for PNs and NAs don't specifically center around the elderly, training is holistic and covers important nursing topics, such as body mechanics, wound care, walking and positioning in bed. After completing a training program, some PNs and NAs take a certification exam to become a licensed practical nurse (LPN) or a certified nursing assistant (CNA).

Selecting qualified workers is necessary, as home-health LPNs and CNAs serve a unique and important role. Home health care assistants care for the elderly person, who is often unable to attend to daily activities alone. Elderly persons and family members should trust the care provider. Sometimes this is easier when the home-health company vets the person providing care.

Typically, providers who specialize in home health care engage in home health skill straining. Home health agencies usually conduct on-site training for people who work for their company, ensuring that their employees offer standardized care for all customers. Home health care agencies interview and screen their employees to make sure that they have an adequate level of knowledge and ability, as well as a clear background check. To find the best in-home elder care for your loved one, check Angie's List for member reviews and ratings. 

What you Can Expect from Elder Care

When you select a home-health company or someone to support an elderly family member or yourself, you should expect that that person to adhere to a level of professionalism and care. The in-home, health-care assistant should arrive promptly and ready to work, complete the job with skill and always protect the dignity and autonomy of the elderly person.

Home-health employees should always arrive punctually and dressed appropriately. Most employees of a home-health agency will have a dress code, which most often entails wearing scrubs. Punctuality is important because the employee sometimes arrives to relieve another worker who has completed a shift. While not all elderly people require constant attention, some do.

Home-health employees should engage in certain tasks during their shift, which often include assisting with bathing, dressing, light cooking and light housework. While most CNAs and LPNs do not have advanced nursing skills, some maintain existing medical support tasks, such as cleaning a urinary catheter or a feeding tube. The assistant should do these tasks with confidence and skill.

Home-health workers should always protect the person's dignity, home and belongings. The assistant should treats the person with kindness, allowing privacy as much as possible and ensuring that the wish to stay home can continue. Many choose elder care in the home because they need to be autonomous, and home health care supports this goal.

Home-health workers may work independently or as part of a business that specializes in the field. In 2010, more than 1.8 million home-health workers assisted those in need.

The huge demand for in-home skilled care will not diminish in the upcoming years, with expected 10-year growth to be higher than average, growing by 69 to 70 percent, according to the U.S. Department of Labor, Bureau of Labor Statistics.


I am not elderly, but I needed in-home care following a hospital stay. I wish to provide you with a review of the agency I used. Please advise if I can do this without joining. Thank you.

Hi Linda,

We do accept non-member reviews! Thank you for wanting to share your experience with our member base. You can find information on how to submit a review here:

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