Caregiver and Senior Man

Most older adults want to “age in place” as long as possible, and hire home care when they need it. This can help them stay as independent as possible in their own homes, and can complement caregiving provided by friends or family members. “Many seniors and families find home care a viable option to move into long-term care,” says Krishna Sharma, owner of Quality Care Companions, “especially during this time of COVID-19.” Let’s delve into two types of in-home care, the benefits of in-home care, and how to choose the right caregiver. As always, feel free to reach out to us with any questions you may have — Quality Care Companions provides in-home care services throughout St. Paul and Minneapolis, and is headquartered in Eden Prairie.

The Two Types of In-Home Care

The two types of home health care are Medicare-Certified Care and Private Duty Care, also called “Companion Care.” Both are licensed through the Minnesota Department of Health, which provides oversight. Some agencies provide one type of care; some offer both. Some agencies are locally owned franchises; some are independently owned. A minimum number of hours per visit is usually required. Many have live, 24-hour phone operators.

Medicare-Certified Care


  • Requires physician prescription
  • Covered by Medicare
  • Usually prescribed after a hospital stay for illness, injury or surgery or for homebound patients
  • “Hands-on” medical care, usually provided by registered nurses (RNs)
  • Typically for a definite period of time
  • Agency may have social workers and care managers on staff

Private Duty or Companion Care

Our article will focus mainly on this type of care. With Companion Care, the senior or family is responsible for payment. Some agencies accept waivers or other government programs as payment; some accept long-term care insurance. Most have a registered nurse who oversees all client cases and staff training.


  • Assistance with Activities of Daily Living (ADLs): toileting, bathing, feeding
  • Light housekeeping
  • Companion care
  • Pet care
  • Meal prep
  • May include transportation
  • Indefinite period of time
  • 24-hour care available, including supporting hospice care
  • Medication and exercise reminders
  • Assessments made 30, 60, and 90 days after start of service, and as needed

The Benefits of In-Home Care

With support in performing activities of daily living, seniors are better able to maintain or improve their health and independence. “In-home support can help prevent hospital visits and nursing home placements and support more secure social connections, lower medical expenses and a greater sense of control of one’s life,” says Sharma. Even the most healthy, active senior will likely need support to remain independent in their own home. Sharma notes, “That’s when home care can benefit a senior.” 

Social isolation has negatively affected most of us during “stay at home” orders and social distancing. But even before the pandemic, older Americans were at risk of social isolation and the resulting increased health risks. Perspectives on Psychological Science cited a 2015 study that found that “prolonged isolation can be as bad for your health as smoking 15 cigarettes a day.” So, as Sharma says, “Companion care is crucial in ensuring that a senior will have face-to-face social interaction. Plus, a caregiver’s presence can provide an extra measure of safety and an extra set of eyes.”

Home Care During the COVID-19 Pandemic

“Because older adults are at high risk of contracting and becoming seriously ill with COVID-19, it’s crucial that families feel comfortable with caregivers coming into a senior’s home,” says Sharma. Ask a potential home care agency about their protocols around safety, personal protective equipment, specific training, and screening of the staff.

Additional Considerations

Sharma’s tips for families: “Ask lots of questions when interviewing potential home care agencies. Ask about their licensing, how the staff communicates with the senior/family members about the senior’s care, and inquire about contracts, schedules, and policies.”

Consider Discussing the Following With Your Caregiving Provider

  • Caregiver training: Be sure to ask how often and what kind of training caregivers receive. Quality Care Companions provides an 8-hour training session related to caring for those with Alzheimer’s and other types of dementia. “Only two hours are required, but we believe a more in-depth training is important,” says Sharma. After the initial training period, each caregiver typically receives continuing education. Quality Care Companions also performs “quality checks” on its caregivers as needed.
  • Customer reviews: Be skeptical about online reviews — do they seem legitimate? Quality Care Companions works with a third party to ensure transparent feedback from clients, family members, and caregivers.
  • Customer service: How is the agency’s customer service and follow up?

Do your homework. Ask a lot of questions of home care agencies that you’re considering bringing into your home. And ask others for personal recommendations so you create the best team possible to care for your loved one.

Quality Care Companions Case Study

In-home care can help in various situations. Here’s one client’s story from Quality Care Companions: Melissa’s father had been hospitalized and she had to find temporary care fast. She called three companies, and went with her intuition and hired Quality Care Companions. And she was glad she did! Melissa noted:

“They exceeded my expectations! My father had a cognitive decline and needed 24/7 care until a memory care room became available. They were flexible and accommodated us completely! Communication was fantastic. Caregivers were consistent, which is so important for someone with dementia. Krishna has a commendable, honest work ethic and truly puts his customer first.”

Sources and Additional Reading

Minnesota Department of Health

“Prolonged isolation can be as bad for your health as smoking 15 cigarettes a day.” – Psychological Science

Krishna Sharma, Owner, Quality Care Companions