GuidesUpdated May 25, 20269 min readReviewed by the CompanionCare care team
"Home care" is really three different services with three different price points, credentials, and use cases. Getting the tier right is the single biggest cost lever families have — most people overbuy.
1. Companion care
What it is: non-medical support to keep an older adult engaged, safe, and independent at home.
- Conversation, walks, hobbies, games
- Meal prep and light cooking
- Light housekeeping and laundry
- Errands, grocery runs, pharmacy pickups
- Rides to appointments and social outings
- Medication reminders (not administration)
- Safety checks and family updates
Who provides it: any trained caregiver. No license required in most states.
Cost (2026): $20–$28/hr on a marketplace, $28–$35/hr at an agency.
When it's the right fit: the older adult is mostly independent but lonely, forgetful, or slowing down.
2. Personal care (CNA / HHA)
What it is: hands-on help with activities of daily living (ADLs).
- Bathing, showering, hair and skin care
- Dressing and grooming
- Toileting and incontinence care
- Transfers (bed to chair, chair to toilet)
- Mobility support and safe ambulation
- Feeding assistance
- Everything companion care includes, too
Who provides it: a Certified Nursing Assistant (CNA) or Home Health Aide (HHA). Trained and state-certified.
Cost (2026): $24–$36/hr marketplace, $32–$45/hr agency.
When it's the right fit: the older adult needs help with 1+ ADLs, is recovering from a hospital stay, or has moderate dementia.
3. Skilled nursing at home
What it is: medical care delivered at home by a licensed nurse.
- Wound care and dressing changes
- Injections, IV therapy, infusions
- Catheter, ostomy, and feeding-tube management
- Medication administration and titration
- Post-surgical monitoring
- Chronic disease management (heart failure, COPD)
Who provides it: a Registered Nurse (RN) or Licensed Practical Nurse (LPN), usually through a Medicare-certified home health agency.
Cost (2026): $45–$80/hr private pay. Often covered by Medicare for a short, doctor-ordered episode.
When it's the right fit: there's a specific medical task that requires clinical training.
How to pick the right tier
- List what the older adult can't do this week without help. If most items are "keeping up with the house" and "getting out of the house", start with companion care.
- If bathing, dressing, or toileting are on that list, move to personal care.
- If a doctor's order names something medical (wound, IV, complex meds), layer in skilled nursing — usually a few hours a week alongside personal care.
Not sure yet? A short intake with our concierge helps you triage in about ten minutes — no obligation. See how the intake works.
FAQ
Frequently asked questions
Companion care is non-medical support — company, errands, meals, light housekeeping, medication reminders. Personal care is 'hands-on' support with activities of daily living: bathing, dressing, toileting, transfers, and mobility. Personal care requires a trained CNA or HHA; companion care does not.
Only when there's a medical task that requires a licensed professional — wound care, injections, IV medication, catheter management, or complex disease management. If daily activities are the issue, companion or personal care is the right tier, not skilled nursing.
No. Skilled nursing must be done by a licensed RN or LPN. Personal care must be done by a certified CNA or HHA. Companion care can be done by any trained caregiver. Many older adults have a companion caregiver most days and a nurse for occasional medical visits.
Usually companion care with a dementia-experienced caregiver — the goal is safety, routine, and engagement. Personal care is added when bathing, dressing, or continence becomes hard. Skilled nursing enters if there's a medical event or complex medication needs.
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