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Bringing a caregiver into the home of a person living with dementia is one of the most personal decisions a family will make. The right caregiver can reduce stress, improve safety, and help a loved one remain in familiar surroundings for as long as possible.
For many families, the search for a dementia caregiver begins during a time of exhaustion, uncertainty, and difficult decisions. Understanding the available options and knowing which questions to ask can make the process more manageable and help families choose care with greater confidence.
Understanding Hiring Options
Families in California generally arrange dementia caregiving in one of three ways: through a licensed home care organization, through a caregiver referral or registry service, or by hiring a caregiver directly. Each option has different responsibilities for employment, scheduling, insurance, and oversight.
No single approach is right for every family. Understanding how each arrangement works can help families select the option that best fits their needs and circumstances.
Employment Responsibilities
If you hire a caregiver directly or through a referral service, you may become the household employer. Depending on the arrangement, you may be responsible for payroll taxes, workers’ compensation insurance, overtime requirements, and other employment obligations under California and federal law.
Before making a hiring decision, ask who is considered the employer and who is responsible for these responsibilities. Understanding them in advance can help avoid unexpected obligations
later.
Questions to Ask About Licensing and Screening
- Is the organization, if applicable, licensed as a California Home Care Organization?
- Is the caregiver registered on the California Home Care Aide Registry and has the required background screening been completed?
- Who is the caregiver’s employer, and who is responsible for employment-relate obligations?
- Is appropriate insurance in place, including workers’ compensation and liability coverage where applicable?
- Has the caregiver received the required TB clearance?
Questions to Ask About Dementia Readiness
- What dementia-specific education or training has the caregiver received?
- How would the caregiver respond to common dementia-related behaviors?
- How is the caregiver matched to the individual, and what happens if the match is not a good fit?
- What is the backup plan if the caregiver is unavailable?
- How will family members receive updates as care needs change?
Verify Before Care Begins
Families can verify caregiver registration through the California Home Care Aide Registry and confirm Home Care Organization licenses through the California Department of Social Services. These resources should be combined with interviews, reference checks, and conversations about dementia experience.
Choosing the Right Caregiver
Choosing someone to care for a loved one with dementia is both practical and deeply personal. Beyond credentials and experience, look for someone who communicates with patience, respects the individual’s dignity, and helps preserve familiar routines.
No caregiver is perfect, and care needs often change over time. Continue asking questions, stay involved, and remember that the best care is built on communication, trust, and flexibility. Families facing dementia do not have to navigate these decisions alone. Physicians, Alzheimer’s organizations, care managers, and community resources can all help evaluate options and develop a care plan that fits each family’s needs.
Helpful Resources
- California Home Care Aide Registry
- California Department of Social Services Home Care Organization Search
- California Domestic Worker Bill of Rights
- IRS Publication 926 – Household Employer’s Tax Guide
About the Author
Rachel Berthoumieux is the founder of Cognihealth and has more than a decade of personal experience caring for a parent living with dementia. She founded Cognihealth after her own caregiving journey. She writes and speaks on dementia care, caregiver education, and aging in place.