Caregiver's Home Companion Caring for someone who has trouble hearing the phone?

Posted March 31, 2008

Ask An Expert

Professional Caregiving: Starting a Home Care Business

Q. I am a CNA and would like to start a business by doing in-home caregiving. Could you tell me how to get started? My thought was to help with the elderly and/or new mothers coming home and needing extra help. Thank you for any help you can give.

Rhonda. Lexington, South Carolina.

A. First of all, congratulations on your career choice. Few occupations will give you greater joy and satisfaction.

Whether you’ve just recently received your certification or have had it for a while, it would be wise to get some direct experience in whichever area (caring for the elderly or helping new mothers) you choose to start your business in. I’ll concentrate here on caring for the elderly, since the skills you’ve acquired as a CNA are more likely to be put to full use in that capacity, and your earning power should be greater.

Gaining experience as an employee with a registered home healthcare agency is an important first step. Not only will it expose you to the many different kinds of situations you will face in providing in-home care for the elderly, it will enable you to build a reputation for the quality of the care you provide.

By far, the majority of new clients in this business come through referrals, and you will need current and former patients willing to provide written references attesting to your skills before you can hope to be successful striking out on your own. Additionally, the professionals you come in contact with (physicians, RN’s, rehabilitation therapists, geriatric care managers, etc.) in the course of providing in-home care will form the core of your referral network as you build your own business.

Another important consideration in starting your own in-home care business is the matter of liability insurance. Even with the best judgment and correct decision-making, accidents sometimes happen. Transferring a client from a wheelchair into an automobile doesn’t always go smoothly, and registered home healthcare agencies are required to carry liability insurance on their employees for such possibilities.

As an independent contractor, you will be responsible for getting your own insurance. Costs can vary widely, and they are influenced by the state you live in and the cities or towns you serve with your business. Specific information should be available to you on the Web or in your local library.

Good luck in your endeavors! There is a great and growing need for in-home care for the elderly, and it’s good to see committed people like you stepping up to provide it.

This answer is provided by Steve McCloskey, president of Caregiver’s Home Solutions, an in-home elder care business based in Fairfield, Connecticut. He can be reached at and his company website is

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