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Here is a thorough list of questions aggregated from ChatGPT5.3...

The agency matters, but the individual caregiver often matters even more. Focus on both the agency's quality and its experience with cognitive impairment if this is your LO's main issue.

Questions to Ask the Agency
1. Are you licensed, bonded, and insured?
Ask specifically:

Are all caregivers covered by your liability insurance?
Are caregivers employees or independent contractors?
Do you carry workers' compensation insurance?
Employee-based agencies generally provide more oversight and protection than agencies that simply refer independent contractors.

2. What background checks do you perform?
Ask whether they conduct:

Criminal background checks
Driving record checks (if transportation is involved)
Reference checks
Drug screening
Ask how often checks are repeated.

3. How are caregivers trained?
Especially if your loved one has dementia, ask:

What dementia-specific training do caregivers receive?
How do they handle confusion, agitation, wandering, or refusal of care?
How are new caregivers supervised?
A good agency should answer confidently and specifically.

Questions About Staffing
4. What happens if my regular aide calls in sick?
This is critical.
Ask:

Is there guaranteed backup coverage?
How quickly can a replacement be sent?
Will I be notified?
Many families discover this problem only after they're depending on the service.

5. Can we meet the caregiver before committing?
Request:

An in-person introduction
A trial shift
The option to request a different caregiver
A quality agency expects this.

6. How much turnover do you have?
High turnover can be difficult for seniors, especially those with dementia.
Ask:

How long has the average caregiver been with your agency?
How long has the proposed caregiver been employed?
Questions About Dementia Care

7. Have your caregivers worked with dementia clients?
Look for experience with:

Repetitive questions
Sundowning
Wandering
Delusions or paranoia
Fall prevention
Ask for examples.

8. How do you document changes?
A good aide may be the first person to notice:

Increased confusion
Weight loss
Medication issues
New falls
Infection symptoms
Ask how observations are communicated to family.

Ask About Supervision
9. How often does a supervisor check in?
Good agencies provide:

Regular supervisory visits
Phone check-ins
Care plan updates
Avoid agencies that place a caregiver and disappear.
During the First Few Visits
Watch for whether the caregiver:
Good Signs

Speaks respectfully to your loved one
Maintains eye contact
Encourages independence
Notices safety hazards
Shows patience
Arrives on time
Red Flags

Constant phone use
Appears rushed
Talks over the senior
Doesn't engage
Complains frequently
Leaves tasks unfinished

Ask for References
Request:

References from current clients
References from families caring for someone with dementia
Then ask:

Were caregivers reliable?
How were problems handled?
Would you hire them again?

Cost Questions
Make sure you understand:

Hourly rate
Minimum visit length
Weekend rates
Holiday rates
Mileage charges
Overnight rates
Get everything in writing.
A Simple Scoring Sheet
Rate each agency from 1–5:
CategoryScoreLicensing/InsuranceDementia ExperienceBackup CoverageCaregiver QualityResponsivenessReferencesCommunicationCost TransparencyOverall Comfort Level
Sometimes the agency with the lowest price ends up being the most expensive because of turnover, missed shifts, or poor communication.

Place the highest weight on:

Dementia experience.
Reliability of backup coverage.
Consistency of caregivers.
Fall-risk awareness.
Communication with family.

Those five factors will likely matter more than saving a few dollars per hour.
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