Most families ring three agencies, hear three versions of the same reassuring answer, and come away no clearer than when they started. These are the questions to ask about dementia care that actually separate one agency from another, along with what a good answer sounds like. We are a nurse led San Diego agency, so we have a horse in this race, but every question below is one we would be glad to be asked ourselves.
1. What dementia training do your caregivers complete, and who wrote it?
From January 2027 California requires dementia training for every home care aide, so from that date any licensed agency should have a straight answer. What you are listening for is who teaches it and how specific it is. Training written by a nurse who runs the agency tends to be about real situations. A generic video bought in bulk tends not to be.
2. What happens when my mother refuses a shower?
Ask this one if you ask nothing else, because it is the most common hard moment in dementia care and the answer reveals everything. A trained answer sounds like: we stop, we leave it, we warm the bathroom, we come back in twenty minutes having changed one thing. An untrained answer sounds like persuading, insisting, or explaining to her why she needs to wash. If the answer involves convincing her, keep calling agencies.
3. What do you do if she asks for someone who has died?
You want to hear that they do not correct her and do not lie to her either, but go to the person she is asking about and ask her about him. If the answer is that they gently remind her he passed away, that caregiver will be delivering that news to your mother again and again, and she will take it as hard each time.
4. How many different caregivers will come to the house?
Familiarity matters more in dementia care than in almost any other kind. A small, steady team that your mother gets used to is worth a great deal, and a rotating cast is genuinely harder for her. Ask how they handle holidays and sickness too, because that is where consistency usually breaks.
5. What will you tell me, and how often?
You should expect to hear what actually changed rather than a tick sheet. The useful version sounds like: yesterday she dressed herself and today she could not find her sleeves, and she has drunk one cup of tea since this morning. That is a caregiver describing what she saw, which is exactly what a caregiver should do, and it is often the first sign anyone has that something needs attention.
6. What happens if she suddenly gets much more confused than usual?
The answer you want is that they report it the same day, because a sudden change is usually not the dementia progressing. It is often something else entirely, and a caregiver who treats every change as inevitable decline will miss it. You also want to hear that the caregiver does not make that judgement alone.
7. Are you licensed, and what is your licence number?
California licenses non medical home care agencies as Home Care Organizations, and the number is public. Aloha Senior Home Care is licence number 374700270. A licensed agency background checks its caregivers, carries insurance, and can be inspected. If you hire someone privately, none of that is happening and all of the responsibility is yours.
8. What is your hourly rate, and what else will I be charged?
Ask for the number, not a range of packages, and ask directly about minimum hours, deposits, contracts and cancellation terms. Ours is $40 to $44 an hour with no contracts and no deposits, and we would rather say so on the phone than make you ask three times.
9. What will you not do?
A good agency answers this quickly and without being defensive. A non medical caregiver supports daily life and may remind someone it is time to take their own medication, but does not administer or sort medication, does not assess anybody's memory, does not diagnose, and does not do anything a nurse or doctor would do. An agency that is vague about its own limits is not a safer agency. It is a riskier one.
10. Can I meet the caregiver before she starts?
The honest answer is usually yes for a planning visit, and the first week should not lock anything in. Expect a visit to listen and plan, then a matched caregiver for a couple of short visits, then a conversation about the ongoing schedule. If an agency wants a signature and a fixed rota on day one, that is about their convenience rather than your mother's.
Questions to Ask About Dementia Care: Two Answers That Should End the Conversation
"Our course is state approved"
California does not approve or certify dementia courses for home care aides. An agency saying its training is state approved or state certified is describing something that does not exist, which tells you how carefully it chooses its words elsewhere.
"We will stop her falling" or "she will never wander"
Nobody can honestly promise that, and a careful agency will not try. Good care reduces risk by keeping routes clear, lighting the way at night and understanding why someone walks. It never removes risk, and anyone claiming otherwise is selling you something.
One Question to Ask Yourself
After the call, ask whether the person on the phone listened more than they talked. Dementia care at home runs on small observations and steady patience, and an agency that will not listen to you for ten minutes is unlikely to listen to your mother for four hours.
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Ask us all ten
We would genuinely rather you asked these questions than did not. Have a free, no pressure conversation with our nurse led team about what support at home could look like in San Diego.
