How to Choose a Home Care Agency for a Veteran or Surviving Spouse

The right home care agency can keep a veteran safely at home for years. The wrong one can mean missed shifts, rotating strangers and invoices that do not match the care delivered. Veteran families have one more thing to consider: whether the agency works with VA programs and whether its records will support a claim for VA pension with Aid & Attendance.

Start With What the Veteran Needs

List the tasks where help is needed: bathing, dressing, toileting, meals, medications, transportation, supervision. Note the time of day each is needed. That list becomes the basis for the agency’s care plan and for your budget. Our guide to activities of daily living explains which tasks matter for Aid & Attendance.

Questions to Ask Every Agency

• Is the agency licensed in your state, and can you show the license?
• Are caregivers employees or independent contractors?
• What background checks, drug screens and training are required?
• Who supervises caregivers, and how often does a supervisor visit?
• How do you handle a caregiver who calls in sick?
• Can we meet a caregiver before service starts and request a change?
• What is the minimum shift length and the hourly rate for nights and weekends?
• How do you document each visit, and can the family see the notes?

Employees are usually better than contractors because the agency handles payroll taxes, insurance and supervision. Ask for proof of liability insurance and bonding.

VA-Contracted Agencies

Veterans enrolled in VA health care may be eligible for homemaker and home health aide services when a VA clinician finds a need. Through the VA’s community care network, the VA pays approved local agencies directly for authorized hours. If the veteran is enrolled, ask the VA primary care team about a referral, then ask the agency whether it is approved to serve VA referrals. Our article on VA home care programs describes these services and others such as Veteran Directed Care.

VA-authorized hours are often limited, so many families combine them with privately paid hours. Keep the two clearly separated on invoices.

Using Aid & Attendance to Pay an Agency

VA pension with Aid & Attendance can pay up to $3,845 per month in 2026, depending on household status, and the money is paid to the veteran or surviving spouse to use as needed. Payments to a home care agency for help with daily living can count as unreimbursed medical expenses, which can lower countable income for the pension calculation.

To support that, ask the agency for:

• A written care plan listing services and hours
• Monthly invoices showing dates, hours, rate and services
• Proof of payment from the veteran’s or spouse’s account

Learn more in VA benefits for in-home care and Aid & Attendance medical expenses. Our in-home care section adds background, and the VA explains the benefit at VA.gov.

Red Flags

• No written contract or care plan
• Pressure to prepay months of service
• Caregivers paid in cash “off the books”
• High turnover with a new face nearly every visit
• Vague answers about supervision and complaints

When Home Care Is Not Enough

If a veteran with dementia needs supervision around the clock, compare the cost of 24-hour aides with a community. Our article on memory care vs. in-home dementia care helps with that decision, and assisted living vs. independent living for veterans explains other options. Some families also look at paying a relative; see whether a family member can be paid.

Patriot Angels has helped veterans and surviving spouses with the Aid & Attendance process since 2012. Call (844) 757-3047 for a free consultation.

General information only. Agency licensing rules vary by state.

If you or a loved one served our country, let us help you secure the benefits you’ve earned.

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Frequently Asked Questions

What is the difference between home care and home health?

Home care is non-medical help with daily living. Home health is skilled care, such as nursing or therapy, ordered by a doctor.

Does the VA pay home care agencies directly?

For enrolled veterans with an authorized need, the VA can pay approved community agencies for homemaker and home health aide hours.

Can Aid & Attendance be used to pay a home care agency?

Yes. The benefit is paid to the veteran or surviving spouse, and agency costs for help with daily living can count as medical expenses.

What records should an agency provide?

A care plan, monthly invoices with dates and hours, and receipts or statements showing payment.

Should caregivers be employees or contractors?

Employees are usually safer because the agency handles taxes, insurance and supervision.

Can we combine VA hours and private hours?

Yes. Many families do, but keep the billing for each clearly separate.