In-home caregivers

The word on the license that decides what they may do

Oregon licenses in-home care agencies, and the license is not one thing. It carries a classification, and the classification is what the state says the agency is allowed to do inside your parent's house. Four of them, and the rule spells them out:

Read the first row again, because it is the one that catches families. An agency licensed Limited may remind your mother that her pills are due. It may not hand them to her, and it may not put them in her mouth. If the reason you are hiring anybody is that she has stopped taking her heart medication reliably, a Limited agency cannot solve the problem you have — and nothing about the sales conversation will make that obvious.

The rule closes the other half of it too: an agency may not use any descriptive title other than its own classification when it advertises. So an agency talking about "nursing support" while holding a Basic license is describing something it is not licensed to do, and you can check which class it holds in about thirty seconds.

Source: OAR 333-536-0007, Classification. Counts are from the Oregon Health Authority's licensed agency list, 235 agencies, read 2026-08-12.

What it costs, and the hours where the arithmetic turns over

An in-home caregiver is bought by the hour, which makes it the one category on this site where the monthly bill is a decision rather than a price. That decision has a crossing point: past some number of hours a week, the caregiver alone costs what an entire assisted-living bill costs in the same market — room, meals, staff, the lot.

The figures for every Oregon market, and the crossing point in each, are on the cost page, measured rather than modeled and each one carrying the survey it came from. Two things worth taking from it before you get there:

• The crossing point is not the same everywhere, and the spread is not small. It is a different number of hours in Corvallis than in Eugene, because the ratio of what a caregiver costs to what a room costs is different in each.
• The comparison flatters staying at home, and the cost page says so out loud. The hourly figure buys the caregiver's hours and nothing else; the assisted-living figure buys the building, the meals, the utilities, the night staff and the person who notices at 4am. Comparing them straight is useful and it is not like-for-like.

Who pays, and the order to ask in

Most families pay for this themselves, and most families find that out after paying for it themselves for a while. Four doors, and three of them are worth trying before the fourth:

• Medicaid, through home- and community-based services, and in Oregon through the Oregon Project Independence programs for some people who are not Medicaid eligible. Your Area Agency on Aging answers this for free and is not selling anything.
• The VA, if your parent or their spouse served — ask about Aid and Attendance, and ask the VA rather than a company offering to file it for you.
• A long-term-care policy bought years ago and forgotten. Look before you assume there isn't one; these are frequently forgotten by the person who bought them.
• Her own money, which is where most of this lands, and which is why the hours-per-week number above is the whole decision rather than a detail of it.

One thing not to skip: Oregon's own care-matching service, Carina, is open to consumers whose care is paid through Medicaid, OPI or OPI-M. If that is your parent, it is free and it is the state's own. If it is not, there is no equivalent public registry for private-pay families in Oregon, and it is better to know that than to keep looking for one.

An agency, or someone you hire yourself

Hiring directly costs roughly a third less an hour, and the difference is not the agency's margin — it is four obligations moving onto your household: payroll taxes, workers' compensation exposure, the background check nobody else will run, and the answer to what happens on the morning she does not turn up. Families do it successfully all the time. It goes wrong when nobody admits an employment relationship exists.

Both routes have a kit on this site with the questions to ask and the records to check: vetting an agency and hiring someone yourself. Take the first one to a phone call, not to a meeting — everything on it can be answered before anybody visits.