KAILUA, Hawaii - When your loved one can no longer take care of themselves at home, and a family caregiver is exhausted, it may be time to consider a paid caregiver. But what do you look for in a home health aide? In this Aging Well, an expert from a home health care service has tips on what you need to know about hiring help.

Home health aide Kerry chats with her client, Winnifred Yano. She goes to Yano's house every day to help the 91-year-old with tasks of daily living.

Shelley Wilson, founder and CEO of Wilson Care Group, explains that what Kerry is doing is part of the services of home health care. "Home care offers you a variety of solutions. You can have basic personal care at home, you can have someone helping you with laundry or housekeeping services, up to giving you a bath every day, giving you your medication, providing ambulation."

Yano has been a client for more than 20 years, but some clients only need temporary care. Wilson recounts, "Most often we see situations where someone had an accident, a fall, and families are scrambling to figure out how they're going to have the care for their loved ones."

Wilson has been in this industry for almost a quarter century. She founded Wilson Homecare in 1996, and expanded her offerings from home health care to assisted living, when she opened Wilson Senior Living in Kailua in 2013. Wilson says one of the most critical questions is one that should be asked well before a crisis. "Have a conversation as much as you can before your loved ones really need the help," she urges.

Most people, Wilson says, prefer to age at home, rather than in a care home. "We all feel better at home. We do better in our own nests surrounded by our things and loved ones," she explains.

One of the most common question Wilson's agency gets is: "When can I have care? Basically it's 24 hours a day. Sometimes we have a family member who works a night shift," Wilson clarifies.

Price is another big question. "The cost varies based on the level of service needed and the circumstances. If someone needs a lot of physical assistance it's going to be more costly," she says. 

Long-term care insurance and Medicaid may also pick up some of all of the tab. If the client is retired from the military, Veteran's insurance may also provide financial aid.

Experts say one of the most important questions you should ask when vetting a home health aide is, Is the agency licensed by the state? "It's a state law and requirement that all companies are licensed. That's going to give families the peace of mind that there are standards in place," Wilson states.

Home health companies also provide the medical equipment needed. "That's a big part of the home care industry as well, providing the appropriate accessories in the home while someone gets better," Wilson adds.

You can hire a home health aide directly, which can be cheaper, but could cost you more in the long run because you will have to get references, do background checks, monitor their work, and deal with any problems.

Every situation is unique, but when you feel your loved one can't be safe without help, home health care is an option to consider.