Home-Based Care Companies Improve Outcomes By Training Family Caregivers

Before home-based care providers send professional caregivers into the home, there is often already a family member — typically a spouse, a parent or adult children — tending to the needs of their loved ones.

Instead of treating these family caregivers’ work as separate from that of professionals, home-based care providers are increasingly engaging with them through education, and sometimes even mobilizing them. Providers that educate family members, sometimes for free, have found that the investment pays off with improved outcomes.

“It keeps people out of the hospital longer,” Peter Ross, CEO and co-founder of Senior Helpers, told Home Health Care News. “It keeps families in the home, happier and healthier longer.”

Maryland-based Senior Helpers is a home care company that operates over 400 franchise locations in the U.S., Canada and Australia. Senior Helpers is one of the largest franchise companies in the home care space. The company was acquired by Waud Capital, a Chicago-based middle-market private equity firm, in 2024.

In 2025, 63 million people in the U.S. provided care for an adult or a child, according to data from AARP and the National Alliance for Caregiving. Senior Helpers is using its existing caregiver training resources to educate families taking on that role.

Senior Helpers uses its centers of excellence as training grounds for its caregivers. These centers are a replica of a standard client’s home. Using durable medical equipment, pivot poles, Hoyer lifts, as well as learning how to do transfers and baths are just some of the training sessions that caregivers on staff receive at these centers.

However, these training centers are not just reserved for Senior Helpers’ caregivers. The company offers a free version of this program where family caregivers, whose loved ones are clients, can receive this education, too.

“In home care, you might be in the home 25 or 30 hours a week. There are 168 hours in a week,” Ross said. “We’re relying on the family caregiver to do just as good a job as we’re doing when we’re in the home. A lot of times, family caregivers have never been trained on how to really care for their loved ones … so when we onboard clients, we also interview the family caregiver to see how we can potentially help.”

The company has also implemented specialized training programs. In September, as part of fall risk awareness month, Senior Helpers offered family caregivers courses on how to reduce fall risks.

Additionally, the company offers family caregiver support groups across the country.

“Many family caregivers get more stressed and more sick over time,” Ross said. “We really want to make sure that they have stress relief. There are ways they can talk it out with professionals and other families so that they can feel good.”

Medicaid supports

In some of the markets where Senior Helpers operates, the state Medicaid program offers opportunities for the company to employ family caregivers. These caregivers are paid through a Medicaid waiver program. Ross pointed out that this is an option for family caregivers who’ve had to give up working to offer full-time care. Some states include Georgia, Maryland, Illinois, Pennsylvania and Massachusetts.

“I really commend the states and the Medicaid programs,” he said. “[They recognize] that these caregivers have to give up a lot on their end … so we facilitate that in some states where this is offered.”

Similarly, Aveanna Healthcare Holdings Inc. (Nasdaq: AVAH) participates in Arizona’s Family Licensed Health Aide (LHA) program. This Medicaid program allows eligible family caregivers to receive wages for the care they provide.

Though the company’s participation in the state program is a small part of its business, it’s another example of how home-based care companies are mobilizing family caregivers.

“It’s an opportunity to supplement skilled nursing hours when staff aren’t available to cover them,” Kristy Rohwedder, chief operating officer at Aveanna, told HHCN. “The goal of participating in the LHA program was to meet family needs in situations where we can’t necessarily hire skilled caregivers quickly enough, due to wage pressures and lower reimbursement rates that limit how fast we can fill those open shifts.”

Atlanta-based Aveanna offers a range of pediatric and adult health care services, including nursing, rehabilitation, occupational nursing in schools, therapy services, day treatment centers for medically fragile and chronically ill children and adults and home health and hospice services. The company has 327 locations across 34 states.

Though reimbursement rates are an ongoing challenge, Aveanna recently shared that the company achieved rate wins in 11 states.

Rohwedder believes demand for this program will grow in areas with coverage gaps.

When training family caregivers versus Aveanna caregivers, the framework is similar, but there are some distinctions.

“Family caregivers don’t really have the same clinical foundation as professionally trained caregivers, and their training is focused on the specific needs of their individual child, rather than broader clinical training that we would otherwise provide … Their training really focuses on providing safe and supportive care with those clearly defined boundaries,” Rohwedder said.

Engaging caregivers

Family & Nursing Care and A Place At Home’s North Austin location educate family caregivers on a case-by-case basis, offering guidance and educational tools.

“We help educate them on [specific] diagnosis that their loved one might have,” Kelly Salb, vice president of client services for Family & Nursing Care, told HHCN. “Our RN team does a really good job with that, and our client services team. We help educate them on programs such as hospice, and even create or schedule a meet and greet with hospice agencies, because a lot of times, these family caregivers don’t know what they have as tools. We also engage in any conversation about what’s going on. Obviously, they’re really dealing with the emotional sense of taking care of someone on top of the practical tasks.”

Based in Maryland, Family & Nursing Care is one of the largest private-pay home care companies in the Washington, D.C., area. Currently, the company provides just under 41,000 hours of care per week.

Stacey Eisenberg, co-owner of A Place At Home’s North Austin franchise location, explained that the company is available for each client’s differing needs. This includes training on various equipment, physical safety and Alzheimer’s.

Eisenberg said that families should not be expected to care for their loved ones alone and without educational resources.

“A lot of people don’t know that they can reach out for help,” she told HHCN.

On Aveanna’s end, participating in the state Medicaid program has allowed the company to bridge care gaps.

“In an environment where wage pressures and reimbursement constraints make hiring difficult, the family caregivers can provide a practical way to bridge those staffing shortages,” Rohwedder said. “However, I don’t believe they should be perceived as a replacement for a skilled caregiver. The goal at Aveanna is to deliver the highest level of value to our families.”

Though providers approach training family caregivers in different ways, providers say it is crucial for companies to engage family caregivers in some form or another.

“I don’t think any company could be successful without acknowledging the role of the family caregiver,” Salb said.