Keeping the Same Home Health Aide: How to Request an Aide and Protect Continuity of Care

Why Continuity of Care Matters So Much

Many families want to request a specific home health aide after the first few weeks of care. That makes sense. An aide who already knows how your mother likes her coffee, which side she gets out of bed on, and what calms her when she is anxious provides better and safer care than a stranger reading a care plan for the first time.

Consistency matters even more for people with dementia, Parkinson’s, hearing loss, or depression. Every new face means new instructions, new trust, and often more confusion or refusals. For a parent who lives alone, a regular aide is also often the first person to notice small changes, like a new cough, swollen ankles, or skipped meals.

How to Request a Specific Home Health Aide

Whether you are starting care or already have an aide you love, the request should be clear and in writing. Here is how to do it:

1. Call the agency coordinator. Say the aide’s full name and ask that they be assigned as the primary aide on the case.
2. Explain why. “She speaks Russian, my father trusts her, and she knows how to help him with his walker” is more useful than “we just like her.”
3. Follow up in writing. Send a short email or letter confirming the request so it is in the file.
4. Ask about the backup. Every aide takes days off, gets sick, or goes on vacation. Ask for one or two consistent backup aides who can be introduced in advance.
5. Ask for notice of changes. Request that the agency call you before replacing the primary aide, except in emergencies.

If you are just starting care and do not have an aide yet, you can still describe what you need: a language, gender preference, experience with dementia or transfers, comfort with pets, or a non-smoker. Our guide to home care in your language explains how language matching works in NYC.

What Agencies Can and Cannot Promise

Being realistic helps you protect what matters most. A licensed agency employs the aide and has to follow labor rules, the plan of care, and the aide’s own availability.

Things that can affect who comes

• Weekly hours. If your parent has many hours per week, one aide usually cannot cover all of them. The agency may split the week between a primary aide and a second regular aide.
• Overtime and scheduling rules. Agencies often limit how many hours one aide works in a week, so two consistent aides is a common and healthy setup.
• Aide availability. Aides have families, other commitments, and sometimes leave the field. A good agency gives you notice and introduces the replacement.
• Plan changes. If your Medicaid plan changes and the agency is not in the new network, that aide cannot continue through that agency.

Can we bring in someone we already know?

Sometimes families know a neighbor or friend who would be a good aide. With an agency, that person must be hired by the agency like any other aide, which means meeting all training and certification requirements and passing background and health checks. If they are willing to train and qualify, ask the agency whether they can apply. Note that Advantage Home Care does not offer CDPAP, the separate program where family members can be paid directly. As of 2025, CDPAP in New York is administered through a single statewide fiscal intermediary, PPL.

Protecting Continuity When Things Change

When the aide is absent

If the regular aide cannot come, the agency should send a replacement for authorized hours. If an aide simply does not show up, you have options. Our article on what to do when the home health aide does not show up explains what the agency owes you and how to report missed visits.

After a hospital stay

Services usually pause while your parent is admitted. Call the agency as soon as you know about the admission and ask them to hold the regular aide’s slot. Then give them the expected discharge date as early as possible. See what happens to Medicaid home care hours during a hospital stay.

When hours increase

If your parent gets more hours after a reassessment, ask the agency to extend the current aides first before adding someone new. Our guide to requesting more hours covers that process.

When you switch agencies

If you need to change agencies, the aide generally does not come with you unless they are also hired by the new agency. Read how to switch home care agencies without losing your hours before making that move, and weigh how much you value the current aide.

Requesting a Different Aide

Continuity only helps when the match is good. If the aide is late often, is on the phone during shifts, is rough with transfers, or your parent is uncomfortable with them, you can ask for a change. Tell the coordinator what is not working, with specific examples. You do not need to be confrontational, and a reasonable agency will not penalize your parent for asking. If you ever suspect neglect or mistreatment, report it to the agency’s nurse or director right away.

Helping a New Aide Settle In

Even with a careful match, the first week takes adjustment. A one-page “about Mom” sheet near the kitchen helps: her preferred name, daily routine, foods she likes and avoids, how she walks and transfers, what upsets her, and who to call. Our guide on the first day of home care has more ideas.

Related Guides

When the aide does not show up · Switching agencies · HHA vs PCA · First day of home care