When you start searching for in-home care, you will quickly encounter a confusing mix of titles: caregiver, home health aide, certified nursing assistant, personal care assistant, companion. These are not interchangeable. Each title reflects a different level of training, a different scope of what the person can legally do, and a different price point. Understanding the differences will help you hire the right person for your family's situation.
Why these titles matter
Caregiving titles are not just labels - they correspond to specific state-regulated training programs and certifications. A home health aide can do things a companion caregiver cannot (and vice versa), and a CNA has clinical skills that go beyond both. Hiring someone whose qualifications do not match your parent's needs can mean paying too much for simple companionship or, more dangerously, having someone without the right training handle complex medical needs.
Companion caregiver
Training
Companion caregivers are typically not required to hold a state certification, though many complete voluntary training programs. Requirements vary by state, and some states require basic training even for non-medical caregivers.
What they do
- Provide companionship and conversation
- Light housekeeping (laundry, dishes, tidying)
- Meal preparation
- Grocery shopping and errands
- Transportation to appointments
- Medication reminders (not administration)
What they cannot do
Companion caregivers should not provide hands-on personal care like bathing, dressing, or transferring. They cannot administer medications, perform wound care, or handle medical equipment.
Best for
Seniors who are mostly independent but need someone to check in, prevent isolation, help around the house, and provide safety oversight. Typical rates: $15-$22/hr.
Home health aide (HHA)
Training
HHAs complete a state-approved training program, usually 75-120 hours depending on the state, and must pass a competency exam. Federal standards require at least 75 hours of training for HHAs working in Medicare-certified agencies.
What they do
- Everything a companion caregiver does, plus:
- Hands-on personal care (bathing, dressing, grooming, toileting)
- Mobility assistance and transfers
- Monitoring vital signs (blood pressure, temperature)
- Basic wound care under nurse supervision
- Assisting with prescribed exercises
Best for
Seniors who need daily personal care assistance but do not have complex medical needs requiring clinical skills. Typical rates: $18-$28/hr.
Certified nursing assistant (CNA)
Training
CNAs complete a more rigorous state-approved training program, typically 120-180 hours, including both classroom instruction and supervised clinical hours in a healthcare facility. They must pass a state certification exam and are listed on their state's nurse aide registry.
What they do
- Everything an HHA does, plus:
- More advanced patient care skills learned in clinical settings
- Experience working in hospitals, nursing homes, or assisted living facilities
- Catheter care and ostomy care (where permitted by state law)
- More detailed health monitoring and documentation
- Range-of-motion exercises and restorative care
Best for
Seniors with more complex care needs - those recovering from surgery, living with Alzheimer's or dementia, or requiring consistent medical monitoring alongside personal care. Typical rates: $20-$32/hr.
Side-by-side comparison
| Feature | Companion | HHA | CNA |
|---|---|---|---|
| State certification required | Usually no | Yes | Yes |
| Training hours | Varies | 75-120 hrs | 120-180 hrs |
| Personal care (bathing, dressing) | No | Yes | Yes |
| Vital signs monitoring | No | Basic | Yes |
| Clinical experience | No | No | Yes |
| Companionship & errands | Yes | Yes | Yes |
| Typical hourly rate | $15-$22 | $18-$28 | $20-$32 |
Which type of caregiver does your family need?
Start with your parent's actual daily needs, not what you think they might need in the future:
- If your parent is mostly independent but needs someone to check in, help with meals, and provide company: a companion caregiver is likely sufficient and the most affordable option.
- If your parent needs help with bathing, dressing, or getting around the house safely: a home health aide has the training to provide this hands-on care.
- If your parent has complex medical needs, is recovering from surgery, or has dementia that requires experienced clinical judgment: a CNA provides the highest level of non-nurse care.
You can always start with a lower level of care and adjust as needs change. Many families begin with a companion caregiver and transition to a CNA or HHA as their parent's condition evolves.
On PairCare, you can filter caregivers by certification level so you find exactly the right fit. Every profile includes their credentials, specialties, experience, reviews, and hourly rate - all in one place. Create a free account to get started.