Home health aide vs home nurse vs companion caregiver: who does what?

“Caregiver” covers three quite different jobs. A companion keeps someone safe, engaged and less alone. A home health aide adds trained hands-on help with the body: washing, dressing, moving safely. A home nurse brings clinical skills — the tasks that involve medication, wounds, equipment or readings a doctor will act on. The titles and licensing rules vary by country, but the ladder of skill, responsibility and price is the same almost everywhere.

Booking the right rung matters twice: paying nurse rates for company wastes money, while asking an unlicensed helper to manage medication is a safety risk. This guide maps the three roles, then shows how to translate a real week of needs into the right mix. It is general information, not medical advice — the treating doctor or nurse defines what care is clinically needed.

The companion caregiver: presence and daily life

A companion’s value is presence: conversation, meals cooked and shared, a walk, errands, a lift to an appointment, and an attentive adult in the house so the family is not the only safety net. For someone who is largely independent but isolated or mildly forgetful, a few companion hours a week often changes daily life more than any other spend.

Companions do not provide hands-on personal care or anything medical. If bathing, dressing or medication is on the task list, you need the next rungs of the ladder.

The home health aide: trained hands-on care

Aides — the exact title differs by country — are trained to work with the body safely: washing, dressing, continence care, and transfers from bed to chair without injuring the person or themselves. They typically also cover the companion layer, which is why aides are the backbone of most home-care arrangements.

What an aide may do with medication varies by jurisdiction: reminders are generally fine, while dosing and administering are usually reserved for nurses. When you book on SoftCare, each CareGiver’s profile shows their qualifications, and their professional licence — number and expiry — has been verified along with their government photo ID and a live selfie.

The home nurse: clinical care at home

A home nurse is a licensed clinician. The clinical tasks — administering and adjusting medication schedules, sterile wound dressing, injections, catheters, reading vital signs a doctor will act on — belong to this tier, along with recognising deterioration early. Our guide to what a home nurse does walks through a typical visit in detail.

Because nurses carry the highest hourly rates, most families book them surgically: a daily medication visit, wound care three times a week, or a weekly check — with aides or companions covering the hours in between. The US National Institute on Aging’s overview of long-term care describes the same pattern: most support at home is personal and practical, punctuated by clinical visits.

How to pick the right level

Write down a real week: every task the person needs help with, morning to night. Then sort the list into the three buckets — company and household, hands-on personal care, clinical tasks. The buckets tell you the roles; the hours tell you the budget. Two rules of thumb:

• Book the lowest tier that safely covers each task — and the clinical tier for anything involving medication, wounds or readings. When unsure whether a task is clinical, ask the treating doctor or nurse, not the caregiver.
• Mix tiers rather than over-booking one: a nurse visit for the 20 clinical minutes plus aide hours for the rest usually beats an all-nurse schedule on cost — see our cost comparison for the arithmetic.
• Revisit the mix when the medical picture changes: after a hospital stay, a new diagnosis, or a fall — needs move, and the plan should follow.
• On SoftCare you can browse all three levels, filter by specialty, chat free of charge before booking, and pay only the CareGiver’s set hourly rate — the patient platform fee is 0%.

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