Personal Support, Nursing, or Companion Care: Which Type of Home Care Do You Actually Need?
A plain-language comparison of the three main types of home care, what they cost, and which one fits your situation.
Why choosing the right type matters
Home care is not one thing. It is a category that covers everything from a nurse managing a wound twice a week to a companion dropping in for coffee and a walk on Tuesday afternoons. The three main types of support serve completely different needs, are provided by workers with different training and credentials, and are priced very differently.
Choosing the wrong type does not just waste money. It can mean real needs go unmet while you pay for services that do not address the actual problem. A nursing agency is not the right answer when the need is companionship and help with meals. A companion is not the right answer when there is a wound that needs clinical care.
The three types can also overlap. Many people need more than one.
Personal support workers: help with daily living
A personal support worker helps with the physical tasks of daily life. This includes bathing, dressing, grooming, toileting, meal preparation, mobility assistance, medication reminders, light housekeeping, and errands. The goal is to help someone maintain their routines and live safely at home or in a care setting.
What they cannot do: Personal support workers are not clinically trained. They cannot administer medications by injection, manage wounds, insert or manage catheters, or make clinical health assessments. If those needs are present, a nurse is required, either separately or in addition.
Where they can work: Personal support workers can be privately hired to provide support in a private home, a retirement residence, or a long-term care facility. This is a common arrangement when publicly funded care in a facility is not sufficient to meet a person’s needs.
What this role is called in different countries
- Canada: Personal Support Worker (PSW)
- United States: Home Health Aide (HHA), Certified Nursing Assistant (CNA), or Personal Care Aide (PCA)
- United Kingdom: Care Worker, Care Assistant, or Support Worker
- Australia: Personal Care Attendant, Support Worker
If you are in another country, ask the provider what training and qualifications the worker holds, and what they are and are not permitted to do. The function matters more than the title.
This type of support is right for you if: The main need is help with daily physical tasks, routines, or household management, and there are no active clinical medical needs requiring a nurse.
Nursing care: clinical support at home
A nurse provides clinical care in the home. This includes wound care, catheter management, injection administration, intravenous therapy, complex medication management, post-surgical monitoring, chronic disease management, and formal health assessments. Nurses are regulated professionals who must be registered with a professional body in their jurisdiction.
Nursing care is prescribed for specific clinical needs. It is significantly more expensive than personal support because it requires regulated professionals. It is not a substitute for personal support when the need is simply help with bathing and meals. And it is essential when it is needed.
Where they can work: Nurses can provide home visits in a private home or retirement residence setting. They can also provide transition care after hospitalization. In many regions, some nursing visits after a hospital discharge are publicly funded. Private nursing visits are also available.
What this role is called in different countries
- Canada: Registered Nurse (RN), Registered Practical Nurse (RPN), Licensed Practical Nurse (LPN)
- United States: Registered Nurse (RN), Licensed Practical Nurse (LPN), Licensed Vocational Nurse (LVN)
- United Kingdom: District Nurse, Community Nurse, Practice Nurse
- Australia: Community Registered Nurse, Enrolled Nurse
This type of support is right for you if: There are active clinical needs at home: an unhealed wound, a catheter, injections, complex medications, or recovery from surgery or a serious illness.
Companion care: connection and social support
A companion provides social support and meaningful company. Companions talk, play cards, go for walks, accompany people to appointments, help with light tasks, read aloud, and generally provide the kind of regular human connection that matters enormously to wellbeing.
What they do not do: Companions are not trained in personal care. They do not assist with bathing, dressing, or physical transfers. They are not clinical workers.
Why companion care is underrated: Isolation among older adults is a significant health risk with measurable effects on physical and cognitive health. Companion care addresses this directly. It also provides regular respite for family caregivers, which has its own value.
This type of support is right for you if: The person is largely independent physically but spends too much time alone, or a family caregiver needs regular, reliable time away.
When you need more than one type
It is very common to need a combination. A personal support worker three mornings a week, a nurse twice a week for wound care, and a companion visit on the weekend is not a redundant arrangement. Each serves a distinct purpose. Some agencies offer all three types of support under one roof. Others specialize. If your needs span multiple types, ask whether the agency can provide all of them, or whether you will need to coordinate multiple providers.
Quick comparison: all three types at a glance
The table below summarizes how personal support, nursing, and companion care differ. The same comparison is available as a printable PDF you can fill in and bring to provider calls.
| Personal Support Worker | Nurse | Companion | |
|---|---|---|---|
| What they do | Bathing, dressing, grooming, meals, mobility, medication reminders, light housekeeping | Wound care, injections, catheters, medication administration, clinical assessments, post-surgical care | Conversation, outings, accompanying to appointments, light tasks, social connection |
| What they do not do | Clinical procedures, medication administration beyond reminders, medical decision-making | Not a replacement for personal care or companionship; roles are complementary | Personal care, clinical procedures, lifting or transfers |
| Typical setting | Private home, retirement residence, or long-term care facility | Private home, clinic, or post-acute recovery settings | Private home, retirement residence, community outings |
| Relative cost | Mid-range | Highest | Lowest |
| Best if… | Daily physical tasks are the need, without complex medical needs | Active medical needs require clinical skills | Largely independent but isolated or needing social connection |
How to figure out what you need
Start by writing down a typical day. What tasks does the person struggle with or need help to complete? Are any of those tasks clinical in nature? How much time does the person spend alone, and is that a concern?
A formal needs assessment by a care coordinator or occupational therapist is the most reliable way to get this right. In many regions, a funded needs assessment is available through the public health system. Ask your family doctor or local health authority how to access one.
The most common mistake families make is hiring based on a title rather than an honest assessment of what the person actually needs. Getting that clarity first saves both money and the difficulty of switching providers later.
Suggested next steps
- Write down what the person currently struggles with or cannot do safely alone.
- Separate tasks into three buckets: daily physical care, clinical medical needs, and social connection.
- Ask the family doctor whether a care needs assessment or referral to a care coordinator is available.
- Download the printable care type grid below and use it to organize what you know.
- Contact home care providers with a specific, written description of what is needed rather than a general inquiry.
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