The agency you choose is going to have unsupervised access to your parent, probably multiple times a week, in their home. The questions you ask before signing anything are not a formality.
Start with the basics. How long has the agency been operating, and are they licensed in your state? If you are seeking Medicare-covered skilled care, are they Medicare-certified? What specific experience do they have with seniors who have dementia or cognitive impairment? That last question is worth asking twice — once in general terms, and once about the specific person they would assign.
Then move to the practical mechanics. What does the care plan process look like? Will they consult your parent’s doctor? How often is the plan reviewed? What happens when your parent’s needs change? What is the minimum number of hours per week they require, and can they accommodate the schedule you actually need?
Ask about caregiver consistency. Will your parent have the same person reliably, or will they be working with rotating staff? What is the backup plan when that person is sick or takes time off? Consistency matters more than families sometimes appreciate at the outset, and agencies vary considerably on this.
Get the full cost picture in writing before you agree to anything. Hourly rates, minimum hours, any additional fees for evenings, weekends, or holidays, what insurance they accept, and what your out-of-pocket responsibility will be. Ask about the cancellation policy. Some agencies require significant notice or charge for cancellation — reasonable to know before you are locked in.
Finally, ask for references. Specifically from families whose parent had a similar level of need — cognitive impairment, mobility challenges, whatever applies to your situation. An agency that is confident in their work will provide these without hesitation.
Get everything in writing. Not because you expect problems, but because clarity at the beginning prevents disputes later.