How to Start a Private Duty Home Care Sitting Service

As the population of elderly adults grows, so does the need to have dependable, qualified staff to empower them to remain in their own homes. Elderly clients who need assistance with activities of daily living can benefit from both live-in and day care. A private duty home care sitting service can be a rewarding and profitable way to help elderly citizens. Sitters also may assist disabled people of all ages.

Obtain needed permits and licenses. Every state has its own licensing authority and regulations. Check with the state department that governs the locale that the agency is to be located in. Consider hiring a consultant who has experience starting or evaluating home care agencies.

Develop a comprehensive business plan. Include market analysis, marketing and financial plans, and business structure.

Obtain financing. Start with the bank where you have accounts. Many banks and lending institutions offer financial through the U.S. Small Business Administration, or SBA, guaranteed loan programs (see Resources). Also contact your local small business association and chamber of commerce to find out about grants, low-interest loans, and other resources available in your community.

Create an office manual. Include a mission statement, organizational chart, infection control procedures, and a quality control plan. Establish a fee schedule. Develop a privacy statement.

Develop a plan for handling customer complaints. Include information about who to contact regarding reports of abuse, neglect and exploitation. Stock up on copies of the home care clients' bill of rights to distribute to all clients (see example in Resources).

Create a policies and procedures manual. Include detailed instructions about how to handle untoward incidents and infectious disease. Document hiring and termination procedures. Include clear instructions about how staff are to perform common duties such as meal preparation, transportation of clients, and other client services. List any limitations on services to be performed. Consider contracting the services of a Registered Nurse to assist with this step. You may also elect to buy resource material such as books or templates to help you compile this manual.

Develop an emergency management plan. Contact the Emergency Management Division of your state (see Resources). Obtain required documents for assessing and registering clients with special health needs.

Create a personnel manual. Include orientation and training materials, background checks, licenses, documentation of state-mandated training and health screening information.

Recruit staff. Start with an administrator and alternate administrator to oversee operations. Interview and obtain background checks on all applicants.

Get the word out. Use your marketing plan. Advertise in retirement community newspapers. Post flyers (with permission) at senior centers. Meet with geriatric care directors at local hospitals, HMOs, and social service agencies. Ask your local office on aging to add your business to their lists (see References for a site linking to state aging offices).


  • Delays in obtaining licensure are common. Plan for some leeway in scheduling your opening day.