A home care agency gets a call on Monday: a client is coming home from the hospital on Thursday and needs an aide for four hours every morning. The agency has nobody free in that zip code. That scenario, repeated thousands of times a week, is what finding caregivers looks like in 2026. The problem is rarely that no one wants the work. It is that the right person, within driving distance, available for those exact hours, has to be found and cleared in days.
How big the gap is
PHI, the direct care research and advocacy group, counts 5.8 million direct care workers in the United States, including nearly 3.5 million home care workers, 714,000 in residential care homes and more than 534,000 nursing assistants in nursing homes. It projects the field will add over 886,000 new jobs between 2025 and 2035, and that 9.6 million total jobs will need to be filled in that period once turnover and retirements are counted. Its separate Key Facts 2025 report estimates 9.7 million openings from 2024 to 2034.
Pay is the other half of the story. PHI puts the median direct care wage at $17.99 an hour in 2025, and says 34 percent of the workforce lives in or near poverty. Any plan for finding caregivers that ignores those numbers will fill a schedule for a month and then lose it.
Decide what kind of caregiver you need first
Three variables cut the candidate pool more than anything else. Credential: a certified home health aide or nursing assistant can do tasks that a companion or personal care aide cannot, and Medicare certified agencies need the former for skilled visits. Schedule: live in, overnight, split shifts and short morning visits attract different people. Territory: caregivers drive between clients, so a radius of 10 to 15 miles from home is a realistic limit for most. Write those three down before posting anything, because they decide which channels below will work.
Where caregivers come from
Referrals from your own aides. Caregivers know other caregivers, often from church, family or a previous agency. A referral bonus paid after 90 days, not on hire, rewards people who stay.
Training programs. Community colleges, adult education centers and CNA programs graduate classes on a schedule. Agencies that send a recruiter to the last week of class, with a start date ready, hire graduates before anyone else posts a job.
Your own past applicants. Most agencies have thousands of people who applied once and never finished onboarding. Our guide to ATS rediscovery explains how to work that list again; for caregivers the trick is filtering by zip code and credential first.
Local community channels. Faith communities, immigrant community groups and neighborhood social media groups reach people who never browse a job board. Post in the languages your clients and caregivers speak.
Job boards. They produce the most applicants and the lowest completion rates. Keep the application to a phone number, a name and a zip code, then do the rest by text.
Screen in days, not weeks
The candidate who applied on Monday will usually accept the first agency that calls back. Reply within an hour if you can, book a short phone or video screen the same day and run background checks, references and any required health screening in parallel rather than one after another. State rules vary on which checks are required for home care aides, so build the checklist from your state health department's requirements and your payer contracts. Our piece on outreach response rates shows how much reply speed and channel choice change who answers.
What makes caregivers stay
PHI's data explains the turnover: low wages and part time hours. Agencies that keep aides offer guaranteed weekly hours, pay for drive time between clients, consistent clients rather than a new house each day, and a visible path from companion to certified aide. Families hiring directly should match local agency pay or better, write down the duties and hours, and agree on what happens when the caregiver is sick. PHI notes that its counts exclude the so called gray market of privately hired caregivers, which means families compete for the same people the agencies do.
Tools that help a small recruiting team
Most home care agencies recruit with one or two coordinators. A searchable applicant database, text messaging that logs replies, and automated scheduling for screens cover the bulk of the work. For harder to fill roles, such as bilingual aides or certified staff in rural counties, the approaches in sourcing hard to fill roles apply, and our ranking of sourcing tools covers the platforms that search beyond job boards.