Paid companions: a private care option for older adults.

Paid companions, operating either independently or through private home care agencies, perform a variety of services for financially secure older adults who can afford to pay for private support in their homes and in care facilities. Drawing on semi-structured, open-ended, in-person interviews and autodriven photo elicitation (whereby individuals take their own photos and discuss them later in the interviews) with 30 participants (15 companions, 8 clients, and 7 key informants), this study examined the work performed by paid companions. The findings revealed that, in many ways, the companion-provided services for clients living in their own homes resemble task-based home care work, but the work's emphasis is different. The social and emotional relationship with clients is the central focus of their work. Facility-based companions provide a unique role filling the care gap left by government cutbacks to staffing ratios which keeps elderly residents, often with dementia, involved and engaged in the world.