Start a Home Nursing Business

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For Faith Williams, one of the most touching aspects of home nursing has been the friendship that developed between her client and son.  

When my husband took on the commitment of building our house, I had to abandon full-time mothering and bring home the paycheck . . . by returning to my prior work as a registered nurse. At first I thought I’d enjoy the old camaraderie and excitement of the hospital routine. But I soon found out that–the second time around–all the activity was more of a hassle than a stimulant. Worse yet, I could never stop worrying about what might be happening to my three-year-old son back at home.

Before long, I decided I was going to have to figure out a way to earn money and be at home myself! I didn’t want to give up caring for people (the one aspect of nursing I’d always enjoyed) . . . and when I thought about it, I realized I didn’t have to. After all, there were plenty of senior citizens in our part of Florida who needed–but couldn’t always afford–nursing help. So why not care for such an elderly client through a home nursing business?

Once my husband and I had discussed the pros and cons of my brainstorm, he agreed that it seemed like the perfect solution to my problem. So I got our landlady’s approval . . . fixed up a room for our prospective boarder . . . and put an ad in the local paper, stating that I was a qualified R.N. looking for a house patient.

Ready Response

I had a specific type of person in mind to care for: a grandfather figure who needed help with dressing, bathing, and other basic care. So when the responses to my ad started coming in, it didn’t take me long–after carefully reviewing each applicant’s problems and needs–to accept a gentleman in his late 70’s with a premature-senility disease. He’d previously been living in an expensive nursing home, but his wife could no longer afford its rates. Consequently, she was so delighted that I was going to caretake her husband that, on top of my $1,200 monthly fee (home-care providers in my area charge from $500 to $1,800 a month, depending on the services provided), she agreed to supply the linen and a hospital bed with side rails!

During his first few months with us, “D” (as I’ll refer to our elderly client) improved tremendously. Every day he grew more active and alert. Whereas he couldn’t stand without assistance before, he soon was able to roam hither and yon. And with the help of my good home cooking (which sure beat the bland rest-home fare he was used to), he gained ten pounds!

All in all, D’s care requires one and a half to two hours a day. This includes bathing, shaving, and dressing . . . taking him for walks . . . and cleaning his room. (I don’t count doing D’s cooking and laundry in this estimate, since I have to do those chores for my own family anyway.) Of course, someone always has to be home should he need help, so when I have to go to the store or run errands, my husband–who works right next door on our house–checks in on him. And when we all want to get away as a family, I make arrangements for a neighbor to stay with D while we’re gone. (I baby-sit her children in exchange.)

One of the most touching aspects of having D with us is the friendship that’s been kindled between him and my little boy. My son–who rarely gets a chance to be with his grandparents–enjoys helping me take D on walks. Despite the gap in their ages (or maybe because of it!), the two fellows have developed a special understanding of and warmth for each other. I think each has helped to fill a void in the other’s life.

Supplemental Income 

Four months after I took up home nursing, my landlady approached me with another in-house employment opportunity. A doctor she knew needed help with his billing and wondered if I’d be interested in working for him. (Of course I would!) After I spoke with him, I took the part-time job at $200 a week . . . which included a brand-new typewriter, desk, office supplies, and the promise of a $25-per-week raise after six months. This additional money brought my total at-home income up to a comfortable $500 a week!

The new job hasn’t compromised the care D receives, either. I just fit the billing work in around his schedule . . . during the evening or any slack time in the day.

So, all things considered, I’m doing pretty well for my family–and for myself!–by working at home. Not only can I provide a more-than-adequate income for my household (while being able to monitor my son’s activities to my heart’s content!), but I even have a bit of free time for leisure activities–such as reading–that I never could manage when I ran the household after those grueling eight-hour hospital shifts!

Before Starting a Home Nursing Business

Here are a few questions to consider before you decide to care for an older person in your home:

  1. Do you truly enjoy caring for others?
  2. Are you a homebody, or do you prefer to be out and about most of the time?
  3. Do you really understand the needs of older — and/or very confused — people … and are you experienced at caring for them?
  4. How well would your family adjust to such a situation?
  5. Would such constant responsibility ultimately be too much to handle or too confining?
  6. Is your current home adequate for such a setup?
  7. Could you swap baby-sitting for boarder-sitting — or get other “relief help” — so you could have some time for yourself (and your family)?

After giving each of these questions serious consideration, if you still want to take an elderly person into your home, it’s time to examine the other hurdle …


While most states don’t require that you be a registered nurse in order to care for an older person in your home, many do demand some form of licensing. Don’t panic, though. In most cases, acquiring such “legalization” is neither difficult nor expensive. However, since it may involve a bit of bureaucratic rigmarole, it can be very time-consuming!

For example, we did some checking in North Carolina and discovered that if you were a Tarheel planning to take in from one to five nonrelated boarders needing special care, you would have to obtain what’s known as a Family Care Home License before you could go into business. The first step on the road to such certification is to visit the Adult Home Specialist at your nearest Department of Social Services office and fill out an application.

After that’s done, agency employees will evaluate your financial stability, health, and so on to determine your ability to care for someone else. Then they’ll inspect your home to make sure it’s suitable for nursing services. This entire screening process could take up to six months to complete, but –at least in North Carolina — it is provided without charge.

Once you’re approved and actually in business, the department will keep tabs on you to make sure you’re living up to the requirements stipulated in the licensing agreement. This may sound like a nuisance, but it has its good side: The professionals at the social services offices can provide supplementary assistance and/or referrals should your patient ever need them.

The procedure for obtaining a license varies from state to state (in some areas you may not be required to get one at all), so before launching your in-house “elder care” business, check out your area’s regulations by contacting either your local social service office or health department.