The comparison at a glance
| Title | Training and credential | Typically does | Cannot do | Usually paid by |
|---|---|---|---|---|
| Companion caregiver | Agency training, no state license required | Company, supervision, meals, light housekeeping, errands, reminders | Hands-on personal care in some cases, any medical task | Private pay |
| Personal care aide / caregiver | Agency training and competency checks | Bathing, dressing, toileting, transfers, mobility, plus all companion duties | Administering medication, any clinical task | Private pay, Medicaid, VA, LTC insurance |
| CNA | State-approved program plus competency exam, on Nevada's registry | All personal care, plus vital signs and clinical support under nurse supervision | Independent nursing judgment, IV, prescribing | Private pay, Medicaid, VA, sometimes Medicare via an agency |
| Home health aide | Formal training, works under a nurse inside a plan of care | Personal care tied to a doctor-ordered episode, help with prescribed exercises, observation and reporting | Skilled nursing tasks | Medicare, when skilled care is also being provided |
| LPN or RN | Licensed nurse | Wound care, injections, IV, catheters, assessment, medication management, teaching | Not applicable | Medicare, insurance, private pay |
The distinction that actually matters: medical or not
Most of the confusion disappears once you sort help into two buckets.
- Non-medical care is help with living: meals, bathing, dressing, mobility, housekeeping, errands, supervision, company. Caregivers, companions and personal care aides do this. It is usually paid privately, and Medicare does not cover it on its own.
- Skilled care is help with a medical condition: wound care, injections, IV, monitoring, medication administration, therapy. Nurses and therapists do this. A physician orders it, and Medicare often covers it.
Many families need both at once, which is why it helps to work with an agency that provides both rather than juggling two providers who never speak to each other. Our guide on home health versus home care covers this split in more depth.
A note on the word "caregiver"
"Caregiver" gets used two different ways, and it is worth separating them. It describes a paid professional who comes to the home, and it also describes the family member doing the work unpaid, usually an adult daughter or a spouse. If you are the second kind, you should know that Nevada has programs that can pay you for it: see how to get paid as a family caregiver in Nevada. And if the work is wearing you down, caregiver burnout is worth reading before you hit the wall.
So which one do you need?
- Company, meals, errands, someone there so they are not alone: companion caregiver.
- Bathing, dressing, toileting, help getting around safely: personal care caregiver, or a CNA if transfers are heavy.
- Recovering from surgery, a stroke or a hospital stay: likely skilled nursing and therapy, possibly with an aide, and possibly Medicare-covered.
- Memory loss, wandering, sundowning: a dementia-trained caregiver specifically, not just any caregiver.
- Wound care, injections, IV, a condition that needs monitoring: a licensed nurse.
If you are unsure, that is normal, and it is exactly what an assessment is for. See also how to hire a caregiver in Las Vegas and what a caregiver actually does all day.
What is the difference between a caregiver and a CNA?
A caregiver is a general term for someone who helps with daily living: meals, bathing, dressing, errands, company and supervision. It is not a licensed title. A CNA, or certified nursing assistant, has completed a state-approved training program and passed a competency exam, and is listed on Nevada's nurse aide registry. A CNA can do everything a caregiver does, plus certain clinical tasks such as taking vital signs, under nursing supervision.
What is the difference between a home health aide and a caregiver?
A home health aide (HHA) works under a nurse's supervision as part of a doctor-ordered plan of care, usually through a Medicare-certified home health agency, and can assist with clinical tasks like helping with prescribed exercises or monitoring a condition. A caregiver providing non-medical personal care does not work from a physician's order and is typically paid privately. The practical difference is who directs the work and who pays for it.
Can a caregiver give medication?
Generally no. In most cases a non-medical caregiver may only offer medication reminders, hand a person a bottle, or open a package, but may not administer the medication, give injections, or manage an IV. Those tasks require a licensed nurse. If your loved one needs medication administered rather than simply remembered, ask specifically for nursing, not caregiving.
Do I need a CNA or is a caregiver enough?
For most families, a well-trained caregiver is enough. If the need is meals, bathing, dressing, mobility, supervision and company, that is caregiving. If the need includes wound care, injections, catheters, IV, or close monitoring of a medical condition, you need a licensed nurse. A CNA sits between the two and is useful when there is heavier physical care such as transfers, or when clinical observation is helpful but full nursing is not required.
Which one does Medicare pay for?
Medicare pays for a part-time home health aide only while your loved one is also receiving Medicare-covered skilled nursing or therapy at home, and only if they are homebound. Medicare does not pay for a caregiver whose only job is help with bathing, meals, supervision or company, no matter what title that person holds.
Last reviewed August 2026. General information, not medical advice. Scope of practice varies by state and by employer policy; Nevada rules govern care provided here.