What Does a Home Caregiver for Seniors Actually Do?

By Sandra Ferreira, Technical Director at Lxiscare.

Lxiscare has been accredited by Portugal’s Social Security since 2009 to provide home care services for seniors, patients and people in situations of dependency across Greater Lisbon. One question comes up again and again in our first conversations with families — including families coordinating care from another country: what does a home caregiver for seniors actually do, day to day?

Formal vs. informal caregivers

There are two distinct realities. An informal caregiver is usually a family member — a spouse, son or daughter — who takes on care without specific training or pay, often alongside their own job and personal life. It’s a demanding role, and over time, an exhausting one — especially when that family member is also trying to manage things from abroad. A formal caregiver is a trained professional, certified in Portugal as Ajudante Familiar (Family Helper) or AAD, Assistente de Apoio Domiciliário (Home Support Assistant), who provides paid, structured care through a provider like Lxiscare or through Social Security’s own home support service (SAD).

The two roles aren’t mutually exclusive. In most of the situations we support, the formal caregiver steps in to ease the burden on the family, not replace it.

What’s included in caregiving

A professional caregiver’s work covers a broad range of tasks, which vary according to the person’s level of dependency:

• Personal hygiene — bathing, dressing and grooming, always preserving the person’s dignity and privacy.
• Nutrition — preparing or assisting with meals, with attention to specific diets and swallowing difficulties (dysphagia).
• Mobility support — help getting up, lying down, transfers, and fall prevention, especially important for people with reduced mobility.
• Companionship — presence, conversation and cognitive stimulation, particularly valuable in cases of isolation or cognitive decline.
• Medication management — organising schedules, confirming doses are taken, and keeping track of quantities and expiry dates at home. Prescribing and adjusting medication always remains the responsibility of the doctor and pharmacist (see our guide to common medication myths).
• Accompanying medical appointments and liaising with doctors and nurses, so information flows reliably between healthcare professionals and the family.
• Related household tasks — laundry, buying hygiene products, and keeping the person’s living environment clean and safe.
• Monitoring vital signs — where applicable, recording blood pressure, glucose, temperature, weight and other indicators, with immediate communication to the family or health services whenever something is out of the ordinary.

This kind of close monitoring matters especially for people living with conditions such as Alzheimer’s disease, where small changes in behaviour or routine can be an early sign worth looking into.

Training and credentials of a professional caregiver

In Portugal, the reference qualification for people caring for seniors is the Ajudante Familiar or Assistente de Apoio Domiciliário (AAD) certification, which covers hygiene and comfort, first aid, mobility and transfers, basic nutrition, and communication with people experiencing dependency or cognitive decline. Beyond initial training, hands-on experience and ongoing learning — particularly around dementia care and emergency situations — make a real difference in the quality of care a family receives.

How Lxiscare selects and supervises its team

Before any caregiver enters a client’s home, Lxiscare verifies their training, experience and references. Oversight doesn’t stop once a caregiver is placed: the team is supervised throughout the service, with direct, ongoing communication between the family, the caregiver and Lxiscare whenever something needs adjusting — the routine, the type of support, or the caregiver themselves.

Private care vs. Social Security’s home support service (SAD)

For a closer look at how this comparison works in practice, see Home Support Services in Portugal: SAD vs. Private Home Care.

Both Social Security’s SAD and private home care meet the same basic need — caring for someone who can’t manage all their daily needs alone — but they work differently. SAD operates through IPSS organisations with cooperation agreements, with limited places and often waiting lists. Private support, like Lxiscare’s, generally allows for a faster start, a personalised schedule — including 24-hour care — and a direct say in choosing your team.

There are situations where this support matters from the very first day at home — recovery after a hospital discharge or a stroke being the clearest example, when a family’s routine changes overnight.

Want to know if this is the right kind of support for your family? Contact Lxiscare and schedule a free assessment.