I was in a situation where I could not get my 97 year old friend released from the hospital to return home until I had in-home care in place. I was impressed with how quickly Aviva responded to me when I called them for help. They were available to me night and day. They worked with the hospital to schedule an assessment and my friend was released shortly afterwards. A few days later they followed up with an in-home visit to make sure the care was complete. They gave me suggestions as to how I might proceed and answered all my questions. But most important, they were available to me 24/7; I never had to worry that a caregiver might not show up. They were 100% reliable. What a godsend! When visiting physical therapists and nurses left instructions for care I passed that on to Aviva and they made sure the caregivers followed through with the orders. As a result, my friend improved dramatically and is now living independently in an assisted living community. I would highly recommend Aviva for in-home care. They will be there when you need them and will do an excellent job.