BACKGROUND: Older adults are increasingly relying on home health aides and attendants (HHAs) to support their care needs and enable them to age in place. In response to workforce shortages and rising care demands, AI systems are often touted as potential solutions. However, little is known about how stakeholders responsible for implementing these systems perceive AI's potential benefits and risks.

OBJECTIVE: To examine the perspectives of HHAs and other key stakeholders on deployment of AI technologies in home care work.

DESIGN AND PARTICIPANTS: A qualitative study was conducted with English-speaking HHAs, home care agency leaders and staff, worker advocates, clinicians, and technology company leaders and staff. Purposive sampling and snowball sampling were used to identify and recruit participants. Semi-structured interviews, including AI scenarios, were conducted.

MAIN MEASURES: Interviews were analyzed using a rigorous three-stage qualitative analysis process: structural coding, inductive sub-code generation, and thematic analysis.

KEY RESULTS: A total of 43 participants across five stakeholder groups participated. The mean (SD) age was 44.6 (11.2) years, 23 (63.9%) identified as women, 35 (97.2%) had completed at least some college education, and 16 (44.4%) reported having no or low knowledge of AI. Four major themes emerged: (1) potential benefits of AI to enhance patient care, strengthen HHA engagement, and improve organizational efficiency; (2) risks of AI eroding patient care, harming provider-patient relationships, and worsening working conditions for HHAs; (3) challenges related to data quality, privacy protections, and AI literacy among HHAs; and (4) the need for timely, equitable AI partnerships and governance.

CONCLUSIONS: Participants recognized both the promise and risks of AI in home care. Findings highlight the need for early, inclusive governance frameworks and labor protections to ensure that AI adoption supports, rather than undermines, care quality, workforce sustainability, and patient-provider relationships in the home care sector.