With the acceleration of population aging in China, home care services, as an important component of the elderly care service system, play a significant role in meeting the care needs of the elderly. However, home care services are confronted with numerous ethical dilemmas and insufficient legal protection in practice. This article systematically analyzes the ethical issues existing in home care services for the elderly, such as the conflict between privacy rights and autonomous decision-making rights, the unfair distribution of care resources, and the balance between professional ethics and family ethics. This paper analyzes the current legal and regulatory system’s imperfection, the absence of quality supervision mechanisms, and the unsmooth channels for rights protection. It also puts forward countermeasures and suggestions from the aspects of improving the legal norm system, establishing ethical supervision mechanisms, and perfecting the channels for rights protection, with the aim of providing references for promoting the healthy development of home care services.