There’s nothing quite like home. Familiar, comfortable, and uniquely ours, it’s no wonder that as we age, a huge percentage of people- as many as 40%- still live in their own homes 1, even though assisted living facilities offer some built-in perks.
Due to some of the changes that may come along with aging and some chronic health conditions, extra help is sometimes needed to maintain independence at home. Often, this starts with family and friends stepping in as caregivers. If a loved one’s care requires 24/7 help, this can become challenging. If you are in this situation and considering the addition of a paid caregiver to offer either respite or regular assistance in your home, how do you choose the best one?
Step one: what are your needs?
Before you begin your search, it’s important to know what your care needs are so that you can find the perfect match in a caregiver. Some of the daily tasks a caregiver can assist with include:
- Bathing
- Toileting
- Dressing
- Meal prep
- Feeding assistance
- Light housekeeping
- Ambulation (walking) assistance
- Running errands/shopping
- Companionship
It’s easy to see how these activities require different skills. Do you or your loved one require extra assistance with transferring from a wheelchair to the bed? Your caregiver will need to be able to safely lift. If transportation assistance is important, a current driver’s license is a must.
In addition, there may be other specific requirements to consider in a caregiver, such as:
- Language skills, if speaking in a native tongue other than English would be helpful
- Gender- if a caregiver will be involved in personal care, does your loved one prefer a male or female?
- Is a live-in caregiver preferred, or one that will come for scheduled shifts?
If you’re a family member locating a caregiver for a loved one, it’s important to take their needs and preferences into consideration. After all, it’s their home. They may have fears about someone stealing valuables, or be hesitant about a “stranger” in their home. If they would prefer a short trial basis to ease these fears, be sure you discuss this possibility with a caregiver.
Hiring on your own vs. using an agency
You’ll also have to decide whether you want to go through an agency for a caregiver, or if you prefer to find your own.
Some agencies keep caregivers on staff as employees and cover their taxes, insurance, and ongoing training. Others act as an employment agency, leaving you with more responsibilities. You’ll want to ask how they operate.
Consider some differences between the two:
| Private Caregiver | Agency Caregiver |
| You are responsible for screening and background checks | The agency conducts background checks and other screening |
| If a caregiver is sick or on vacation, you must secure a replacement | Fill-in caregivers are provided by the agency as necessary for caregiver absences |
| You must decide how to handle taxes, worker’s compensation insurance, and pay | Administrative details like taxes, worker’s compensation, and pay is handled by the agency |
| Cost may be lower | Cost may be higher |
| Search for caregiver with the right skills is your responsibility | Caregivers with many different skills may be available through the agency |
| May not be covered by long term care insurance | May be covered by long term care insurance |
| Coordinating scheduling is your responsibility | Scheduling is taken care of by the agency and there are multiple caregivers available to cover shifts |
Hiring a private caregiver
If you’ve decided to conduct your own search and hire a caregiver privately, there are some important questions to ask when you interview prospects:
- Remember to go over your list of needs and make sure they’re able to meet those needs- can they lift someone to transfer them? Are they able to cook meals?
- What certifications does the caregiver have? Two common certifications are Home Health Aide (HHA) and Certified Nurse Assistant (CNA)
- Does the caregiver have a current driver’s license and/or transportation of their own for the job? Or would they need to use the client’s car?
- Can the caregiver provide references?
- Is the caregiver CPR certified? (this includes training on managing choking emergencies)
- Is the caregiver bonded and/or insured?
You can also ask some questions about how the caregiver handles interactions. For example:
- Ask the caregiver to describe a time when they had a conflict with a client, and how they resolved it
- What experience do they have with clients with memory issues, if applicable?
- What is their favorite activity to do with their clients?
- How do they respond to an angry or confused client?
- What has been their most difficult caregiving task in the past?
After the interview, you’ll want to conduct a background check, contact references provided, and decide how you will handle administrative details. There are several important things to consider related to this.
For example, how will pay be handled? Will it be provided weekly or bi-weekly? Will you withhold taxes? There are new federal regulations affecting how caregivers are classified for tax purposes. You may have a responsibility to pay employment-related taxes for in-home caregivers and file the appropriate paperwork. These IRS rules should be discussed with your professional tax consultant to avoid potential penalties.
Will you be paying for any vacation time? Are meals provided? Will the caregiver be live-in, or will they work scheduled shifts?
When you hire a caregiver, you’ll want to create a contract that spells out your job expectations. These include:
- Notice required for vacation or sick time
- Scheduled hours
- How tardiness will be handled
- Payment schedule
- Job duties, such as meal prep, housekeeping, etc. Will the caregiver be expected to help with pets?
- Transportation arrangements (whether the caregiver will have access to a car, or use their own for helping with errands and outings)
- Confidentiality expectations
- How you will handle reimbursement of any expenses the caregiver might incur in their role
- Is smoking allowed on the property?
- Notice required for ending employment
To ensure your contract legally protects you, it is advisable to review your contract with an attorney before offering it to any prospective caregivers. For assistance with this, you may find it helpful to contact your local council on aging for recommendations on discounted legal services, or a federal agency called the Administration for Community Living (ACL) offers a Legal Services for Older Americans Program.
Using an agency for caregivers
If you’d rather go through an agency to find a caregiver, you will have some other considerations. Here are some things you can ask:
- How long has the agency been in business?
- Is the agency licensed by the state? (not required by all states)
- Can they provide a fee schedule?
- Are references available?
- What certifications do they require of caregivers?
- What kind of training is offered to caregivers each year?
- How much notice will they need for schedule changes?
- How do they handle any potential concerns with caregivers?
Good professional care can improve daily life
Ultimately, the right caregiver can make a big positive impact on both the senior living at home and any involved family. A professional caregiver can provide companionship, reduce the risk of depression, and prevent family caregiver burnout. They can reduce the risk of health complications such as falls. Their relationship can even grow to be like part of the family!
If you’re looking for a professional caregiver through a home care agency and would like to discuss options with Caresify, we can answer any questions you might have and help you find a great fit for your loved one. Read more about our services here, or call 888-799-5007.
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