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How to Find and Hire a Caregiver for Seniors

Jeff Hoyt Jeff Hoyt Editor in Chief
Scott Witt Scott Witt Elder Home Care Expert

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Finding the right caregiver to help you or your loved one get through the senior years safely and comfortably can be challenging—when you don’t know what to look for, that is. There are several types of caregivers with varying degrees of credentials, so you’ll want to know which type you need, what to look for in qualified providers, how to go about hiring one, and last but not least how to finance this assistance. Our mission is to help you get all of the answers you need and help you find the most qualified and compassionate senior in-home caregivers possible.

Exploring Senior Caregiver Options

Before delving into the various types of caregivers, you should consider the logistics of the care you want and the duration of the care that will be needed. Those looking for short-term or part-time caregivers that give regular caregivers a break should consider looking for respite care, which can take place in the home on set days or within a facility when longer overnight care is needed. Many seniors prefer to stay at home for comfort and convenience, and this is when families should consider long-term in-home caregivers who can be employed part-time, full-time, or can reside within the home.

Those needing specialized care, palliative or end-of-life care often opt for full-time caregivers, whose skill sets, credentials, and will fees vary depending on the client’s needs. There are three primary types of caregiver roles: companions/homemakers, home care aides/assistants, and medical caregivers such as CNAs and registered nurses. Each has the skills and authority to perform specific duties and roles in the caregiving process.

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Companion Caregivers and Homemakers

As non-medical caregivers, the role of companions and homemakers is limited concerning offering medical or hands-on client assistance. However, they play a very valuable role for seniors and their families. When families need a respite from their caregiving duties, companions provide support and comfort to seniors. These individuals can also perform housekeeping duties, prepare meals, and transport clients to outings and appointments. Consider looking for a companion with a Certification for Homemakers from the National Association for Home Care and Hospice or a comparable organization.

Home Health Care Aides

These professionals can perform the same duties as companion caregivers and more. Certified home health care aides can render certain hands-on care and help seniors with their activities of daily living such as bathing, dressing, grooming, and ambulation. Like companions, aides cannot administer or dispense medications, and can only prompt and remind clients to take them. Look for candidates with a Certification for Home Care Aides from the National Association for Home Care and Hospice or a similar organization.

Medical Caregivers

Medical caregivers typically consist of certified medical assistants (AMAs), certified/registered nursing assistants (CNAs/RNAs), and registered nurses (RNs). Most families and seniors can have their needs met with AMAs or CNAs, but RNs are often called in for specialized care needs such as cancer, advanced dementia, or stroke patients. Medical caregivers can perform all the duties described above in addition to providing comprehensive medical care in both the home and in a facility setting. Some examples of their additional authorizations and skills include:

  • Monitoring vital signs and recording health patterns and behaviors.
  • Keeping in close contact with other health care providers and the family.
  • Administering medications and giving intravenous injections.
  • Pre-filling medication boxes.
  • Wound care and applying topical ointments.
  • Performing treatments such as enemas, douches, enteral feeding, catheterization, etc.

Now that you have an idea of the type of assistance you or your loved one needs, let’s explore the best way to find the right caregiver.

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How to Find the Best In-Home Caregivers for Seniors

Next, you’ll need to determine whether you want to use a service or agency to find the ideal caregiver or if you want to place an ad in effort to secure a private hire, both of which have their own benefits.

Using an In-home Caregiver Placement Agency

Get referrals from friends and/or check the Better Business Bureau and reviews of potential agency’s reputation. The primary appeal of using a caregiver service or agency is that these providers typically:

  • Screen each applicant carefully and check references.
  • Provide or confirm training and credentials.
  • Perform background checks on candidates.
  • Handle essential paperwork such as contracts and legal matters.
  • Handle payroll and taxes.
  • Provide backup caregivers if regular staff is unavailable.

Finding a Private Hire Caregiver

When hiring a caregiver directly, there are a few pros and cons. Primarily, you will have the benefit of getting a feel for the candidates personally during the interview process rather than simply getting to consider individuals the agency recommends. However, you’ll need to take over and be ready to handle the tasks mentioned in the list above to ensure that you hire the right caregiver. Read on for more advice concerning choosing a caregiver regardless of your preferred method of finding one.

What to Look for in a Senior Caregiver

Here are a few things that seniors and families should consider when hiring a caregiver, whether they be full-time, part-time, live in the home, or work in facilities.

Personality is Essential—Someone can have the credentials and experience in the world and simply not have a personality that meshes with the client and/or family members. You’ll have to go with your gut instincts after running a thorough background check through a national database if there are no red flags. Also, be sure to ask final candidates some questions to determine their interests to see if there’s common ground with the client.

Credentials, Licensing, and Experience—Be sure to find a caregiver that has the right credentials and experience to be able to provide for your loved one’s needs, particularly if they require assistance with medications or daily activities. However, it’s important to note that some states don’t require certification or credentials to hold certain caregiver roles, so make sure to confirm and licensures.

References—Do more than ask for them… call them and listen for any complaints or any hesitancy in commenting that can be indicative that there were issues. Also, confirm their length of employment, especially if you’re looking for a reliable person long-term.

Will They Sign a Contract?—If you use an agency or service, this is covered. However, if you are doing a private hire, be sure to consider including the following details within your contractual agreement with new hires to avoid many potential problems down the line. Within the contract outline:

  • Expected job duties, scheduled hours, home privileges, meal access, etc.
  • Compensation whether hourly or salary including performance review schedules for potential raises and bonuses.
  • Rate and frequency of days off and vacation time guidelines.
  • Transportation issues if the caregiver will be using their or your private vehicle or public transportation for client outings or running client-related errands.
  • Confidentiality expectations concerning sharing personal information work in the home.

How to Pay for Senior Caregiver Services

Depending on your situation, there are a number of possible ways to offset the cost of home care services such as long-term care insurance policies, traditional insurance, self-payment, and state and federal programs such as Medicare and Medicaid that may help in certain situations. If you are planning to use a service or agency, they will have financial advisors and/or social workers who can advise you about your best payment options. However, those opting for private hires will have special considerations, as you’ll have to pay your caregiver out-of-pocket and then seek reimbursement from your coverage provider.

Tips for Hiring a Senior Caregiver

Aside from the traditional way of finding care, there’s a new techy and convenient way of finding and hiring caregivers you can trust.

Most of us hesitate to get a caregiver, but our need for them is often heavier than having none. How will you know if the home health aide can be trusted? How will you know if the person who applied is very fit for the job? How will you know if they have enough patience to stay longer taking care of you or your loved ones?

These uncertainties are normal. Hiring an in-home caregiver is often nerve-wracking. Knowing where and how to find and hire a caregiver can help you overcome indecisiveness about getting private care. The following tips on finding and hiring a caregiver in the US will help you address your concerns and guide you when you’re in the process of getting a home health aide or a private caregiver for you or your loved ones in need.

Use Referrals to Find a Caregiver

The most common way of finding and hiring personal caregivers is a home care agency. Although hiring from agencies may be expensive, they do almost all the bureaucratic work for you such as covering payroll taxes, background checks, and other legal consequences of employing a home health aide.

Referral is also another way most people find care, but it is the most taxing. When looking for a caregiver, you have to do all the work by asking everyone you know if they know someone who may be up for the job. And If you get someone based on word of mouth, often, you’ll be sure that the recommendations from your friends are trustworthy. Most importantly, get referrals from people in the medical community such as doctors and social workers.

Usually, hiring private caregivers through referrals is cost-efficient for both the caregiver and the employer. You can also post your search for a caregiver in classified ads in newspapers. Also, you can try searching through online job sites and forums such as Craigslist and Indeed.

Carefully Assess Your Needs

Once you’ve decided where to find caregivers, do not make a call yet. Instead, make a detailed list of the jobs the personal caregiver must handle. You can also jot down what you expect in hiring one. Is the level of work part-time or full-time? Do they need to stay at home 24/7 or can they go home after 5 in the afternoon? If the job only requires them to be at home three days a week, it means that your job post is for part-time work. Here are some points you need to assess when finding a caregiver:

  • Duties the caregiver should perform and the frequency.  For example, caregivers should do some weekly housekeeping, driving the patient to his doctor’s appointment or helping the patient bathe every morning).
  • Types of specialized care. If your loved ones have incontinence, renal urological disorder, or dementia, caregivers with special skills are required.
  • In-home or live-out?
  • Language. Can you hire someone who speaks a dual language such as Spanish-English, or do you need someone who’s a native speaker?
  • Gender. Are your loved ones more comfortable around male or female caregivers?
  • Qualities you’re looking for in a caregiver. Since personal caregivers would be living inside your homes for many hours, they should have the characteristics of someone who you can trust. Listing the qualities that can make you and your loved ones safe and feel comfortable is a must. Some qualities they should have include patience, perseverance, kindness, and a sense of humor.
  • List your loved ones’ bug bears or irritations that the caregiver should prepare to face. Does he or she like to take long strolls every morning? Does she hate and get easily frustrated with messiness and disorder? Does he or she have fits whenever he or she sees someone smoking? Does he or she have allergies to perfumes? Give this list of pet peeves to your candidates so they can prepare.

Screen Candidates

The traditional way of getting private caregivers will envolve looking for contacts, making some calls, scheduling interviews, talking to caregivers personally, and sifting through your candidates. This can take weeks or months to find the right one. If you do not have time to do this, you can settle for home care agencies to do this for you.

Conduct an In-Depth Interview

During the interview, be sure to avoid being discriminatory towards future employees. Your screening process should be devoid of discriminatory policies. Based on the Fair Credit Reporting Act, you should ask for written permission before getting a prospective employee’s credit report.

Here are some helpful talking points and questions you must ask caregivers applying for your job listing. How long have you worked as a caregiver?

  • Can you tell me a little bit about your work experience?
  • What can you say about your previous jobs and your likes and dislikes about them? Can you tell me about your specialized training?
  • What can you say about the list of duties and the patient’s special care needs? Can you handle everything in the list of the patient’s nuances and irritations?
  • Can you think of possible activities appropriate for the patient?
  • If ever your patient becomes combative and irritable, how will you deal with the situation?
  • Based on your experience, what makes you happy while at work?

While conducting the interview, make it known to interviewees the details of the job. Some concerns include:

  • List and characteristics of people the caregiver will eventually interact with. These are the people who may sometimes visit your loved one. Caregivers should know them so they won’t be surprised when they do a social call.
  • Visitor policies. Is your in-home caregiver allowed to have visitors or not?
  • Salary and benefits. Schedule of payment. Is it weekly, bimonthly, or monthly? Discuss a payment system that both parties can agree with.
  • Are they allowed vacations and holiday pay?
  • Your regulations for petty cash. Sometimes, you need to leave a little money for household expenses that may arise every week. You can also reimburse the caregiver for expenses they spent. Just ask for receipts as proof of payment.

Hiring

Give the caregiver a cheat sheet that includes the details of the care recipient, home, emergency protocols, and special care needs. Here are some instructions and details that need to be on your list:

Details of your loved ones receiving care

  • Signs when he or she needs to be rushed to the hospital
  • Behavioral issues and ways to address them
  • Preferences or likes and dislikes
  • Characteristics
  • Diet and eating restrictions
  • Mobility problems
  • Medical condition and illness
  • Medication list and intake schedule
  • Exercises and schedule of therapies

Home details that the caregiver needs to have access

  • Own room or space for in-home caregivers
  • Keys to accessible areas of the house
  • Security precautions, emergency exits
  • Medical supplies
  • Kitchen for food, appliances, and cooking tools
  • Room where the cleaning and washing supplies are
  • Where flashlights, fuse boxes, candles, extra light bulbs, and emergency kits are
  • Cabinet or room for extra clothes or linen

Contact numbers and addresses in case of emergencies:

  • List of names and numbers of guardians, adult children, and the one in charge of the care recipient
  • List of names and numbers of doctors, clinics, hospitals, etc.
  • List of contacts for house matters (repairmen, cable, carpenter, pest experts, etc.)

Always remember, live-in or in-home personal caregivers are people. They should be provided a private space to be comfortable for a while doing their jobs. Make their shifts and working hours reasonable as they too need to have some personal time alone to do the things they love.  As caregiving is a very stressful job, giving them time for themselves will keep their work performance balanced. By treating the caregivers caring for your loved ones with respect and kindness, you can be sure that they will treat their care recipient the same.

Written By:
Jeff Hoyt
Editor in Chief
As Editor-in-Chief of the personal finance site MoneyTips.com, Jeff produced hundreds of articles on the subject of retirement, including preventing identity theft, minimizing taxes, investing successfully, preparing for retirement medical costs, protecting your credit score, and making your money last… Learn More About Jeff Hoyt
Reviewed By:
Scott Witt
Elder Home Care Expert
Scott founded Select Home Care Portland in 2009 and has been helping seniors live their best life at home or in their local senior community ever since. As an advocate for seniors, the primary philosophy has been to listen, educate… Learn More About Scott Witt
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