Choosing a Caregiver for your Loved One

Choosing a Caregiver for your Loved One

Most clients want to live in their own homes for as long as possible. However, for those who are elderly and have disabilities, that may be possible only with the help of outside care.  More than 41 million Americans, according to the Institute for Health & Aging at the University of California, have a chronic condition that limits their daily activities in some way, and 12 million are unable to live independently.  Of the 1 out of 5 elders who have reached age 85, more than half are impaired and need long-term care, that is, personal assistance that enables them to perform activities of daily living such as bathing, eating, and dressing.

In many cases, that outside help comes from unpaid care provided by family and friends.  More and more, however, older adults and their families are recognizing the benefits of hiring caregivers.  This assists the older adult to stay in their home longer while ensuring comfort and safety, and giving the family greater peace of mind.  Some states and the federal government are now setting aside funds to pay for outside help.

It is not an easy decision when it comes to choosing an in-home care agency, for when you or someone you love needs care. There are many options to choose from and not all private caregivers or agencies offer the services you may need.  This post outlines the basic steps.

Assess What is Needed in the Home

Evaluate the help that is needed in the areas of health care, personal care, and household care.  Do you need physical therapy or medication management (home health care)?  Do you need help with bathing, dressing, toileting, and meal preparation, or are you looking mainly for a companion or someone to be with you (non-medical personal care)?  Do you need help with cleaning your home, grocery shopping, maintenance of your home, running errands, or with bill-paying and managing your money?  As you complete your assessment, make a list of the tasks where caregiver help is needed.

Write a Job Description

Once you have listed the tasks to be completed, the next step is to create a job description.  Using your list as a guide, this should include the list of duties along with the experience, qualifications, and credentials you want to see in candidates.  You want a caregiver who has experience in the specific areas in which you need assistance.  For example, people who have been diagnosed with Alzheimer’s disease often need help with toileting and bathing, so look for someone who has experience working with elders with this illness and experience.

Be sure to include the following:

  1. Health care training – for example, Certified Home Health Aide, Licensed Practical Nurse, Registered Nurse.
  2. Driving requirements – for example, a car needed and/or only a valid driver’s license.
  3. Ability to lift care recipient and/or operate special medical equipment.

Develop a Caregiver Agreement

Based on the job description, the care agreement is the most thorough description of the caregiving position.  It should include the following:

  1. Wages, including when and how payment will be made.
  2. Hours of work
  3. Employee’s Social Security number – you must report wages paid to the caregiver to the IRS.
  4. Job description and duties.
  5. Unacceptable behavior – examples may include smoking, abusive language, tardiness, etc.
  6. Termination – be sure to include how much notice, reasons for termination of relationship without notice, etc.
  7. Dated signatures of employee and employer.

Identify Candidates

Once you know what the job will entail, the next step is recruitment.  Identify the pool from which you can find a caregiver – websites such as are a great place to start.  You may have neighbors or friends who would be good prospective caregivers.  If you belong to a church, ask your pastor or minister for prospects.  Family members can be caregivers, but first and foremost, hiring, managing, and firing a caregiver are all business decisions, and for that reason, many family members do not make a good paid caregiver.  Hire a professional if you can afford it and don’t waste your time looking in places where you won’t find someone suitable for you.

Prepare for Interviews

Assemble a list of questions to ask.  Have a list for any applicant, caregiver agency, referral source, or reference you may call during your search.  If you don’t know what questions to ask, call a caregiver agency.  The agency should be helpful because you are a prospective customer.

Interview Caregivers

After you have screened applicants on the phone, and they have met the basic requirements for the job, you should interview them in-person.  Invite a family member or friend to sit in on the interview to provide a second opinion.  Always observe interactions between the worker and the person who will be the recipient of care.  If you are interviewing an agency, ask to interview the in-home caregivers yourself.  Many agency employees look good on paper, but will not be a good fit for cultural, social, religious, or any number of other reasons, or you may just not like the person the agency has assigned to you.

Check References

It is important to check references carefully – talking to everyone who is given as a reference.  You are not only looking for someone who is qualified to do the work, but also for someone who is dependable, reliable, and caring as well.

Conduct a Background Check

People who are paid by state funds must pass a criminal background check.  Even if someone does not have a conviction for a disqualifying crime (which would be identified through the background check), he or she may have convictions for offenses that would concern you or present a safety risk. Examples include using drugs, driving under the influence of alcohol or drugs, driving without a license or insurance.

Hire Thoughtfully

Try to hire a licensed and bonded caregiver.  If the agency is not licensed or bonded, you may want to look somewhere else.  Likewise, that probably disqualifies your next-door neighbor or churchgoing companion, whom you may want to hire nonetheless because the person meets all your other requirements.

Monitor the Caregiver’s Performance

Set up a schedule to monitor the quality of the services being provided to you or your loved one.  This is especially important for family members.  Ask the caregiver to keep a log of any tasks or duties they are helping the elderly with, for each of their shifts.  Monitor performance by making personal contact with the caregiver and regular home visits and getting periodic reports from the caregiver and the agency.  Consider hiring an independent geriatric care manager to monitor if you are unable to do this yourself.

Have a backup plan in case the caregiver or the agency fails to follow through or problems arise.  This is people caring for people and things will happen – caregivers may get sick, want to take a vacation, or not show up for a shift when you are relying on them.  Watch for signs of abuse, neglect, and exploitation. Report any suspicious activity to the agency and state authorities.

If you are worried about your elderly loved one and their care needs, Fendrick Morgan can help. Call 856-489-8388 to schedule a family consultation. We look forward to hearing from you.

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