You need someone to help your loved one around the house. So, how do you go about hiring an elderly caregiver? Before you jump in, make sure you read this essential information about hiring a caregiver. We’ll share some common misperceptions and important considerations. Families will also share stories of mistakes they made so you can avoid them.
How to Find an Elderly Caregiver
The two basic ways of hiring an elderly caregiver are privately (you’re the employer) or through an agency. Here’s what you need to know about each of these options.
Option 1: Independently Hiring
If you hire someone directly, you might use ads/online search or locate someone by referral. There are also various matching services specifically for caregivers. A referral is always great, but it still needs to be the right fit and don’t neglect key hiring steps.
Here are the important considerations if you decide to employ an elderly caregiver directly:
- How will you screen applicants? You can pay a service to complete background checks. Think about what other screening methods you want to use such as references, required qualifications*, interview questions, etc. If the elderly caregiver doesn’t work with agencies, it can be hard to find out about work history and any past problems (outside of criminal record).
*Two primary qualifications for elderly caregivers are the HHA (home health aide) certification or CNA (Certified Nursing Assistant). For both of these, the person has to pass a certification exam and demonstrate key skills. Other caregivers may not have any formal certification. Some work as “companions” or assistants, focused less on personal care (and typically then without the related training). Agencies typically have requirements, but when you’re hiring on your own it is up to you to determine your minimum standards.
- As the employer, you need to handle all hiring and firing issues as well as important things like taxes and insurance. Look into all of this before making a decision. Compare total costs and time involved.
- See below for more on risk management and legal issues.
One Family’s Experience: Hiring a Nursing Student
Mom needed someone to help her around the house when we couldn’t be there. We thought it would be great to get a nursing student who’d be willing to work for room and board. This was easier said than done. We tried all kinds of resources, and finally found someone who was willing to do it.
I hadn’t really thought through how to set things up. Our expectations were wildly different and we had no contract or outline of duties. Though she was training as a nurse, she didn’t really know how to handle many things Mom needed. It was awkward to fire her due to the living situation, so we had to pay someone else to come in for a while. Eventually, we ended our arrangement and hired through a local agency. We understood better what we needed and let them handle being the employer.
Option 2: Using a Caregiving Agency
Home health care and other types of care agencies specifically focus on providing caregivers. Each agency handles things a little differently. Interview the agency. Ask about their hiring practices and training.
What types of caregivers do they employ (are they all CNA/HHAs or are some “companions”)? Do they use screening to determine caregiver ethics and how they’ll handle difficult situations? What type of orientation and training do they provide? Do they require it and/or pay caregivers for training time? Find out how they handle supervision. Do they make home visits to check on the caregivers? Do they create a careplan and provide guidance? What will they do if you don’t like the caregiver or have a problem?
Check out Important Questions (and Answers) about Home Caregivers. We’d love to answer all your questions: let us share the EasyLiving difference with you.
Types of Caregiver Agencies/Regulations
There are different types of elderly caregiver agencies. Each state regulates such agencies. In many states, non-medical care (the type you’re likely dealing with) is largely unregulated. This can be really confusing!
In Florida, agencies fall into three categories: nurse registry (provides independent contractors), homemaker companion services (for non-hands on care only, like errands and household help),and home health agencies (skilled agencies offer more acute services like nursing, physical and occupational therapy, non-skilled agencies provide caregiver services and some combine both). Read more about Florida’s home health care regulations.
How do you know which you need? Set up a call with us to discuss your situation.
Setting Expectations: Duties, Qualifications, Consistency
Before anything else, know what you need. Think of the duties do you want someone to do. What skills will the person need? What type of caregiver (qualifications/training) is needed for these duties?
Here are a few important things to consider up front. Some duties, such as giving injections, changing a dressing, or setting up a pillbox, require a nurse. Other tasks should be done by properly trained elderly caregivers. For example, personal care is physically demanding and requires safe techniques. Dementia caregivers should understand the disease and ways to deal with challenges.
Not only do you need to get an elderly caregiver with the right qualifications, you need to provide guidance about duties. Set clear expectations for a successful experience. A good agency should handle these things for you. Find out how they assess your needs and develop a care plan.
Families sometimes think an agency will give them a different caregiver every day/week. This doesn’t have to be the case. High-quality agencies focus on getting you the right caregiver(s). They may use a team approach, ensuring you consistency and coverage.
Risk Management: Liability, Injury, Oversight, Backup
Physical care comes with a level of risk. It’s easy for caregivers to sustain an injury when they don’t know proper techniques for lifting, transferring, etc. If your insurance doesn’t cover a caregiver’s injuries, you open yourself up to liability. Families often mistakenly think their homeowner’s insurance will cover such situations. Make sure you clarify.
Elders can be vulnerable, especially when someone’s providing personal care in a private setting. Oversight is a must. How will you (or a care manager, or the agency) check in? What methods will you use to evaluate the caregiver? If there’s a problem, how will it be handled? What are your repercussions, such as if something is stolen?
You depend on the elderly caregiver to be there when you need them. But, people get sick and things happen. An agency typically has a plan in place to deal with this. Ask them for details. If you hire privately, what will you do when a caregiver can’t be there or quits? Make a plan before a crisis. Also, consider what you’ll do when your needs exceed what the caregiver can handle. Map out long-term options and how you’ll track changes.
Should We Be Worried? When Your Elderly Caregiver Gets Injured on The Job
Our family hired a caregiver for Grandma, via a friend’s referral. A few people mentioned an agency, but we didn’t like the idea of lots of different caregivers. Grandma’s caregiver handled her needs well and they got along.
Several months later, we got a call. The caregiver had slipped while helping Grandma. She fractured her arm. That’s when I called my friend who’d been recommending an agency and said, “Should we be worried?” She was kind enough not to say, “I told you so.” The caregiver had minimal insurance and was now out of work.
We feel fortunate that she accepted our offer to help with hospital bills and pay for the remainder of the month. This could have been a significant hit to the assets that helped Grandma for the rest of her life. In the end, we hired an agency and got a high-quality caregiver…without the risk.
Staying within the Law
Improper handling of payroll taxes gets a lot of people into trouble. Remember all the stories of politicians owing back taxes for “under the table” household help? There are a lot of misconceptions about hiring household help. Check out this important information from the Department of Labor.
As mentioned above, you should also understand what qualifications are required for certain tasks. Medical care must be provided by skilled medical personnel. Most caregivers are considered non-medical personnel.
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