How to Choose Caregivers for Home Care

According to the National Association for Home Care, more than 7 million people receive formal home care services, and approximately 69% of those recipients are over the age of 65. Those numbers are growing as more seniors decide they want to age in place as long as possible. While more aging adults want to remain in their homes, at some point, they often require some assistance with daily activities, housekeeping, cooking, and other activities. 

Some of the signs that may indicate your loved one needs home care include social isolation, a messy home, forgetfulness, injuries, difficulty cooking, and poor hygiene. Once you make the decision to go this route, the next step is to choose caregivers. Finding the perfect fit is crucial, and the following tips can make it easier to connect with the best people for the job. 

Do an assessment of your home care needs 

The first step should be to assess your home care needs. While you may realize that your loved one requires the help of a caregiver, you also need to understand why. In what areas does your parent need help? Do they need help around the house, personal care, medication management, or some type of home healthcare? Is home care enough or would assisted living be a better option for their needs? Perhaps they do just fine with personal hygiene, but they need a companion or someone to provide transportation for errands, medical appointments, and shopping. Fully understanding the help your loved one requires will equip you with the right information to decide on the skill sets and experience needed in a caregiver. 

Come up with a job description

Once you’ve determined your loved one’s needs, now it’s a good idea to come up with a job description for the person you want to hire based upon the help required. In your job description, include details like the ability to drive, level of healthcare training required, or the ability to lift. It’s essential for all parties involved to be upfront and honest about the tasks that a caregiver will need to perform. 

Be aware of your finances 

You also must think about how you’re going to pay for senior care at home. Be aware of your finances and what you, your parents, and other families can realistically afford before you begin your search. Find out if Medicare, Medicaid, or your long-term care insurance will assist with the costs. 

Choose between private care and agency care 

Next, decide whether you’re going to hire someone privately or go through an agency to find a caregiver. With an agency, you may pay a little more, but individuals working with an agency are usually easier to vet. Hiring someone directly to provide care may offer monetary savings, but you’ll be the one responsible for overseeing, hiring, firing, confirming certifications, doing background checks, and more. 

Ask around for recommendations 

Ask around for recommendations and get to know the resources in the local community that hire caregivers. Talk to family members, neighbors, medical professionals, or friends who have gone through similar things. Ask about the pros and cons of caregiver agencies to help you narrow down your options or find out if people you know have personal recommendations for direct hires. If you’re going to go the agency route, you’ll also want to read online reviews. While you don’t want to rely entirely on anecdotal evidence when making your hire, it can prove helpful. 

Prepare for the interview 

Make sure you’re prepared for the interview with prospective caregivers. Have a list of questions you want to ask applications, whether you’re dealing with private individuals or working with an agency. Even if you are going through an agency, you’ll still want to interview potential caregivers. Don’t just go by their resume. While some may look great in their resume, they may not be the best fit for your situation. 

Interview applicants with some help 

When you hold the interviews with applications, have some help on hand. If you’re interviewing for your parents, it’s a good idea to have your parents on hand. Having another family member or a good friend on hand is another good option since it gives you a second opinion. 

During that interview, make sure you ask the questions you’ve prepared. Take note of the person’s personality and observe how they interact with your loved one. Don’t be afraid of asking tough questions. Ask about similar work they’ve done in the past. Question if they’ve ever clashed with certain personalities previously. Be upfront about your expectations during the interview to get a good feel as to whether the individual you’re talking to will be able to meet them. 

Take time to check references 

After the interviews, take time to check the references of applicants you’re considering. Talk to everyone who is given to you as a reference. Have a list of questions to ask references. Remember, you want someone who is not only qualified to do the work, but also reliable and dependable.

Ensure a background check is done  

If you’re hiring an individual, make sure you do a background check before hiring. If you’ll be hiring through an agency, ask them about their background checks and ask to see the paperwork they are using. Along with background checks, it’s a good idea to find out about the caregiver’s credentials. If they’ve noted credentials on their application or resume, check them to ensure they’re legit. 

Hire carefully 

Hire someone who has experience in the specific areas in which your loved one needs help. For example, if your parent has Alzheimer’s, choose someone who has experience working with other seniors with this disease. Beyond experience and credentials, make sure that you and your loved one are comfortable with the caregiver. They’ll be spending a lot of time in the home, so it's crucial to feel safe and at ease.

What type of home care do you need?

As you narrow down the type of home care your loved one needs, start with this basic question: Do you need a caregiver who will live in the home and be available 24/7? Or will your loved one be fine with someone who comes in daily or even just a few hours a week?

To make this choice, assess how much care your loved one really needs. Are they safe and comfortable during nighttime hours, or could they run into trouble in the middle of the night? If your loved one is experiencing the early stages of Alzheimer's disease or dementia, they may be prone to waking up at night and to nighttime wandering. In this case, live-in care may be the safest and most practical choice.

If you're not comfortable with that option or don't have anywhere for a live-in caregiver to sleep, consider hiring multiple caregivers who split shifts and work around the clock.

If you opt for a caregiver who's going to come during daytime hours only, you have another question to answer: Does your loved one need medical care, or just help with the activities of daily living? Once you know these answers, you're prepared to start your search for the right caregiver. While you may have the perfect caregiver available through a personal referral, most people need to work with home care agencies to find the right person.

Evaluating home care agencies

To make sure that your loved one stays safe and healthy at home, you need to work with a high-quality home care agency. Feel free to ask every question you might have. Here are a few important areas to explore and questions to start with.

How will the agency determine your loved one's needs?

Someone from the home care agency you're considering should conduct a full assessment of your loved one's needs. Optimally, this involves coming to your loved one's home, meeting them in person, and checking out the home environment as part of determining the right level of care. If your loved one has significant medical needs, this initial assessment should be performed by a registered nurse or the equivalent.

What conduct does the home care agency expect of its caregivers?

Practical and medical skills are important, of course, but you also want to find a caregiver who displays exemplary character. Because you're inviting the caregiver into your home, you want to find someone who will treat both your loved one and their belongings with respect.

How are caregivers supervised?

Does the home care agency arrange for unscheduled visits to make sure the caregiver is living up to expectations? The supervisor who performs these visits should also be a point person you can contact freely if there are issues you don't want to discuss with your caregiver.

How will you communicate with the agency?

Related to the previous question is the issue of ongoing communication with the home care agency. If you have questions or concerns, will you contact the same person every time, or do you just speak to whoever is manning the phones? You should also ask if you'll be notified of any change in your loved one's condition, since a daily caregiver may pick up on issues that you might not notice yourself.

What is the agency's availability?

Your loved one might need assistance at any time of day or night. Even if you have live-in care, your caregiver might be taken ill or have another emergency on a holiday weekend or at 3 a.m. If this occurs, will you be able to reach the home care agency?

Evaluating home care caregivers

Before you engage an in-home caregiver for your loved one, you'll want to meet them and get a sense of whether they'll be a good fit. Caregivers have an extremely intimate relationship with their clients, and they can become very close emotionally. During your interview, you're looking for more than just the professional qualifications and skills needed. You're also looking for someone who's trustworthy and who's a good match in personality for your loved one. Here are some questions to get you started when interviewing prospective caregivers.

What time off and vacation time do you expect?

This question is particularly important if you're hiring a live-in caregiver. If you're working with a senior care agency, they may be able to arrange for substitute caregivers. Ask the caregiver as well about how they'll prepare your loved one for their absence.

What experience do you have with specific tasks?

You already have a good idea of the areas in which your loved one needs assistance. Now focus on those areas with the prospective caregiver. Ask them to describe previous clients who needed help with bathing, toileting, dressing, and grooming. Ask what types of food they tend to cook. If you need the caregiver to provide transportation then ask for proof of a clean driving record.

What will you do when my loved one....?

You know your loved one's most negative tendencies. Maybe they become cranky at certain times of the day. You may have seen moments of aggression or anger. Whatever those negatives are, make sure you bring them up to a prospective caregiver. You want to know how they'll respond when those behaviors surface, and you also don't want a caregiver to quit because they weren't fully informed of what to expect.

Are there any services you won't or can't provide?

If you need a caregiver to drive your loved one on errands, you don't want to learn after hiring them that they can't drive after sunset. Go through the full list of services your loved one needs, and make sure none of them pose issues for the prospective caregiver.

How will you respond if my loved one offers you a gift?

As seniors become emotionally attached to their caregivers, they often offer them gifts. In many cases, this doesn't become a problem. However, if your loved one forgets that she promised her grandmother's jewelry to her granddaughter, and gives it to the caregiver instead, you could find yourself dealing with some seriously hurt feelings. You have the right to ask the caregiver to refuse any gifts or to ask to approve any gifts your loved one might offer.

Your interview with your caregiver will help you determine if you've found the correct match while also providing the caregiver with the information they need to know whether to accept the position.

Don’t forget to monitor care after hiring 

Once you’ve made the hire, don’t forget to continue monitoring care. Ask your loved one about their care. Make regular home visits so you can see how things are going yourself. If you’re working with an agency, get periodic reports. Schedule informal meetings now and then with the caregiver. If you don’t live nearby and you’re unable to monitor care yourself, consider hiring an independent care manager to help with this. 

Finding a quality caregiver that matches the needs and personality of an aging adult can be life-altering. With the right person to care for them, your loved one will enjoy a better quality of life, and you’ll be able to rest assured that they’re in good hands.