It is natural to be worried and overwhelmed at first when needing to hire someone for help with personal care. This is no small task; it will affect your day to day life. Try to keep in mind that you have options and can find someone who is right.
This document will help guide you and answer the questions:
- Where do I start?
- What do I ask?
- How will I know if someone will provide what is needed?
To make the hiring process as easy and smooth as possible, it is important to first think about what is needed and what you are looking for. This is true whether searching for someone before leaving the hospital or at another point in time. Understanding what needs to be done will also simplify the questions to ask each person being considered for the job. Creating a realistic picture of the situation will help with finding the caregiver whose background, skills and personality meet the needs of the individual who requires care.
For anyone currently in the hospital, the rehabilitation treatment team can assess the type of care needed at home and can also train a caregiver before discharge.
Start by identifying what type of help is needed by using the checklist that follows. This list can also serve as a job description for the caregiver. Once the jobs have been identified, the process of finding a caregiver can start. Generally people use a home health care agency, caregiving agency, employment agency or find a caregiver on their own. Below is a description of each option and information to help with making a choice.
* Getting in and out of bed
* Walking or pushing a wheelchair
* Using stairs
* Brushing teeth, shaving, hair care, makeup
* Using the toilet or other bladder or bowel care
* Taking medications
* Other home medical care _________
* Meal preparation
* Dish washing
* Making or changing the bed
* Cleaning bathroom
* Washing floors
* Taking out garbage
* Lawn or yard work
* Snow shoveling
* Other _____________
Activities - Home
* Shopping for groceries/household items
Activities - Personal
* Doing home exercises
* Picking up medicines
* Medical appointments
Activities - Social
* Recreation activities
* Visiting friends
* Going out
* Religious services
* Driving to family events
* Other __________
Using a Home Health Care Agency
Agencies often focus on providing skilled care, but may also have non-skilled workers such as companions and homemakers available.
- Skilled care includes services of certified and licensed professionals, such as registered nurses or occupational therapists. Skilled care may be necessary for someone with specific medical needs.
- Non-skilled care includes assistance with activities of daily living, such as dressing, bathing, eating and household chores. It may also include providing supervision for safety. Caregiving agencies employ people who are trained to provide these services.
- If the caregiver is unable to work, the agency arranges a substitute.
- Payment is made to the agency. The agency pays the caregiver and assumes responsibility for withholding taxes.
- Strict guidelines determine which tasks can be performed by caregivers. For example only a licensed nurse is allowed to perform catheterizations, injections or tracheostomy care.
- Greater cost – there are both caregiver and agency fees.
Using an Employment Agency
- Agencies select prospective non-skilled caregivers and schedule interviews.
- You become the employer; the agency is not responsible for any supervision.
- Staff may not necessarily be specialized in personal care.
- Some employees may not speak English.
- A fee, usually equal to one week’s salary, is charged to the employer. This fee is nonrefundable, but the agency should replace a worker for no additional fee if you are not satisfied.
Hiring a Caregiver on Your Own
To begin a search, think about talking to friends or neighbors who may have used a caregiver. Also consider placing an ad in your community:
- Neighborhood newspapers
- Ethnic newspapers
- Church newsletters
- Community or neighborhood clubs
- Hospital bulletin boards (Nursing and medical school students may already have some care experience and be willing to exchange care for room and board.)
- Grocery stores
- Area Independent Living Agency
- College newspapers, bulletin boards and placement offices
- Costs may be lower
- You determine if the person is suited for the job.
- Job expectations can be set individually.
- Caregiver can be trained to do tasks the way you want them done.
- May take more time to find the best person.
- There is no backup if the caregiver becomes sick or is unable to work.
Interviewing & Finding the Right Person
After identifying potential caregivers, the next steps are to conduct interviews and check references.
Use the same questions with each person so that you can make comparisons. During the interview ask about:
- Previous caregiving experience including length of employment at each job and reason for leaving. Avoid anyone who quit a number of jobs because employers were considered mean or unreasonable. This may indicate a problem with authority.
- Reasons for wanting the job.
- Openness to take direction. Avoid those who "know best."
- Available, reliable transportation.
- Other responsibilities that may interfere with work, such as classes, family obligations or a second job. This does not need to disqualify someone as long as your hours are flexible.
- Overall health status and the ability to perform heavy lifting or other required care.
Part of the hiring process includes calling previous employers. You can verify the traits noted above by talking to the person’s references. It is reasonable to check both employment and personal references.
Regardless of whether you hire a caregiver through an agency or on your own, the process of finding the right person will involve your impressions and best evaluation of a few key traits:
- Can the person perform the tasks that are needed?
- Does previous experience resemble duties they will need to perform?
- Will this person show up as expected and follow through with job duties?
- Do you, the person needing care, and the new caregiver seem compatible?
- Will this person be genuinely concerned about the well being of someone in their care?
- Is the person open to working with you and ensuring that needs are met?
Take your time in making a decision. Try to interview at least three people before making a final decision. Do not be afraid to follow your instincts. Warmth, compassion and respect are crucial for a long lasting working relationship.
Remember that you need to oversee the care that is being provided. Check in with the caregiver and your loved one on a routine and unexpected basis to ensure that everything is going well.
Setting up the Terms of Employment
Before beginning to interview, decide the following:
- Wages you expect to pay
- When/how often payments are made
- Work hours
- Time off schedule
- Job description - write out tasks and be as specific as possible
When thinking about wages, consider that this is not the place to cut corners. The pay you offer shows caregivers how much their time and talents are valued. To determine a fair wage in any area, call local agencies or senior service organizations. Ask about the “going rate” for similar services.
Always pay caregivers on schedule and for the full amount according to time worked. This includes time spent waiting if someone else is late to relieve them.
If financial resources are limited, some caregiver assistance from the Department of Rehabilitation Services or the Department on Aging may be available. A social worker or care manager can help with this.
Even when feeling overwhelmed, it is important to remember that there are options and you will find someone who is right for you.
The guidelines above are designed to help lessen your feeling of being overwhelmed with the task of finding a trustworthy and caring person for help at home. Finding the right caregiver may take time and you may have to repeat the process if the person first selected does not meet expectations. You have the knowledge and resources to make a sound decision.
This content is for informational purposes only and may not be comprehensive. Information contained does not imply an endorsement from Shirley Ryan AbilityLab, and does not replace the advice of a qualified healthcare professional. See here for further details. © Shirley Ryan AbilityLab (formerly Rehabilitation Institute of Chicago). Henry B. Betts LIFE Center – (312) 238-5433 – https://www.sralab.org/lifecenter.
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