8 Steps to Hiring a Caregiver for a Loved One

Based on expert advice and personal experience, Seniors Guide writer Terri L. Jones suggests eight important steps in hiring a caregiver for a loved one. Knowing in-home care options can ensure peace of mind for everyone involved.

My dad has vascular dementia. He suffered a stroke five years ago. Having fallen several times recently (once fracturing numerous ribs), he now walks with a rollator walker and needs help dressing and showering as well as with almost everything else he does.

My stepmother, Linda, is adamant about the two of them remaining in their home, and they’ve spent a significant amount of money to make that possible. She shoulders the responsibility of caring for my father all on her own, except for the random times she wants to go out with friends, and then I pinch hit for her.

My stepmother’s plan was working fine until she injured her knee recently, and the doctor recommended a knee replacement, which has a six-week recovery time. Suddenly, the delicate balance of their arrangement started to fall apart, and my stepmother was forced to start researching caregivers to help.

Tips for hiring a caregiver

From expert advice and personal experience, my family and I have discovered eight steps in making this important in-home care decision:

1. Determine the type of assistance

First, determine the specific help your loved one needs. Do they just need someone to ensure they’re safe or do they need help with basic grooming needs or with toileting, taking medications, or other medical needs? A geriatric care assessment can help you define exactly what your family member needs before you start talking to caregivers. This is a multidisciplinary assessment tests mental, physical, emotional, and psychological health. It also assesses functionality, living conditions, socio-economic environment, social circles, family involvement, and many other factors. Talk to your primary care doctor about obtaining this assessment.

2. Understand the difference in caregivers

Once you know the specific assistance your loved one needs, then you can determine what type of caregiver to look for, based on the level of need.

First, companions help with simple tasks such as cooking, transportation, etc.

Non-medical home care provides support with various activities of daily living (ADLs) like dressing, grooming, meals, transferring and mobility, which is what my father needs.

Home health care provides licensed medical care, which includes assistance with medications and medical equipment, taking vital signs, physical therapy, and skilled nursing care. Care management and coordination services use experience and expertise to help families make the best decisions for their loved one’s care.

Levels of at-home caregivers

3. Ask around

My stepmother had already connected with a home care agency after my dad fractured his ribs, but their hourly rates were on the high side. For the basic help that my dad needed, she reached out to friends for recommendations on private caregivers whom they had used. Typically, private caregivers’ rates will be lower than those you hire through an agency. She received a few referrals that she decided to follow up with.

4. Create a job description

This is a job like any other and should have a job description so that your candidates know what to expect. This description should focus on the personal needs (and idiosyncrasies) of your loved one, an estimation of when you’ll need assistance, and any other expectations you have of the caregiver. It should be as detailed as possible, so everyone is on the same page and there are no misunderstandings.

5. Conduct caregiver interviews

The face-to-face interview , in the setting where the caregiver will be working, is perhaps the most important step in selecting someone to help your loved one. It’s your opportunity to ask tough questions, such as the person’s ability to handle situations that might occur with your loved one, to get a feel for their personality and overall temperament (are they calm or high-strung, a good listener or a talker?) as well as to go over your loved one’s needs. Care.com offers suggested questions you can ask.

Make sure any family members who are involved in your loved one’s care are all present. Most importantly, ensure the family member who needs care is there and participates in the conversation (if they’re able).

My father connected immediately with the very first person that they interviewed because she listened patiently to his stories and had a calming presence. However, even if your loved one has this instant connection, it’s wise to talk to more than one person and maybe even have a few options available in case there’s a scheduling conflict.

6. Check references

Even if a friend recommended a particular caregiver, you should still check other references, as people’s values and insights vary. For example, one person’s idea of professionalism and efficiency might come off as coldness and lack of compassion to another. Or someone else could’ve seen a side to this person that your friend didn’t. Also, do an online search for the caregiver’s name, which may uncover information that is pertinent to you.

7. Conduct background checks

If you’re trusting the safety of your loved one (and everything in their home!) to a stranger, it’s important to conduct a background check on the person. A reputable agency should have performed such a check, but if you’re hiring a private caregiver, you will need to run this check on your own.

With a variety of online resources to help you conduct this important verification, here are types of information you should be looking for:

• Criminal convictions
• Pending criminal cases
• Listing on the abuse and neglect registry
• Sex offender registry information
• Domestic Terrorist Watch List information
• Education verification
• Employment verification

While non-medical home caregivers do not need professional certifications, all home health aides need to be trained, certified, and licensed to work in this role. Requirements vary by state.

The Seniors Guide Care Assessment: Find What Fits Your Needs

8. Make a decision

Hopefully, you’ll be able to make the best decision the first time around. But remember, the choice isn’t final. If your loved one isn’t comfortable with their new caregiver (after an adjustment period), if that person isn’t taking care of their needs, or if things aren’t working out for whatever reason, you can always find someone new.

My stepmother started her caregiver search early, well before she was scheduled for surgery, and she took her time with the process. When she finally came to a decision, taking my dad’s opinion into consideration, Linda hired a home care worker to come in for trial visits a couple times a week, primarily leaving the two of them alone but checking in now and again. It took a while for my dad to accept having someone new in the house on a regular basis (that’s the dementia). However, thus far, things are going well. My stepmom finally feels ready to move forward with her surgery.

If you are the primary caregiver for your family member, you can’t do it all. And even if you can now, you may not be able to forever. Finding someone who can cover for you ensures that your loved one is well-cared for at all times. It also gives you a chance to recharge to continue doing the hard work. After all, providing the best care for your loved one is what it’s all about!

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