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How to Choose a Caregiver for an Elderly Loved One

How do you choose a caregiver for an elderly loved one?

More than 41 million Americans have a chronic health condition that limits their daily activities in some way, according to the Institute for Health & Aging at the University of California, and 12 million are unable to live independently. Of the one out of five elders who have reached age 85, more than half are impaired and need long-term care — that is, the personal assistance that enables them to perform daily routines such as eating, bathing, and dressing.

Most people want to continue to live in their own homes for as long as possible. For those who are elderly and have disabilities, that may be possible only with outside help.

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

If you or someone you love needs care, how should you go about choosing an in-home caregiver? This article outlines the basic steps.

Assess Home Care Needs

The process with a needs assessment. Evaluate the help that is needed in the areas of health care, personal care, and household care. Do you need home health care, such as physical therapy or medication management? Do you need non-medical personal care, such as help with bathing, dressing, toileting, and meal preparation, or are you looking mainly for a companion or sitter? Do you need help with housecleaning, shopping, home maintenance, and 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've listed the tasks to be completed, the next step is to create a job description based on your list. This job description 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 help. People who have Alzheimer’s disease often need help with toileting and bathing, for example, so look for someone who has experience in working with elders with this illness.

Be sure to include the following in your job description:

  1. Health care training needed (for example, Certified Nursing Assistant, Licensed Practical Nurse, Registered Nurse)

  2. Driving requirements (car needed or only valid driver’s license)

  3. Ability to lift care recipient and/or operate special equipment

Develop a Job Contract

Based on the job description, the job contract 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 (because you must report wages paid to the caregiver to the Internal Revenue Service)

  4. Job description

  5. Unacceptable behavior (such as smoking, abusive language, tardiness, etc.)

  6. Termination (how much notice, reasons for termination without notice, etc.)

  7. Dated signatures of employee and employer.

Identify Caregiver Candidates

Once you know what the job will entail, the next step is to recruit candidates. 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 are OK, but first and foremost, hiring, managing, and firing a caregiver are all business decisions, and for that reason, many family members don’t make good paid help. Hire a professional caregiver if you can afford it. 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 a private caregiver, call a caregiver agency. The agency should be helpful, because you are a prospective customer.

Interview Applicants

After you have screened applicants on the telephone, you should interview in person those who meet the basic requirements for the job. Invite a friend or family member to sit in on the interview to provide a second opinion. Always observe interactions between the worker and the person who will be receiving care. If you are interviewing a caregiver 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, religious, social, or any number of reasons. 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 looking for someone who is dependable and reliable as well as someone who is qualified to do the work.

Conduct a Criminal Background Check

People who are paid by state funds must pass a criminal background check. But 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 driver’s license or insurance, etc.).

If you are hiring an agency or from an agency, make sure that the agency does criminal background checks. The law in many states requires a background check, but that doesn’t mean it has been done.

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 of your other requirements.

Monitor the Caregiver's Performance

Set up a schedule to monitor the quality of the services the caregiver provides. This is especially important for family members. Do this by making personal contact with the caregiver and regular home visits with the elder, 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 it yourself.

Have a backup plan in case the caregiver or the agency fails to follow through or problems arise.

Watch for signs of abuse, neglect, and exploitation and report suspicious activity to the agency and state authorities.

Questions? Takacs McGinnis Elder Care Law can help. Give us a call at 615.824.2571.


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