As loved ones age and their care needs increase, families often turn to professional in-home caregivers for help. Hiring in-home caregiver help has benefits for both you and your elderly loved one. Help at home can relieve you of certain tasks, giving you more time to yourself and reassurance that your loved one is in capable hands.

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Whether through a home care agency or a private hire, an in-home caregiver can provide professional, hands-on care. They can help with activities of daily living (ADLs), such as dressing or bathing, and much more. A home care professional also offers valuable companionship, extended independence, and peace of mind for you and your family.

Read: Hiring a Live In Caregiver: Pros and Cons

Hiring an in-home caregiver may seem simple on the surface, but there’s plenty to consider. You want to hire the best caregiver you can, so make sure you weigh your options carefully before making your decision.

What type of home care help do I need?

Ultimately, the type of home care help you’ll hire will depend on the level of daily assistance your loved one needs. Make sure to also consider your own needs as a caregiver when hiring home care help.

In combination with a professional medical evaluation, an ADL needs assessment can help you evaluate your loved one’s functional status to determine what type of care plan will best suit their needs. Additionally, a physical or occupational therapist can evaluate your loved one’s home environment and mobility. They can also recommend adjustments and mobility aids. A home care agency may have resources available to help you with this.

Once you’ve developed an understanding of your loved one’s specific needs, the next step is to identify the type of care you should hire. Know the distinction between home health care and nonmedical home care to guide your search for a home care professional.

Nonmedical home care

Nonmedical home care, such as personal care or companion care, is supportive care that doesn’t involve medical skill. Usually provided by a senior care aide, nonmedical home care is a great option for seniors who would benefit from a little extra help and some friendly socialization. Typical services provided by nonmedical home caregivers can include: 

  • Companionship
  • Assistance with activities of daily living (ADLs), such as grooming, dressing, and toileting
  • Medication reminders
  • Light housework
  • Meal planning and preparation
  • Running errands
  • Safe transportation

Home health care

Also described as clinical or skilled care, home health care is in-home medical services provided by health care professionals, such as a registered nurse (RN), a licensed practical nurse (LPN), or a certified nursing assistant (CNA). It’s often short term and typically requires a prescription from a doctor to obtain. While the caregiver may also provide some nonmedical care like light housework, home health care implies medical services like: 

  • Medication administration
  • Monitoring vitals
  • Wound care
  • Various therapies
  • Expertise in specific medical conditions
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Should I hire a home care professional through an agency or an independent caregiver?

Whether you hire an in-home caregiver independently or through an agency will depend primarily on your needs, your loved one’s needs, your schedule, and your budget. Hiring through an agency is the formal approach, while hiring a caregiver privately is considered more informal. Before hiring, it’s important to know what your options are.

Hiring through an agency

In-home care can be a great option for any senior who needs extra care but wants to remain in their own home or for any family caregiver in need of respite. If you find you need help, feel free to contact one of AgingCare’s Care Advisors. They can guide you through the process of hiring in-home care, provide personalized senior care advice, and offer a simplified breakdown of home care services and fees, all at no cost to you.

When choosing a home care agency, it can be difficult to know who to contact first. Many people simply ask their loved one’s doctor for recommendations, or they get suggestions from friends or family who have used a home care agency’s services before. You can also check your local senior center and trusted online sources for listings, recommendations, and agency reviews. Most cities and suburban areas have many home care agencies, but, unfortunately, it may be difficult to find an agency in rural areas.

Pros of hiring through agencies: 

  • Hiring, screening, pay, and taxes are typically handled through the agency, though not always.
  • Agencies employ a large pool of caregivers with a variety of skills, so you can get matched with someone who can provide the care and help you need.
  • They can accommodate your schedule, even if it’s inconsistent or unpredictable.
  • If your caregiver is unavailable on any given day, the agency will usually provide an alternate for you.
  • The agency can help settle any disputes between you and the caregiver.

Cons of hiring through agencies: 

  • If work hours are inconsistent day to day, the agency may need to assign more than one caregiver, which means you and your loved one might have multiple new people to adjust to.
  • The agency may limit or charge more for certain tasks.
  • Hiring through an agency is often more expensive than hiring independently.

Hiring independently

If you’d rather not go through a formal agency, you can opt to find help on your own, whether that be through a friend’s recommendation, word of mouth, or postings on a bulletin board at your local senior center. However, while it’s certainly possible to find a great caregiver on your own, know that it comes with much more responsibility. You’ll be responsible for all aspects of being an employer. You’ll also need to review and comply with the bill of rights for domestic workers, as well as the Fair Labor Standards Act (FLSA).

Pros of hiring independently: 

  • Independent caregivers may be able to provide a broader range of support services.
  • Families can be more selective about the caregivers they hire.
  • Hiring independently can be less expensive than hiring through an agency.

Cons of hiring independently: 

  • You’re solely responsible for managing the hiring process, screening and background checks, payroll and withholdings, applicable tax implications, liability, and insurance. If your caregiver is sick one day, you’re also responsible for finding alternate help.
  • You’re responsible for resolving any disputes between you and the person you hire.

How do I hire a nurse for home care? 

Your hiring process may differ depending on if you hire a nurse or caregiver independently or go through an agency. If you go through an agency, most of the work will likely be done for you, including verifying the candidate’s credentials. You’ll just need to determine if the specific agency is a good fit for you. You can do this by requesting they send you a packet of information describing their services, fees, and a list of references. From there, you may choose to set up an interview with an agency representative.

If you’ve found a private caregiver independently, you’ll likely be responsible for checking the caregiver’s credentials on your own. Make sure you run a background check, verify their skills and certifications, contact their references, and conduct an interview so you can get a sense of their character and personality.

If you’ve chosen to hire a private nurse or an in-home caregiver independently rather than through an agency, the following steps may help you through the hiring process.

Conduct an interview

An interview with a potential in-home caregiver is an essential part of getting to know them. Ask the right caregiver interview questions to help you gather basic information about their services and develop a better understanding of their caregiving style.

Ideally, your interview should be held either over the phone or in person. If you’re comfortable enough, you may invite the candidate to your home for a casual visit or invite them out for coffee and a chat. In an in-person interview, it might even be helpful to bring along the loved one they’d be caring for. This can give you an idea of how the two of them interact and if they’d get along long-term.

Know what qualities and credentials to look for

Whether you hire independently or through an agency, ask your candidate to provide proof of their credentials. Training, licensing, and certification requirements vary by state. There’s currently no universal standard for caregiver training; however, most states require basic training for a state certification. Basic certifications typically cover: 

  • Safety standards
  • Proper hygiene care
  • Mobility and transfer training
  • Emergency situation training

Your preferred personality characteristics will, of course, depend on your own preferences. But, the best qualities of any good caregiver include things like: 

  • Patience
  • Dependability
  • Confidence
  • Attentiveness
  • Compassion
  • Creativity
  • Flexibility

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If you’re hiring a home health care specialist, make sure your candidate has the proper credentials since they’ll be providing critical medical services. Depending on what state you live in, their credentials may include: 

  • Training in first aid and emergency care, including CPR, basic life support (BLS), and automated external defibrillator (AED) use
  • Licensure as a registered nurse (RN), licensed practical nurse (LPN), or home health aide (HHA), or certified nursing assistant (CNA) certification
  • Certifications in specific disease care, such as a dementia care certification, diabetes care certification, or Parkinson’s assessment and treatment certification

Check their references

While most of the information you need during the hiring process can be found through the candidate’s resume and an in-person interview, contacting their references can give you a better idea of what it may be like to manage or work with this person. Simply ask your candidate(s) to provide at least two to three references and their contact information. When you contact these references, you can ask questions like: 

  • What are the candidate’s greatest strengths?
  • What was it like to work with this candidate?
  • What were this candidate’s biggest accomplishments while you worked together?
  • How did this candidate handle challenges?

Run a background check

A background check consists of several factors, including social security verification, criminal record, drug testing, credit check, employment history, and driving record — all the information you’ll want to know when determining whether a candidate is dependable enough to look after your loved one. To run a background check, follow these steps: 

  1. Keep things organized and create a file for each person you interview.
  2. Review your state’s specific laws about background check regulations. You can usually find this information on your state’s department of public safety website.
  3. To comply with the Fair Credit Reporting Act (FCRA), you’ll need to email your candidate an outline of everything you’ll be checking in their background along with an attached consent form for them to sign.
  4. Use a background check website, such as GoodHire, TruthFinder, or Intelius, to review their records. This can help you find any evidence of criminal or other civil records. Depending on the website you use, this may require a fee.
  5. If you feel it’s necessary, you can ask your candidate to take a drug test, which you can conduct with an at-home test kit or through a visit to the doctor’s office.

Create a contract

A caregiver contract is a written agreement that’s notarized and signed by all parties. It helps ensure that everyone is on the same page about responsibilities and expectations. Once you’ve chosen a caregiver, have them sign the personal care agreement outlining their specific benefits, payment and compensation, work hours, time off, and responsibilities.

You may even want to find an elder care law attorney to draft a contract that fits your specific needs. Having a professional’s help is important since a contract that’s poorly or incorrectly worded may have serious consequences that can be incredibly costly.

How can I cover the cost of in-home care?

Fortunately, there are many resources available to help you cover the cost of in-home care. Most people use personal funds to pay for home care. Benefits vary from state to state, but you may be eligible for coverage from Medicaid, Medicare, or Medicare Supplement Insurance (Medigap). Medicaid is an assistance program for patients with low income and limited assets. Medicare is an insurance program for disabled people and people 65+ that can cover the cost of medical care. Generally, neither Medicaid nor Medicare covers nonmedical expenses unless these services are part of a patient’s prescribed care plan. You can also look into private health insurance plans, long-term care insurance, life insurance, and any applicable veterans’ benefits for help paying home care expenses.

The information contained in this article is for informational purposes only and is not intended to constitute medical, legal, or financial advice or to create a professional relationship between AgingCare and the reader. Always seek the advice of your health care provider, attorney, or financial advisor with respect to any particular matter, and do not act or refrain from acting on the basis of anything you have read on this site. Links to third-party websites are only for the convenience of the reader; AgingCare does not endorse the contents of the third-party sites.