Friday, September 17, 2021

In-Home Caregivers: How to Find and Hire The the Right Caregiver

As we age, the time may come when many of us may need a caregiver, whether it is a temporary arrangement after surgery, or a permanent way to avoid moving into an assisted living facility.  You may need the caregiver for yourself, or for someone in your family.  When the need arises, do you know how to find one and what services they can be expected to handle?  How can you be confident that you can trust the person you hire?  What do you need to do to avoid financial and legal problems?

These are all important questions for patients and their families to ask themselves before hiring a caregiver.  The more you educate yourself and the better you prepare to benefit from the service they provide, the smoother things will go for both the patient and caregiver.

What Services are Performed by Caregivers?

Caregivers can be expected to help a patient with their normal activities of daily living. This can include:

Dressing and bathing
Personal hygiene
Ambulation or transferring between a bed and wheelchair
Help with medications
Shopping and food preparation
Light housekeeping and laundry
Transportation to medical appointments or for personal care

In addition, having a caregiver will reduce your loneliness, because they will have conversations with you and may even play card games or engage in similar activities, all of which can help you postpone dementia.

Best Way to Find a Caregiver

In order to avoid the risks involved in using an unlicensed caregiver, it is best to use an in-home care agency which is licensed in your state.  These companies have to meet their state's requirements regarding training and background checks.  

If possible, it is important for a family member to supervise the hired caregiver, especially at first.  According to, the average state-mandated training hours for certified caregivers is approximately 75 hours of study.  Some states require even less time; others require more.  Essentially, this means caregivers must participate in only about two weeks of training.  

Before leaving your loved one with a hired caregiver, or hiring one for yourself, you will want to make sure the person fully understands their duties, including how to properly dispense medication, prepare meals the patient will enjoy, manage the transition in and out of chairs and beds, assist in dressing the patient, know how to use common home appliances, and is capable of helping the patient use the toilet, etc.  Do not leave a patient alone with a caregiver until you are completely satisfied that the person is able to handle all their routine duties, as well as any emergencies which could arise.  

In addition, make sure you write down a detailed fact sheet for the caregiver.  It should include instructions on how they can best help the patient, including allergies the patient may have, medications they take, contact numbers for doctors, neighbors and family members, and any other information you think would help the caregiver.   Even if you are the patient, make sure you put all this important information in writing. This will help the caregiver know what to do in the event you are injured or have a medical emergency and are unable to communicate your needs. 

In hiring a caregiver, you will also want to use an agency which has been approved by the American Board of Home Care.  Their goal is to "uphold the trust you have placed in them to review, check, and ensure the best quality of home care providers looking over your family, friends, and patients."

You can contact the American Board of Home Care at:

(877) 436-5259

Finally, it wouldn't hurt to do a Google search of your own on the caregiver, to see if this person has been mentioned negatively online or has been accused of any crimes. If you suspect they may have had a past problem, bring up the issue with the agency for an explanation.  You would not want to put yourself or a family member in the care of anyone who could be dangerous, or take financial advantage of a fragile person.

What If a Family Member Offers to be the Caregiver?

In some cases, a member of your family may be the best caregiver.  In this case, it would be smart for both the patient and the family member to sign a Long-term Care Personal Support Services Agreement.  In this way, everyone knows exactly what care will be provided, how often, and during what period of time.  In addition, it also will clarify what financial compensation they may receive, and whether this compensation will come from the person receiving the care, other family members, or the state.

A family member may be uncertain exactly what services they need to provide and how to keep track of everything.  You might find it helpful to get a copy of the "Caregiver's Workbook:  Checklists and Worksheets for Family Caregivers."  (Ad) It could help reduce your stress and keep you organized. 

In many cases, state governments will pay caregivers through Medicaid to assist low-income patients who qualify for in-home care. Having a written agreement will show the state where the money is going and what services are being provided.  The checklists and worksheets mentioned in the book above can also help you prove to Medicaid that you are performing the necessary tasks, and the hours you are working.  

Having a written agreement and agreed compensation will also reduce misunderstandings among heirs over the reduced amount of money which they might inherit, as a result of the financial compensation paid to the caregiver.

What Should be Included in the Agreement for a Family Caregiver?

If a friend or family member is going to be paid to provide the care, everyone should see this as fair and reasonable. In order to do that, the caregiver agreement should include the information listed below.  You may want to consider having an attorney draw up the agreement.

* It should be a written agreement.
* It should cover only services which will be provided after the agreement is written; not services provided in the past.
* It should provide for reasonable compensation which would not be greater than would be charged by a licensed caregiver service in your area.
* It should stipulate the types of care which will be performed and the hours the caregiver will work.
* It should specify who will pay the caregiver and how frequently. 
* It should be flexible and include the statement that the services provided may change as mutually agreed upon by the parties.
* There should be a clause allowing either party to terminate the agreement in writing.
* There should be a "backup" person listed in the event the primary caregiver is temporarily not able to provide their services (for example, if they become ill themselves).
* It should cover any additional factors such as room and board, if the caregiver lives with the patient, income tax withholding, medical insurance for the caregiver, vacation pay, etc.
* It should require a detailed log of duties performed, to justify their salary

Advantages of a Family Caregiver

Although having a family member perform the caregiver duties can cause jealousy and problems with other family members, it can also provide an extra level of care which might not be appropriate if the family hires a professional caregiver.  Some of these extra duties include:

Dealing with household and medical bills
Handling other finances
Going to medical appointments and assisting in making medical decisions

Whether you decide to go with a professional caregiver or have a family member provide that service, it will make life much easier on everyone to know that appropriate care is being provided either temporarily or permanently for yourself or a frail or ill member of your family. 

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1 comment:

  1. This is a great checklist that can help both patients and the caregiver. Nice job!


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