Hiring an In-Home Caregiver for Your Loved One

Caregiver reading to Senior

All of a sudden, due to some change in the life of one or both of your parents, it is time to start hiring an in-home caregiver for your loved one.  The days and months went by with some episodes but you managed until it became apparent that there was an unsafe condition that was likely to cause harm to your Mother or Father or other loved one.  It could also be that you realized that your loved one needed some life enrichment and/or transportation and your job responsibilities would not allow you to do it personally.

The role of a senior in-home caregiver is an important and weighty position; one of respect and dignity. Tia Walker, the author of The Inspired Caregiver once wrote on caregivers: “To care for those who once cared for us is one of the highest honors.”

When Mom or Dad (or both) can’t be alone any longer, and you need to hire help as soon as possible, there are many things to consider, including factors that will be specific to your personal situation. Sage advice always includes thinking about these things in advance to have enough time to plan without having to rush into making a hasty decision that you will regret later. The success (or failure) of hiring a caregiver depends largely on how far in advance you start the process. If you wait until the inevitable is upon you, plan on many unanticipated and complicated problems–all at a time when any additional stress is most unwelcome.

In a future piece, we will provide a comprehensive guide on how to find and hire a caregiver. Yet there is a lot to be gained from just knowing what not to do. Knowing this will allow you to avoid many of the mistakes that were learned by others on their journey to successfully hiring a caregiver for their loved one.

Hiring an In-Home Caregiver:

5 Things Not to Do

Don’t hire someone who is overqualified

If the individual who needs assistance can do well with someone who comes in and spends time with him or her and does a little light cleaning and or shopping, it is not necessary to hire a CNA or a nurse. If, though, the nature of the patient condition warrants more intervention, such as wound management, vitals monitoring, and recording, and, especially, medical equipment use and maintenance, a CNA or nurse is probably a better choice. Though laws and qualifications vary from state to state, a CNA may be able to do everything from light cooking and cleaning to assisting with some forms of treatment. Ensuring a medication schedule is adhered to, as well as vitals monitoring, are typical services provided.

Whether hiring a companion, nurse or a CNA, you will set up a schedule so that all involved know what they are supposed to do and when they are supposed to do it, including how many times per week. This will help the individual being cared for feel more secure and will make caring for the individual much more organized and easier. As the memory declines or illness sets in, the routine is of great comfort to the person in need of care.

At the same time, it is essential not to under hire. It is challenging to deal with relatives and close friends in need. As a result, it is possible to hire a companion when you need a CNA or hire a CNA when you need a nurse or a nurse when you need hospice care. Discuss the situation with the family and the doctor and determine what level of care is needed. If adjustments are needed, arrangements can be changed at any time. There are agencies in every state that deal with the aging and infirm. These agencies often provide lists of services, including transportation for the elder, disabled or homebound, meals and activities, financial resources, suggestions on aging in place and on creating an effective caregiving plan.

Don’t hire without checking references

Make sure to check references, but don’t stop there. Anyone can give a great reference, and hardly anyone will give a bad reference in the interest of being politically correct and polite. Use social media such as Facebook, Twitter, and LinkedIn to research the potential caregiver. Get to “know” their personality and values by what they post. Call each reference given and find out why the caregiver is no longer with the previous family and if the family would hire the caregiver back. An even more thorough way to go is to have the applicant sign an authorization for a complete background check. The background check will provide criminal, credit, and job history. Ask questions and take to heart the answers.

Don’t assume the caregiver is licensed

A nurse or CNA is required by law to keep their certifications up-to-date and should be able to provide them upon request. Check that the license is current and there are no sanctions in the state that they are licensed in. If the caregiver you choose is licensed in a state that your loved one does not reside in, this could be a red flag. CNAs and nurses need to be licensed in the state they work in.

A companion differs and does not generally carry a license (even though there are a growing number of certifications for non-medical caregivers). In general, a companion comes in and spends time with the person, reading, watching movies, taking them to the store, and helping with other personal things, but gives little or no medical assistance. As a result, a companion is not required to be licensed. However, verifying other information such as the validity of driver’s license or corroboration of personal details can give you comfort that the person is trustworthy. This is a person you are allowing to be in your loved one’s home and who will have access to medicines, money, credit cards, and more, so again, the background check will come in handy. It is important to take precautions and to make sure you have verified that this individual is honest.

Don’t expect smooth sailing in the beginning

It is crucial that there be a backup plan. There needs to be an emergency care plan in place for the unexpected. The only constant we have to count on is that life changes. Caregivers have accidents, get sick, go on vacation, and sadly, sometimes just don’t show up to work. If a backup caregiver is already in place, an emergency will be slightly inconvenient but not completely disruptive. On occasion allow the backup caregiver to fill in for the regular caregiver. By getting the caregiver introduced slowly, it will be easier to insert the backup person into the home during an emergency.

Interviewing and using an agency for one or two days per week is a good backup solution when you first begin hiring an in-home caregiver. It can even be continued after the caregiver is settled in, to allow for days off for the primary caregiver or to give you peace of mind that in an emergency that someone else is familiar with the situation.

Don’t be afraid to take it slow

It is a process to find the right person. Especially if this is your first time, do not rush into a decision. Plan on interviewing several candidates and having at least two interviews with the top two applicants. Meet them at different times of day and consider having them come to work for 2 – 3 days and give you and your loved one a better feel for their demeanor. This is somewhat similar to dating someone new, so don’t expect to fall in love right away; general compatibility is a must for this type of partnership, though.

Do not lower your standards or be talked into something you are not comfortable with. If you need a live-in, do not settle for someone who can only stay three nights a week. If you do not want a smoker in your house, use your instincts (and olfactory senses) to decide if the caregiver really doesn’t smoke.   You may feel pressured to hire, but you will feel a lot more pressured if you get the wrong person and have to start over or find that the situation is uncomfortable or dangerous.

Hiring an in-home caregiver is an important decision. The seriousness of the task cannot be underestimated, but it is very rewarding when done properly. Steering clear of some of the mistakes that others have made is a great first step in a successful search.


The Inspired Caregiver: Finding Joy While Caring for Those You Love, Speers, Peggy and Walker, Tia, Copyright 2013.