3 Key Steps to Take Before Hiring an In-Home Caregiver

Many a well-intentioned family member has taken on the responsibility of caring for an aging parent only to realize that they’ve committed to more than they can handle on their own.

And many more people will need to step into a caregiver role in the coming years.

The U.S. Census Bureau projects that the population of people 65 and older will grow by approximately 50% over the next 30 years!

That’s a lot of people who may need some extra help.

If you are already a caregiver (or anticipate becoming one in the not-too-distant future) you should know that you don’t need to do it all on your own. Hiring a professional caregiver to help with overall coverage and/or specific skills can make a world of difference both in the quality of the care your parent receives and the quality of your life.

But how do you choose a caregiver? Where should you look for one? What kinds of questions do you need to ask?

Working with a professional home health agency

Everyone has heard heartbreaking news stories about in-home caregivers who were dishonest, unqualified, negligent, or even abusive.

No one wants that for their loved one. But that is certainly not always the case. There are truly many, many hired caregivers who handle their roles with excellence.

To help you navigate the process of finding the right home care professional for your family, we’ve put together a few tips and a list of the most important questions to ask when working with a professional home health agency.

Step 1: Assess Your Needs

The first step in the process of selecting a home care professional is to get a firm grasp of exactly what you need. There are all different kinds of home care professionals, from unlicensed personal care aides to registered nurses.

Do you need someone to provide some company, do some light housework, and provide transportation for errands and doctors appointments?
Or, do you need someone who can manage medications, change dressings, monitor equipment, and assist doctors with medical procedures?
Does your loved one need specialized care such as physical therapy, speech therapy, or maybe specific support for recovery from heart failure or some other disease or procedure?

Your loved one’s primary care physician should be able to help you define specific needs and priorities. In addition, many home care agencies offer an initial assessment visit to provide additional guidance.

Step 2: Assess the Agency

Once you know what you need, it’s time to find the agency that can deliver on those needs.

There are 3 main areas to consider when evaluating whether an agency is a good fit: reputation and certification, people and services, and protocols and processes.

Reputation & Certification

Apart from a glowing recommendation from a friend, family member, or doctor, other indicators that an agency has a solid reputation include a long history in the community, positive write-ups in community-based networks like Nextdoor, and the approval of other local elder care organizations such as a council on aging.

A few specific questions to ask:

How long has the agency been in business?
How long has the agency been serving the community?
Does the agency have Medicare/Medicaid certification?
What other certifications and accreditations does the agency have?
Does the agency meet local and state certification requirements?
Do they undergo regular inspections by an outside organization?
What is their rating from the Centers for Medicare and Medicaid Services (CMS)?
How do patients and families of patients rate their services?
How does the agency recruit, select, and train its caregivers?
Is the agency willing to provide references from partners and clients?
Is the agency able to provide literature that details out their services, eligibility requirements, fees, and other concerns such as their “Patient Bill of Rights”?

People & Services

Once you are satisfied that an agency meets your criteria, it’s time to take a closer look at the home care professionals it employs and the specific services it provides. After all, while the agency may be up to par, it’s the people behind the agency that make the real day-to-day difference for you and your loved one.

A few specific questions to ask:

Does the agency do thorough background checks? (Don’t be afraid to ask for details on methodology and frequency for screening.)
What kind of training and certification do caregivers receive? Do they have basic CPR and First Aid training?
What about specialized training for specific types of care, language skills, or cultural skills (such as working with LGBTQ community members or dementia patients)?
How often do employees engage in ongoing training and education?
What levels of service does the agency provide?
Do they offer skilled nursing providers as well as home health aides?
What are the various staff credentials?
What kinds of specialty services does the agency provide?
What kinds of services does the agency not provide?
Does the agency provide 24/7 service? Are substitute care professionals available to fill in if your primary caregiver is unavailable?
Are you able to meet a potential caregiver in advance of engaging them to ensure a compatible match for both you and your loved one?

Protocols & Processes

Finally, you want to get a little “in the weeds,” as the saying goes, and ask direct questions about exactly how the agency runs its business and manages its caregivers.

A few specific questions to ask:

How is a care plan developed? Will the process include input from the patient, the patient’s family, and the patient’s primary care doctor?
Will the agency provide a written copy of the plan and update it as needed?
How are in-home caregivers supervised? Are there drop-in supervisor visits? How frequent are those visits?
How does the agency track and measure personnel performance and progress on specific elements of the care plan?
What is the protocol for an emergency? Who can you call?
What practices does the agency have in place to ensure patient privacy and confidentiality?
If you have a complaint about care, what is the process for raising the issue and getting it resolved?
Will the agency provide a line-by-line estimate for services ahead of time so you are able to plan for expenses?
What are the agency’s billing practices in general? How are disputes handled?

Step 3: Get the Support You Need

While working with an agency can increase costs and potentially require a commitment to a minimum number of hours per week, it also can provide many intrinsic benefits including handling the screening of workers, managing liability, and taking care of payroll and taxes. With an agency, you also have faster, easier access to backup care if your primary caregiver is unable to provide services for any reason.

Another consideration is that once you find the right professional caregiver, is there help to cover the costs of in-home care?

Many people assume that you have to be completely broke to qualify for Medicaid, but that’s not at all the case. In fact, if you are proactive about it, there are a number of ways to protect assets without jeopardizing eligibility. (Qualifying for and applying for Medicaid is a complicated process, but the effort is usually well worth it. Reach out to us if you’d like to learn how we can help take some of the burden off you.)

Choosing a professional in-home caregiver is not a task to be taken lightly, but it doesn’t have to be enormously difficult. If you are able to clearly define and articulate what you and your loved one need, you will have made a great start. From there, it’s just a matter of asking the right questions and narrowing down your choices until you find the perfect match.

Pay Caregivers What They’re Worth: It’s Long Overdue

Paying Home Care Workers – Are You Compliant?

How to Stay Out of a Nursing Home (And Get the Care You Need At Home)

Medicaid and Caregiver Compensation: Avoid This Costly Lesson

Being a Healthcare Advocate: How to Best Engage with Healthcare Professionals