Family Caregiver Blog

I could staff a large employment agency with the number of people I have hired to help over the years with my father, mother
and mother-in-law. They have ranged from outstanding to good enough, with a few being bigger pills than the ones they
dispensed.

Hiring help for your aging parents or spouse comes down to chemistry and competence. Of course, the most efficient person
can be too talkative, bossy or mean. The delightfully affable might be inept.

Sometimes, it’s hard to predict if it’s the right fit, but your chances are exponentially better if you ask the right questions.
Of course, you can’t do that until you know what your aging parent or in-law needs.

Assess the Situation

How do you find out what Mom or Dad needs? If it’s possible, ask them! (Don’t be surprised if they tell you they don’t need
anyone.) Is it companionship, help bathing or dressing, someone to cook, give them medication or take them around town?
What have your siblings, physician or neighbors observed? What kind of help do they think makes the most sense?

It doesn’t matter if you go through an employment agency, an online company or hire on your own. All three can be good options.

Here’s help for the help:

1. Be specific. What are your expectations (i.e. that the aide works cooperatively, communicating with family members via email
   or phone calls regularly, doesn't take non-urgent personal calls, understands the terms vis-a-vis vacations and holidays,
   is patient and understanding)?

2. Think about writing a detailed job description. It can be helpful in figuring out what you want even if you don’t end
   up sharing it.
3. Prepare questions for the prospective employee or agency. For instance, take work experience. Has the person done personal
   care or worked with someone with Alzheimer’s or mobility issues or who is non-English speaking? Are they comfortable
   with your parent’s specific needs? Why did they leave their previous job? What about it didn’t they like? What are
   they hoping for in this job? How do they like to get feedback?
4. Tell them to bring their resume with their work history and contact information as well as references—and check them
   out. If you’re hiring on your own, request their proof of identity such as a Social Security card, driver’s license
   or photo ID. Let them know you are going to do a background check.
5. Find out what hours, days or holidays can or can’t they work. Do they have their own obligations and constraints (an
   upcoming vacation, a class, young children)? Will their outside commitments impact yours, and if so, how?
6. Ask them what they find appealing about this job and the eldercare field. Get a sense of who they are.
7. Trust your gut. If your gut is asleep at the wheel, then rectify the situation—whether that means changing aides or tweaking
   the arrangement.
8. Consider a trial run of a week or two to see. Give it a little time but not too much. Would clearer instructions or more
   training and guidance turn around the situation?
9. Know your resources. Start with the Family Caregiver Council, a coalition of national caregiving organizations and experts,
   to get a better sense of the different kinds of help, where to find it and strategies for that difficult you-need-help
   conversation.

The Agency or Online Route

When you use an agency or online employment website, you’re really doing two interviews: one with the company and the other
with the would-be worker.

Yes, an agency or company is supposed to do the vetting, reference and background checks, but find out what that means. Do
they check the prospective worker’s driver’s license and record if they’re going to be chauffeuring your mother-in-law?
What kind of car do they have? If they’re using your Dad’s car, do they need to be added to his insurance policy? What’s
their policy on drug testing? Do they have liability insurance?

Consider asking these questions:

1. What is the agency’s training and follow-up process? Do they make home visits to make sure all is well? How do their
   caregivers communicate (technology, written reports, phone calls) so the agency has a constant update? Is there a
   written custom care plan and a free needs assessment? Does a nurse do that evaluation?
2. Do they have a minimum number of hours (often four) for which you must pay? What’s in their service agreement?
3. Are the aides or workers independent contractors or employees? Is the agency or online company bonded? Find out if they pay
   workers compensation and provide unemployment insurance. While you’re at it, ask if they handle all payroll paperwork
   and are Medicare certified.

4. Assuming Mom has long term care insurance, does this company accept payment from her company?
5. How do they handle issues that arise between the helper and the person or family?
6. Do you get a choice of candidates? Remember, the agency is working for you. If that’s what you want, request options.

When possible (if there’s not a cognitive issue, for instance), include your parent in discussions and decisions. After all,
it’s about them. Giving up some autonomy isn’t easy. Asking the right questions isn’t, either!