The Art of Finding the Right Caregiver
The Art of Finding the Right Caregiver
Family caregivers provide about $500 billion in unpaid services, and they spend, on average, 253 hours a month providing care. That’s roughly a sixty-hour-a-week job!
It is not selfish to take time away from caregiving to defend your wellness. It is imperative that you take the time to exercise, socialize, and buy and prepare food that is nourishing and energizing. If you’re not sure how much of a toll caregiving is taking on you, try completing this self -assessment (also available in Spanish) from the National Alliance for Caregiving.
You need respite time. So hopefully you’ve found friends, relatives, and volunteers to provide it for you. Maybe you’ve looked at Adult Day Care or residential facilities. If none of those options work for you, or simply don’t provide enough support, you’ll most likely look at hiring in-home help.
The process of finding the right agency, choosing between a registry and agency versus hiring freelancers, knowing how much to pay, and sourcing freelancers is another topic entirely. Whether you decide to go with a home care agency or hire an independent caregiver, the goal is to match the right people together. It’s kind of like making a romantic connection. When it works, it’s great. When it doesn’t, everyone winds up miserable.
Pre-Screening Questions to Ask When Hiring a Caregiver
Before interviewing anyone, you'll need to ask yourself a bunch of questions that will enable you to pre-screen caregivers before interviewing them. Your answers to these questions will help the agency, or you, narrow down the candidates to those most likely to be a match for the person in your care.
- What kind of personality would your loved one feel most comfortable around?
- Should the paid caregiver be female or male, or is either okay?
- Does a young person or older person feel more suited?
- What about energy level – someone perky or more serene and quiet?
- What is your budget?
- Do you have long-term care insurance or some other policy that will cover the payments?
- How many hours a week would you need covered?
- If your caregiver cannot keep their shift, will you have back-up coverage?
- Will the caregiver need to work overnight shifts or weekends?
- Is there any travel expected for the caregiver (e.g; come on vacation, visit family for special events, transition your loved one between family members rotating care, etc.)?
- Is it a full-time or part-time position?
- Will the person live with your loved one?
- Do you need someone who drives, has their own car, and is willing to drive? If so, is that person’s insurance active?
- Will your paid caregiver provide cooking and/or feeding, light housekeeping, and/or simple handyman tasks?
- In addition to companionship, what ADLs (activities of daily living) are needed: grooming, dressing, bathing, toileting, etc.?
- Are mobility tasks required (i.e. transitioning from bed to chair, bed to wheelchair or walker, in/out of a vehicle)?
- Will the caregiver handle errands with your loved one (i.e. escorting your loved one shopping, to doctors, other appointments) or handle errands before or after a shift (picking up prescriptions or packages, collecting grocery or restaurant orders that were called in)?
- Do you need someone licensed to provide medication management (i.e. giving pills, injections, applying creams, etc.)?
- Do you need someone to assist with exercises (i.e. rehabilitation, mobility, stretching, general fitness)?
- Are there specialties the caregiver you hire should have? For example, does the person have experience working with clients who are blind, autistic, wheelchair-bound, deaf, or have a pacemaker? What about those with specific conditions (i.e. Lupus, Multiple Sclerosis, Parkinson’s Disease, Alzheimer's, etc.)?
- Does the caregiver need to be fluent in a specific language? Are accents okay with your loved one?
- Would someone familiar with a potential source of trauma (i.e. combat; Holocaust, physical, sexual, or emotional abuse; rape) be preferred?
- Do dietary restrictions (i.e. vegan, kosher, halal, vegetarian, diabetes, gluten free, lectin free, paleo, keto) need to be followed?
- Are there religious restrictions or traditions (i.e. Buddhist, Christian, Jewish, Muslim) that need to be observed?
- Is there an animal in the home? Will the caregiver be responsible for care of the animal(s) as well? Are pet allergies a potential issue?
Conducting Caregiver Job Interviews
It is a good idea to have the first meeting with a potential caregiver on the phone or video chat to answer all the basic questions and to determine compatibility. Being as honest as possible up front will help you get pretty close to what you want/need from an agency/caregiver. There’s nothing worse than thinking you found someone only to realize they will refuse to do what is needed and you have to start all over. Here are a few tips:
Questions to ask about duties and expectations
- Be as specific as you can as to what is expected:
- Offer a typical daily schedule and how much is assumed will be provided by the paid caregiver.
- Give the prospective caregiver a list of duties (needed now and likely to be needed as the person’s condition worsens), and ask if they have any objections to doing anything on the list.
- Do they have any questions about the tasks listed?
- Be honest about any possible issues the caregiver might find from the person for whom they will be providing care. (Examples: tempers flare, very cumbersome to move, completely bed-bound, sarcastic, prone to telling inappropriate jokes, quite bossy/demanding, etc.)
- Let them know the house "rules" on cleanliness, clutter, expectations of breaks/dining times, noise levels, entertainment/media usage, etc.
- What are their expectations of you, the client, and the position?
- Are there any schedule restrictions on when they will be unavailable? (I.e. After school childcare, school vacations, seasonal unavailability; availability dependent on their own childcare or spouses travel schedule, etc.)
- What is their preferred method of communication? Do they like things in writing or to be told/called, to be texted or emailed?
- In what format and how often will they communicate with you on what items are needed, services recommended, health issues they observe, etc.?
Questions to ask about personal care/wellness
In what ways does a caregiver take care of themselves to reduce the stress of caregiving for someone who is not family?
Personal grooming and habits can sometimes be an obstacle. Some people: wear perfume; do not use deodorant; do not shave leg hair; use soaps, lotions, or creams with a smell; etc. Some people live in a home with smokers. If these situations, or others like it, are issues for the people the professional caregivers will be around, you’ll want to ask questions about self-care practices. You might also be concerned about someone bringing anything unhealthy into your home/the caregiving environment. If this is the case, you’ll want to ask:
- Are you able to work for me/us exclusively?
- If not, how many other families/people are you working for?
- Do you work with multiple agencies/registries?
- Do you have a back-up person to fill-in for you if you can’t make it for a shift?
- What kind of exposure to illness do you have in your home (partner/spouse/roommate/child working in a hospital or as an EMT/first responder, for example)?
Questions to ask about qualifications and training
General questions on how long someone has been doing the job and what kind of certifications or licenses they have are good to ask when you’re interviewing an in-home caregiver. If you’re going through an agency, they will handle checks for police records, sex offenses, legal issues, and more. If you're not going through an agency, you should make sure to get this information. Start by ask the prospective caregiver: Before I do a background check, is there anything you’d like to share with me?
Questions to ask about safety
If your loved one is prone to UTI’s, diabetic or epileptic seizures, tends to fall or pass out, or has heart problems, you might want to ask a few questions around typical symptoms to see if this paid caregiver would know how to assess and move forward.
Questions to ask to get to know the potential caregiver
Long-form, open-ended prompts will help you get to know the caregiver as a person. Consider questions like:
- What made you decide to become a paid caregiver?
- What is your favorite part about caring for people?
- Can you share your most fulfilling caregiving experience?
- What was your worst caregiving day, and how did you handle it? What might you have done differently?
- If someone invites you to dinner, and you realize you don’t like the food they’re serving, what would you do/say? The answer to this will give you some idea of how flexible and compassionate this person is likely to be when facing something they don’t personally like but is what you require.
- How do you handle clients/patients that are unwilling to do what you ask of them? (Bathing/showering, brushing teeth, taking a walk, eating, and drinking water are common resistances.)
- Do you have an emotional support system? Who do you turn to when you’ve had a really rough day?
- Who do you turn to when you have a care situation and need advice?
After an In-Home Caregiver has Been Hired
The first few visits/first week for the paid caregiver should be considered a trial. Either party can discontinue if it doesn’t feel right. The first time is hardly ever smooth sailing. During this trial period, someone should be there to show the hired person where everything is, how to use household gadgets, get the schedule down, and provide clues and tips to help the new hire get to know the client. Caregiver binders with all information related to your loved one’s care are appreciated.
To keep the caregiver you like, if something happens, let the agency know. If you’re not happy, let the agency know while it’s still fixable. Have the agency manage conversations about service delivery with the caregiver. If you’re not happy with the person, ask the agency for a replacement. It may take you a few tries until you find the magic connection but with the right criteria set to help with screening, your chances of “a match made in heaven” will be greatly improved.
This content was adapted from the chapter, “Caregivers in the Home," from I’ll Be Right There: A Guidebook for Adults Caring for their Aging Parents by Fern Pessin.
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