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Hiring In-Home Caregiving Help

Expert Donna Schempp's advice on getting caregiver help with your loved one at home

I am a single male, 68 years of age, living alone in a rural area. It's getting harder and harder for me to live on my own. I have never had a caregiver and don't know where to start. Please advise.

If you're having a hard time taking care of household chores, you could start by hiring someone to be a housekeeper for you. If you need help with personal care, I would call a home care agency in your area and have someone come to the house and talk about what he or she offers. If you don't know anyone, ask your physician what home care agency he or she might recommend. Oftentimes, a member of your faith community or senior center can help you find someone in your area who does this kind of work. Before meeting with someone, sit down and write a job description of what you need done. That way, whomever you hire will know what you want, and that will make it easier for you to ask for things to be done. There is a fact sheet at the Family Caregiver Alliance website called "Hiring In-Home Help" that can be a guide for you.

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"... good caregivers are passed around among friends who need the same sort of assistance." — Getty Images

What kind of work can I ask my wife's caregiver to do? If she just helps with my wife's personal needs, there is a lot of time she's not doing anything.

It is important to have a job description of what you expect from your caregiver. He or she can do many things, as long as the agreement is clear on what you want or need done. A caregiver can do light housekeeping (usually keeping the area around the bed and the bathroom clean), cook and wash dishes, and maybe do the laundry. Some caregivers help with shopping and take the people they are caring for on outings or walks, to the senior center for activity, or to a doctor's appointment. Making sure your needs are met, as well as those of your wife, is the important thing. If you have hired through an agency, ask about what kinds of help the staff offers. They likely have very clear guidelines. If you have hired a private caregiver, it's up to you to decide what is appropriate. Sometimes there is a negotiation that occurs in order to meet your needs and work within the constraints of the person you have hired.

We want to get a home companion/aide for my aunt. Can you advise us on where we might place an ad to get the best results?

First, have a clear sense of what you want the person to do, what days and hours you need her, and what salary you are offering. People sometimes use Craigslist or other such websites to post ads; some people have been successful this way, and some have found inappropriate caregivers this way. You can also post a job offering at a senior center, put a notice in the newsletter of your faith community, and network with friends. Oftentimes, good caregivers are "passed around" among friends who need the same sort of assistance, or your primary care physician might know of someone or recommend an agency that he or she trusts. Some nursing home staff are willing to work part time on their days off — so if you know people who are connected with a nursing home, you might ask them. If you hire a private caregiver and do not go through an agency, you need to know about background checks, Social Security and Medicare taxes, workers' compensation insurance and liability insurance for your aunt's home. Another thing to keep in mind: Who would help your aunt if the caregiver could not, for some reason, make it to work on a given day?

Where do I begin to look for someone to stay with my father during the day? He is 96 and hard to deal with.

If someone is hard to deal with, I would start by calling the home care agencies in your area. Some agencies have expertise in dealing with difficult situations, and they will be more willing to work with you and your dad. Also, an agency has many different people they can send. Oftentimes, it takes a number of tries to find the right person. But once the right person is found, he or she is priceless. Does your father have dementia? Sometimes the first sign of cognitive impairment is irritable behavior. You might want to have his physician check him for cognitive decline, as there might be some medications that will help him to cope.

Donna Schempp is the former program director at the Family Caregiver Alliance and a member of the AARP Caregiving Advisory Panel.

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