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Choosing a Home-Care Worker

When did you realize that your loved one needed help? For some people, the recognition came with a phone call—"Mom has fallen and broken her hip," or, "Dad has had a stroke." For others, the awareness comes gradually—they might notice that Mom can't get around like she used to, or that Dad's forgetfulness has gotten progressively worse.

Whether the need for you to play a caregiving role comes quickly, slowly, or in fits and starts, you really are better off not trying to provide all the care by yourself. You need help! Why? Because when you share the care, you can be sure that your loved one gets all the attention he or she needs. For many caregivers, hiring a home-care worker is a good solution. A trained home-care aide can help you meet the needs of your loved one while he or she remains safely at home.

But hiring someone can be a tricky business. So, here are some tips and resources to consider if your loved one needs assistance at times when you can't be there.

Defining the Purpose

You know your loved one wants to remain independent. However, before you run out and hire a person to provide home-care services, sit down with Mom—and her doctors if appropriate—and discuss her needs. Does she need help with any of the following?

  • Household chores, such as cleaning, laundry, and preparing meals
  • Non-medical personal care, such as bathing, dressing, and moving about the house
  • Transportation to get her to doctor's appointments and to the grocery store
  • Trained medical assistance, such as monitoring a health condition, administering medicine, or providing physical therapy

Before hiring someone, you'll have to know how often your loved one will need the services listed above.

After you've determined the kind of help Mom or Dad needs, you'll be in a better position to look for a home-care worker to support your family member on a regular basis.

The Screening Process

It can be scary to think of a stranger coming into your loved one's home. The aide will have access to everything in the house and may be helping your Mom or Dad with intimate needs, such as bathing or dressing.

The worst fear for most people is that the home-care worker might take advantage of your Mom or Dad with abusive behavior or theft. The article, "Who's Helping Your Parents?," details an extreme example, and yet the story affirms why it's important to be thorough in the hiring process.

There are lots of steps you can take to ensure that the person in your loved one's home is providing quality, professional care. Some families select an aide on their own; others use an agency. Here are some ideas for selecting an independent home-care worker.

Hiring an Independent Home-Care Worker

You can search for a home-care worker in a variety of ways:

  • Use your social network by asking friends, neighbors, co-workers, or other caregivers you know for references.
  • Post an ad on the bulletin board at your place of worship or community center.
  • Run an ad in your local newspaper.

If you post a job opening, be sure to fully describe the position and its hours, and give your name and phone number. Be sure to list your phone number—not your loved one's—so that you can ask basic questions about the aide's previous work experience, special training, and their ability to get to work on time. And before you interview any candidate, you'll need to know how much you can pay. According to the Bureau of Labor Statistics, these workers generally earn about $10.25 an hour.  

At the Interview: Discuss your parent's needs, health concerns, and likes and dislikes. Be friendly but professional. Remember, you're trying to determine whether or not this is the right candidate for the job, so you'll want to know the following:

  • The worker's name, address, phone number, Social Security number, and driver's license or id-card number
  • The reason why the aide is seeking the position
  • How to contact the worker's references
  • Any former experience or special training the person has had in providing at-home care


After the Interview: Be sure to check references. Take no one at his or her word when it comes to providing care for your family member. In addition, consider paying for a criminal background check. A recent AARP research report concludes that taking this step can keep the wrong people from gaining access to your loved one's home.

Hiring and Monitoring. Have your first choice meet with your Mom or Dad. This is a very personal relationship, so their comfort level with the person can make or break your hiring decision. Make sure that your parent and the aide communicate well and understand each other, because they'll spend a lot of time together.

Once you've determined the person you want to hire, write out a contract, which includes hours, job duties, pay schedule, time off, start date, and reasons for termination. I strongly recommend you start with a trial period—two weeks or a month—whatever feels right. This settling-in period, in which everyone learns each other's style and personality, can be difficult. Despite your best intentions, issues might arise. Oftentimes, you can settle these matters easily, but keep in close touch with both parties to see how things go. I recommend that you occasionally stop by unannounced at different times to be sure everything is going well.

When problems are resolved before they get out of hand, everyone wins. Perhaps you'll learn that your Mom isn't happy with the meals being prepared. The reason could be as simple as seasoning or the menu choice. Perhaps the home-care worker needs a break during the day but isn't being allowed to take one. Stay on top of these issues, and your chances of success will go way up. But if things don't work out, you’ll need to let the aide go and start looking for someone new.

Using an Agency to Find Home-Care Workers

Some families prefer to use a home-health agency to get help for their family members. One advantage of choosing such a service for in-home care is that the agency will go through all the steps outlined above, such as interviews and background checks for you. Looking at the Web sites and advertisements for home-health firms, you'll see that the companies all stress quality. They know that is what all caregivers want for their loved ones. But an agency can have an uneven management style, so it's important to ask about the services that it provides. Considering these factors can inform your choice and make it easier:

  The agency must be licensed by the state

  • Find out the range of services the company provides
  • The kinds of professionals, and their different specialties,  the agency has available to clients
  • Does the agency conduct background checks on all its contractors, and how are they trained and supervised?
  • What do you have to do to change to a different aide?
  • The agency must have a firm plan for dealing with emergencies, such as no-shows

Another benefit of working with an agency is that it might provide assistance with paying for some home-care services. Some agencies have a sliding scale that takes into account the financial situation of your loved one. Others are certified by Medicare and Medicaid, which might cover the cost of some care.

Whether you choose to use an agency or go it alone to find a home-care worker, remember that you're in charge. Insist on the highest quality of care for your Mom or Dad. You are their best advocate, so stay in touch with them to make sure that the support they receive keeps them happy, healthy, and independent in their own home.

Be Open, Yet Vigilant

Having a stranger enter your Mom or Dad's house to provide care can be a scary prospect. But by asking the right questions, carefully evaluating who gets hired, and keeping up with the care being given, you can make your life and that of your family member easier and more peaceful. Yes, all this costs money, but by talking with your Mom, Dad, and other relatives, who can contribute financially, you can also settle on a care budget.

Whether you need five or 30 hours of an aide's time each week, you can find the help. Hiring a home-care aide is a great alternative to doing it all on your own. It's really next to impossible to do it well by yourself. Besides, with professional assistance, you've got support on your caregiving journey.

Take care,