By Jim Miller
Dear Savvy Senior,
I need to locate a good in-home caregiver for my 83-year-old mother. What’s the best way to find and hire one?
Looking for Care
Finding a good in-home caregiver for an elderly parent can be challenging. How can you find one that’s reliable and trustworthy, as well as someone your parent likes and is comfortable with? Here are some tips that can help.
Know Your Needs
Before you start the task of looking for an in-home caregiver, your first step is to determine the level of care your mom needs. This can pinpoint the type of help she’ll need. For example, if she only needs help with daily living tasks like shopping, cooking, doing laundry, bathing or dressing, a “homemaker” or “personal care aide” will do.
But if she needs health care services, there are “home health aides” that may do all the things a homemaker does, plus they also have training in administering medications, changing wound dressings and other medically related duties. Home health aides often work under a nurse’s supervision.
Once you settle on a level of care, you then need to decide how many hours of assistance she’ll need. For example, does your mom need someone to come in just a few mornings a week to help her cook, clean, run errands or perhaps bathe? Or does she need more continuous care that requires daily visits or a full-time aide?
After you determine her needs, there are two ways in which you can go about hiring someone. Either through an agency, or you can hire someone directly on your own.
Hiring Through an Agency
Hiring a personal care or home health aide through an agency is the safest and easiest option, but it’s more expensive. Costs typically run anywhere between $14 and $25 an hour depending on where you live and the qualification of the aide.
How it works is you pay the agency, and they handle everything including an assessment of your mom’s needs, assigning appropriately trained and pre-screened staff to care for her, and finding a fill-in on days her aide cannot come.
Some of the drawbacks, however, are that you may not have much input into the selection of the caregiver, and the caregivers may change or alternate, which can cause a disruption.
To find a home-care agency in your mom’s area ask for referrals through friends, family or doctor’s offices, or use the home-care locator service tool at PayingForSeniorCare.com — click on “Find Quality, Affordable Care.” In addition, Medicare offers a home health compare tool at Medicare.gov/HomeHealthCompare to help you find and compare home health care agencies.
You also need to be aware that original Medicare does not cover in-home caregiving services unless your mom is receiving doctor’s ordered skilled nursing or therapy services at home too. But if your mom is in a certain Medicare Advantage plan, or is low-income and qualifies for Medicaid, she may be eligible for some coverage.
Hiring an independent caregiver on your own is the other option, and it’s less expensive. Costs typically range between $12 and $20 per hour. Hiring directly also gives you more control over who you hire so you can choose someone who you feel is right for your mom.
But be aware that if you do hire someone on your own, you become the employer so there’s no agency support to fall back on if a problem occurs or if the aide doesn’t show up. You’re also responsible for paying payroll taxes and any worker-related injuries that may happen. If you choose this option make sure you check the aide’s references thoroughly, and do a criminal background check, which you can do through sites like eNannySource.com.
To find someone, ask for referrals or try eldercare-matching services like Care.com or CareLinx.com. Or, for a fee, an aging life care expert (see AgingLifeCare.org) can help you find someone.