As more and more seniors are opting to "age in place", more families consider privately hiring senior caregivers as a way to help their loved ones stay in their homes, which are a safe and happy environment . This is uncharted territory for most people, and adult children who may have hired nannies to care for their children years ago wonder what they need to consider when hiring the senior caregiver.
1. Job Description and Household Rules
The first step is to do a needs assessment. Your loved one's needs are unique, and likely to change over time. What are the caregiver's duties? Are there any special skills required? Does your loved one have specific interests that you want to try to match? A senior who loves to play cards needs a caregiver who shares that interest. Does Mom prefer traditional Italian food, like to get out and about but just needs some assistance, or maybe is just addicted to the soaps? Consider your senior's personality and preferences, as well as physical needs.
Household rules are also important to consider. Do you allow smoking in the home? Do you want the doors locked at all times? Alarm system armed? Are you okay with your Dad going out and about with his aide? Are there dietary preferences?
2. Research Costs
When you hire a senior caregiver you are almost always on your own financially. Explore what the costs are for the type of care you are looking for. There are 3 general models, but endless variation, so do your homework!
- Agency caregivers are employees of the agency. The agency handles payroll, taxes, insurance and scheduling. Expect to pay $18 - 30 per hour to the agency for the typical senior caregiver - costs vary considerably by geography.
- Registry caregivers are recruited and scheduled by the registry but you pay the caregiver directly, or engage the registry to process the net payroll. The registry collects a fee for their services either on an hourly or daily rate model. Because you pay the caregiver, or outsource the payroll to the registry, in most states you become the employer, with tax and workers compensation insurance responsibilities. Be very careful here, many registries will tell you "don't worry, we do the payroll." The critical question is whether they are paying the caregiver's employment taxes. If they answer no, the family receiving the care is generally on the hook legally. Increasingly states are requiring that registries fully disclose this to their families.
- Private hiring - going on your own. This is the most economical means, but places considerable scheduling and record keeping responsibilities on the family. Expect to pay $12 - 20 per hour, and factor in the costs of payroll taxes and insurance.
3. Behavioral Interviewing
Good interviewing is critical to a good and safe job match. Ask questions of the applicants about how they have handled common situations in the past. Ask open ended questions and get the applicant talking!
4. Check References
This is just as important as the interview! Don't rely on the letters of reference the applicant brings with them. Talk to their references, and ask them good open ended questions too.
5. Background Check before Hiring!
A legitimate pre-employment background check will run $100 - $150 and must be done. There are far too many stories of theft, sexual abuse, and worse by caregivers of vulnerable seniors. You absolutely need to be able to confirm the identity of the prospective caregiver, and assure yourself there is no record of prior criminal history.
6. Plan Backup Coverage
How will you handle your caregiver's scheduled vacation? Unscheduled sick time? Many famlies who privately hire senior caregivers will make arrangements with an agency to cover vacation time. Unscheduled sick time, or the caregiver who just quits, is harder to pre-arrange.
7. Document Emergency Procedures
Your specific emergency plan should consider not only your loved one's possible physical and mental limitations, but also the everyday things that can happen. Who does the caregiver call when there is an emergency? What types of things whould you like to be notified of? When should emergency services be called? When should the primary care physican be consulted? Is it necessary to provide the caregiver with a limited medical power of attorney?
