When hiring a caregiver, it's important to make sure you're hiring right. Nothing is more important than the health, well being and happiness of your loved one. Following this checklist will help ensure you're getting a caregiver who's responsible, compassionate, honest and has the appropriate expertise and credentials for your needs.
That said, trust your gut. Only hire someone you feel comfortable with. Start off with a trial period. After hiring your caregiver stay present with frequent visits and phone calls. Stay vigilant and monitor your loved one's well being. Make sure she or he is clean, well dressed, well fed, and her living conditions are neat and sanitary. Your loved one should seem like her normal self, or better.
Download printable checklist here.
Care Management Requirements
Before hiring an in-home caregiver, make sure you understand what the client's needs are, so you can clearly articulate roles and responsibilities to prospective caregivers and evaluate their experience and expertise relative to those needs.
__ Personal care (toileting, dressing, eating, bathing)
__ Household care (cooking, cleaning, shopping, laundry)
__ Companionship (walks, talks, daily outings)
__ Health care (medication management, injections, IV, catheter, taking vitals, change dressings, etc.)
__ Transportation (driving to doctor's appointments, friends, shopping, etc.)
__ Specific ailment expertise (incontinence, dementia, diabetes, Parkinson's, psychiatric, etc.)
When screening new candidates make sure they have:
__ Experience caring for the elderly
__ Experience providing care for your areas of need i.e toileting, bed transfer, wound care, Alzheimer's etc.
__ The credentials required for your areas of need i.e. home health aide, licensed nursing assistant, etc.
We recommend you do 3 interviews. The first interview is over the phone, the second is an in person interview with you, and the third interview is with yourself and your loved one to ensure they're part of the process and approve of the hire. Here are some questions you might want to consider:
- Tell me about your experience working with the elderly?
- What do you love about working with the elderly?
- What don't you like about working with the elderly?
- How would you handle an emergency situation (give an example e.g. client chokes, falls, etc...)?
- How would you handle a situation if the client refuses to let you in their home?
- How would you handle a situation if the client screams, yells or hits you?
- Do you have experience working with Alzheimer's, Parkinson's, palliative, post-operative, etc.
- Do you have experience working with individuals in their home, a residence or the hospital?
- Do you have experience working independently, without supervision?
- Do you know how to use a lift or how to transfer a client into their bed, if required?
- Do you have experience assisting clients with toileting, dressing, cooking, etc?
- Are you comfortable assisting with housekeeping needs?
- Are you comfortable escorting the client outside and/or to medical appointments?
- Are you familiar with overseeing dietary restrictions?
- Can you assist with basic exercises?
- Are you comfortable managing vital signs, weight, blood pressure?
- Do you drive? Do you have a valid license?
- Do you smoke?
- Would you work in an environment with pets or where the client smokes?
- Do you have a criminal record?
If your caregiving candidate satisfied you during your interview process, it's time to verify. In this stage you'll want to verify reliability, responsibility, compassion, timeliness, honesty, expertise and their professional credentials.
__ Call 3 or more reference checks of former employers:
- Ask how the caregiver performed
- Ask what the caregiver's responsibilities were
- Ask how long they were employed for
- Ask if they would hire the caregiver again
- Ask if they would recommend the caregiver for the requirements of your job
__ Ask to see a government issued photo ID (driver's license, Green card, Immigration card, Military ID, etc.)
__ Record the caregiver's name, phone number, home address & social security number
__ Keep a photocopy of the applicants ID on hand
__ Ask the applicant to sign a waiver of confidentiality allowing you to perform a background check
__ Verify credentials (Licensed Nursing Assistant, Certified Nursing Assistant, Registered Nurses, etc.)
- Ask for copies of certificates
- Verify certification with the issuing organization e.g. Board of Nursing
__ Verify driver's license and driving record with the DMV, if driving is required
__ Verify car insurance, if they're using their car
__ Prepare a written Plan of Care to be followed by the caregiver
__ Determine whether caregiver is an employee or contractor (discuss with your accountant)
__ Sign an employment contract (wage, hours, days of the week, benefits, vacation days, etc...)
__ Take out extra liability insurance, workers compensation etc... (discuss with your insurance company)
__ Have your caregivers Employer Identification Number (EID)
__ Verify caregiver can legally work in the United States (check Homeland Security's E-Verify)
__ Pay a salary and all witholdings and deductions at source (discuss with your accountant)
What Type of Caregiver Do You Need?
|Task||Personal Care Assistant (PCA)||Home Health Aides (HHA)||Certified Nursing Assistant (CNA)||Registered Nurse (RN)|
|Toileting, dressing, eating, bathing||Yes||Yes||Yes||No|
|Cooking, cleaning, shopping, laundry||Yes||Yes||Yes||No|
|Check vital signs||No||No||Yes||Yes|
|Set-up medical equipment||No||No||Yes||Yes|
|Administer IV drugs||No||No||No||Yes|
|Administer needles / shots||No||No||No||Yes|
|Range of Motion Exercises||No||No||Yes||Yes|
|Certification Requirements||None||Some states require a background check, certification and vocational training||Must attend an accredited vocational or college program and pass a Nursing Assistant's Competency Exam||Must attend an accredited program and pass the national nurses exam - NCLEX-RNtion|
It should be noted that some designations allow caregivers to perform certain functions if they take a specific course. Ask to verify if the applicant is qualified and check with the licensing body governing the designation.
Post Hiring Safety Tips
It's imperative you stay involved and present to avoid cases of elder emotional, physical or financial abuse or neglect. Some precautions include:
__ Make unscheduled visits
__ Stay in contact with your loved one frequently
__ Monitor your loved one's living conditions to ensure their neat and sanitary
__ Monitor your loved one's mood to notice signs of depression, agitation or fear
__ Monitor your loved one's appearance for signs of neglect (poor hygiene, loss of weight, bed soars, etc.)
__ Review bank and credit card statements for unusual activity frequently
__ Keep a live video camera, with audio, (like a nanny cam) in the client's home
__ Keep significant valuables and cash out of the house
__ Take a picture of all valuables in the house prior to hiring