Savvy Senior: How to hire a caregiver for in-home help

Dear Savvy Senior,

I need to hire a good in-home caregiver to help my elderly father who lives alone. What’s the best way to do this?

— Searching Sarah

Dear Sarah,

Finding a good in-home caregiver for an elderly parent is not always easy. 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 HIS NEEDS

Before you start the task of looking for an in-home caregiver, your first step is to determine the level of care your dad needs. 

For example, if he 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 he 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 he’ll need. For example, does your dad need someone to come in just a few mornings a week to cook, clean, run errands or perhaps help him with a bath? Or does he need more continuous care that requires daily visits?  

After you determine his 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 $15 and $30 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 dad’s area use search engines like Google or Bing and type in “home health care” or “non-medical home care” followed by the city and state your dad lives in. You can also use Medicare’s search tool at Medicare.gov/care-compare – click on “home health services.” Most home health agencies offer some form of non-medical home care services too. 

You also need to know that original Medicare does not cover in-home caregiving services unless your dad is receiving doctor ordered skilled nursing or therapy services at home too. But, if your dad is in a certain Medicare Advantage plan, or is low-income and qualifies for Medicaid, he may be eligible for some coverage. 

HIRING DIRECTLY

Hiring an independent caregiver on your own is the other option, and it’s less expensive. Costs typically range between $12 and $25 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 dad. 

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 at companies like eNannySource.com.

To find someone use an elder-care matching service like Care.com or CareLinx.com, which both provide basic background checks.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.