Tips for Hiring a Caregiver for an Elder

Jacqueline Marcell Health Guide
  • Convincing Your Elder of The Need for a Caregiver

    Tips for when you've already made the decision that a nursing home or Alzheimer's care center is not the right fit for your elder.

    Regardless of whether your elder has Alzheimer's or dementia, keep in mind that any kind of change is frightening for elders and the fear of the unknown can be intensified. Have the doctor write a "prescription" to get a caregiver and ask the doctor to sternly advise the elder that they must have help in their home or legal action may have to be taken.

    You can have a caregiver agency send an administrator to help convince your elder how much easier things would be if someone came in to help them. Assure your loved one that you will monitor this person to make sure they do things properly.
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    If that doesn’t work, and your elder is in danger of hurting himself or someone else, and cannot be left alone, contact Adult Protective Services who will send a social worker to talk to your elder. Their report automatically goes to the police department, so an officer will visit them soon. A uniformed police officer may be just enough to help convince your elder of the seriousness of the situation.

    Caregiving Agency or Individual Hire

    Decide if you want to hire through a caregiving agency (which is more expensive, but the workers are usually supervised and bonded) or if you want to find someone on your own (which will require a lot more on-going supervision). Ask if the agency is bonded and if it is a member of any state or national home care organization. Call to check them out.

    How to Handle References and Interviewing Caregiver Candidates

    Ask for references of families who have a caregiver supplied by the agency right now. Call to see how happy the clients are with the service. Some agencies will do extensive background checks, drug screenings, others will not. Inquire as to exactly what background checks have been done on the caregiver you are thinking of hiring from an agency and get everything in writing. If they will not put this information in writing, they probably have not done the background checks. If you have Long-Term Care Insurance, be sure that the agency will take direct payment from the LTCi company. In any case, it’s extremely advisable to pack up valuables and remove temptations from caregivers who come into the home.

    As you begin interviewing caregivers, involve your elder in the process. Obtain an Application For Employment form from your local stationery store, which will list the questions you can legally ask. Together, make a list of the non-negotiable qualities you want in your caregiver. Don’t waste time interviewing applicants in person who do not meet your minimum requirements over the phone. For example: Do they have a valid driver’s license? Will they give out their social security number so you can pay taxes properly? Do they live close by? Do they have adequate elder care experience? Will they give you checkable references? Do they speak, read and write your language at a reasonable level? Do they have any objection to being fingerprinted? Have they ever been arrested and/or convicted? Will they sign a waiver to have a background check run on them? If you get a lot of hesitancy or refusal, save yourself the time of interviewing in person.

  • Get as many references as possible and check them all. Talk to previous employers, families they have cared for, co-workers, landlords, neighbors, relatives and friends. Find out if they have been reliable, punctual, what duties they have performed and if there were any problems. By visiting the applicant in his or her own home, you will immediately see their level of cleanliness and organization. This is the level you can expect to see in your elder’s home.

    Tapping Law Enforcement Resources or Private Investigators

    It is illegal for the police to run a check on an individual for you, unless there is probable cause of an outstanding warrant for their arrest. Try this: Ask the applicant if they’d mind having their picture taken, and if you could take their fingerprints, just as a precaution. This may be just enough to scare off any who have a record!
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    You can also hire a private investigation firm, but be sure to ask: Are they checking in the county, state or nationwide? What types of crimes do they search for? How many years back do they check? They can check public records on: real estate, social security, DMV, taxes, etc. You can do some of this yourself by searching your county’s public records.

    Be Clear about Caregiver's Responsibilities

    Write down all of the caregiver’s responsibilities now and what they may become. This should be done with everyone present so that it is very clear what will and won’t be expected. Make sure they know the list may need to be expanded as your loved one’s health deteriorates. Will they change diapers if necessary?

    You may be surprised at the amount of work caring for your elderly loved one requires. Some of these tasks may include: Toileting, diapering, bathing, brushing and flossing teeth, shaving, fixing hair, soaking feet, applying ointments and moisturizers, cleaning wax out of ears, applying makeup, trimming nails, dressing, shopping, cooking, serving, feeding, administering medications, housekeeping, laundry, running errands, answering phone calls, keeping medical and dental appointments, providing social interaction, chauffeuring, monitoring medical devices, and providing emotional support.

    Additionally, recognize that you may be expecting your caregiver to be a "psychologist" asking them to tolerate a difficult person who may be uncooperative, manipulative and maybe even physically combative. Be sensitive to the many needs of your caregiver, overlook minor mistakes and allow for a learning curve.

    Once the caregiving begins, your elder may make unreasonable demands. Therefore, a written list will assure the caregiver of their responsibilities. Since most elders respect authority, if you give your caregiver a white medical lab coat, it may influence the most rebellious elder to behave better. When complaining about the caregiver begins, which it inevitably does, don’t automatically defend the caregiver to your elder and get into a heated argument. Simply assure everyone that you will get to the bottom of the problem.

  • A Nanny-Cam?
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    You may want to consider installing a nanny-cam so you can see for yourself what is happening. A small camera lens can be installed in a lamp, clock radio, smoke detector, Kleenex box, phone, or just about anywhere. It sees a 90-degree angle of the room and transmits into a recorder. If the complaints are well-founded, report to the agency or take appropriate action on your own. If the complaints are superficial, strengthen the caregiver’s resiliency about how to handle their difficult patient. Make it very clear to everyone that your elder does not have the power to fire the caregiver, or you’ll go through this many times. Be sure to block all 976 and International calls on the phone, and don’t forget to ask for a copy of the caregiver’s driver’s license and car insurance–in case your elder travels in their car.

    You can learn more about Jacqueline and find information about her book at
Published On: December 27, 2006