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Hiring help at home

Mistakes to avoid along the way

By Caroline Tapp-McDougall

Your parent’s well-being is linked to stability and routine in this area—and your stress can be reduced with qualified home healthcare professionals by your side.

Finding a reliable and qualified care provider or home helper for your relatives requires research. The best advice I can give is to be relentless and don’t compromise on the quality of care, training, and expertise of care providers and their availability to fit your needs.

Getting started
List the caregiving and housekeeping related tasks and responsibilities clearly and ask applicants to check off those that they are willing and able to perform. (One family told me that their caregiver refused to toilet their eighty-year-old mother.) Clearly address subjects like benefits and wages, frequency of paydays, lateness, absences, vacations, and notice time. Make sure the applicant has reliable transportation to get to and from work on time. If you work and are heavily dependent on the homecare assistant, emphasize the importance of reliability right from the first interview and be sure to have a back-up plan in case the caregiver does not show up or becomes ill.

You may wish to consult a family physician, hospital discharge planner, or geriatric case manager to recommend or help you locate home-care providers in your area. Think carefully about your elder’s needs before you venture into the world of interviewing and hiring. It’s just like finding suitable child care; with the right person or people, things are well under control at home, and you can head off to work without additional worries. If the dynamics are wrong, it’ll be nothing but trouble, so make a change and put yourself out of your misery as soon as you can.

Involve your parent
Even if you aren’t sure, it’s best to find ways to ask for a supervisor’s assistance when an agency is involved, or if you’re in a private situation, replace the homecare worker as quickly as possible.

Beyond a doubt, your parent should be as comfortable as possible with their homecare situation and deserve appropriate, professional care. If possible, involve your parent in initial selection decisions to ensure they are comfortable and feel safe with the candidate. Check in with Mom and Dad on a regular basis to confirm that their needs are being met, discuss any potential concerns, and verify that they feel that they are being treated with dignity and respect.

Where to look
Relative as caregiver: Your elder may prefer care from a relative rather than a stranger. Perhaps there is someone in your family who might offer care without receiving any compensation or in exchange for living rent free. It might be a perfect arrangement for someone who is finishing school, between jobs or marriages, or is ready for a change. This is an officially paid position in some families, with a written agreement and benefits.

Private agencies: Paid caregivers with training are referred and managed by home healthcare or nursing agencies in your region. Some of these are branches of larger national firms, while others are very local. Find out if the caregiver provided by the agency is an employee of the agency or an independent contractor. Avoid up-front deposits and payments in advance. Check references and ask for financial arrangements in writing. Some agencies charge a one-time finder’s fee and offer a 30- to 60-day guarantee. Others charge by the hour or pay period.

Recruiting locally: Running an ad in the daily newspaper or searching the yellow pages under “homecare” hospice or nurses is how you go about this task. Avenues for hiring homecare workers include asking other caregivers for referrals and going to senior or other employment agencies.

Be clear about your needs: Establish a list of your basic needs and “nice-to-have” extras. Your first priority is to determine what kind of help is necessary. The easiest way to do this is to create a list of circumstances and tasks. This should allow you to narrow down the key areas where a professional can be of assistance.

Try to match: The personality of the caregiver is key to that of the person receiving care. Can they get along? Will they work together? Are they patient and friendly with each other? Is the caregiver capable and strong enough for moving and lifting? Can they cook the food that your parent likes? Does your loved one need a nurse for medical treatments—dressing changes on wounds or pressure sores, IV therapy, diabetes monitoring? A personal care worker could provide assistance with bathing, laundry, or meal preparation. Will driving be required? What about shopping and banking? Language, menus, tradition, and family values are pivotal in making a selection. Consider cultural or religious issues that will make your loved one most comfortable. Don’t expect your Hungarian father to suddenly fall in love with Chinese food.

It may take a few tries before a good match is made. In general, it’s the cheerful, positive helpers that make the most difference in your life and your elder’s.

Credentials do matter. Screen applicants carefully to ensure that they have the necessary qualifications, training, and/or temperament. Your interview should include a full discussion of the client’s needs and limitations as well as yours, since it relates to time away and other responsibilities. Have a written copy of the eldercare job description, conduct a careful review of the care worker’s home healthcare training/experience, and take time for a discussion of his or her expectations and availability (Are they looking for a short-term or long-term placement?).

Have applicants fill out an employment form that includes their name, address, phone numbers (home and cell), date of birth, social insurance number, educational background, work history, and references. Have applicants provide a driver’s license, school/training certificates, and citizenship and photo ID. Also be sure that you have detailed information on previous employers, and watch for gaps in their work history. With the applicant’s permission, conduct a criminal background check.

Additional considerations.
After reviewing the job description and the applicants’ qualifications once more, think about these last few points.

• Heavy Lifting: If the older person needs to be transferred from a wheelchair to a commode or lifted into bed, make sure the aide knows how to do this safely. A lifting device may be requested as many agencies and individuals follow a zero-lift policy to protect their backs.

• Full-Time Plus: Don’t try to hire someone on a seven-days-a-week basis. Not only is it against the law, but also no one can manage to remain effective. Know that aides who live in or sleepover cannot be expected to be on call twenty-four hours a day. If your relative needs frequent help or nighttime supervision, consider hiring a second person or have family members fill in.

• Ensuring Personal Security: However trustworthy you feel your caregiver might be, it is essential to protect your parent’s assets and precious items. Put private papers and valuables in a safety deposit box or safe and put a few proactive procedures in place such as:

• Check the phone bill for unauthorized long-distance or 1-900 calls.

• Set a limit on cheques and credit cards for household accounts, if money must be handled at all.

• Don’t leave cash around the house, and insist on receipts for all purchases.

• Have mail sent to your home or a safety deposit box where you can pick it up.

Assuming responsibility for someone else’s well-being is a big task. Getting support and reliable help at home for them involves diligence, monitoring and ongoing commitment to quality care.

Caroline Tapp-McDougall is the editor of a variety of healthcare magazines and the author of  The Complete Guide for Family Caregivers. Call 416-421-7944 to order.

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