A Roadmap For Finding Excellent In-Home Help

Home is where the heart is concept card

by Karen Keller Capuciati

For most of us, the prospect of hiring in-home help can be overwhelming. I remember the first time our parents needed in-home care, back in 2006. Dad was very ill and required round-the-clock assistance. We needed someone to help out at night so that Mom could get some sleep.

We had no idea where to even look for help, let alone how to find the right person. There were so many variables to resolve, like convincing Mom that she needed help in the first place, and then deciding whether to hire from a licensed agency or find an independent contractor, like a friend-of-a-friend from church, for example (referred to as “the grey market”). Most of all, we weren’t sure how to find someone our parents would feel comfortable having in their house at night, or how to make sure that person would be reputable and qualified. I remember thinking there were endless problems to overcome.

Eldercare professionals, like the ones I meet with every month, often help their clients find the best in-home-care candidates. They do some interviewing and checking of references, qualifications and backgrounds, and then provide a couple of recommendations. And after years of doing this, and observing the results in various situations, these professionals have learned what works, what doesn’t and which pitfalls to avoid.

So I asked my group to give us some tips on finding excellent in-home help. Here is some of the solid advice they offered:

Joan Blumenfeld, a geriatric care manager:

Here are some things I recommend, though not in any order of importance:

  • Aides from agencies, rather than the private, pay-under-the-table kind, for liability reasons and back-up coverage in case the aide can’t show up due to illness or car trouble.
  • Someone who has a solid track record and comes with references — not just a brand new warm body.
  • An agency that is recommended by either a geriatric care manager or a friend who has worked with the agency successfully.
  • Aides that have an attractive and neat appearance; they should make eye contact, have a cheerful disposition, and, of course, have experience and training.
  • Someone who speaks English (if the client is English-speaking) — there’s no reason to add obstacles that might impair communication.

And trust your gut feeling and first impression as to whether or not it would be a good fit. Expect to spend some significant time orienting the aide you hire to the specifics of your situation.

Joan Garbow, a geriatric and disability care manager:

I believe that live-in help should have a “home base” for their days off and other lengthy downtime. Certain issues can arise if they don’t have a home to go to. For example, it could be awkward if a caregiver invites friends to your house during their time off, and just as disconcerting if you have to tell them they can’t bring friends over. Additionally, caregivers should get scheduled time off and breaks to avoid burnout.

Laura Kaplan, licensed clinical social worker and geriatric care manager at Connecticut Eldercare Solutions, LLC:

If a client is not demented, I think it is very important to have them involved in the interviewing process. One way would be to have the family and the geriatric care manager do the initial interview and present the recommended candidates to the person they will be caring for, in order to get his or her approval, before they are hired. Of course, it is not always that simple, but, if possible, it can be useful for a better adjustment.

Kathryn Freda, a gerontologist and eldercare manager:

If a client ascribes to a certain religion, check with his or her place of worship as a starting point in the search for someone to care for them. This is particularly useful in finding social companions who have volunteered to help out, which, in turn, provides an hour or two of respite for you.

Donna Fedus, a gerontologist and the founder of Borrow My Glasses, LLC:

I suggest creating a list of “must” and “preferred” tasks, and traits to match the family’s needs. If dementia care is a must, I ask the candidate to describe when and how they were trained to care for people with Alzheimer’s or other kinds of dementia. I then ask a series of questions to learn about their experience and approach, such as:

  • Tell me about a time you took care of a person with Alzheimer’s or another kind of dementia.
  • What specific kinds of issues did the person have?
  • What did you help with?
  • What was challenging about that?
  • Tell me about a time when the person was agitated.
  • Do you know what cause them to become agitated?
  • How did you handle it?
  • Tell me about how you enriched their life.

Many in-home caregivers are kind and compassionate, but I would not hire caregivers to care for a person with dementia unless they have training and experience specifically in dementia care.

There are many questions you can ask to elicit philosophy and get a sense about how they would handle issues that arise, based on their past experience. You can also tell if they have had dementia-care training and hands-on experience.

Marsha R.B. Beller, a geriatric care manager:

I am looking for a kind of demeanor in the caregiver that is calm and assured, yet allows them to stay open to learning from others (client, family member, or other professionals). A caregiver can promote the client’s dignity, comfort, and self-worth with her or his approach — recognizing that this is the client’s home, that a person is more than a collection of symptoms or behaviors to be managed, and that serving involves more than just accomplishing tasks. At its best, when the “fit” is there between care partners, the relationship can be very special.

Karen Keller Capuciati, co-founder of In Care of Dad:

Before we could even start looking for help for our parents, we needed to get past our mom’s resistance — she didn’t think she needed help nor did she want a stranger in the house. So we started slow. We got our mom to agree to in-home help for just four hours a week for just one single month. If she didn’t find it helpful, then we said we’d stop bugging her about it.

The agency was very professional and assigned an aide that our parents loved. It didn’t take long before Mom recognized that she couldn’t live without the help, and we were able to increase the aide’s hours to cover entire nights.

Also, we recommend you use this list of questions we compiled for interviewing various in-home care agencies.

 

Karen Keller Capuciati is the Co-Founder of In Care of Dad.



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