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Hiring an In-Home Caregiver: A Step-by-Step Guide

14 minute readLast updated December 20, 2023
fact checkedon December 20, 2023
Written by Kevin Ryan, senior living writer
Reviewed by Maureen Bradley, senior care expert and former community directorMaureen Bradley, a specialist with A Place for Mom, has advised families on senior care for 20 years.
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Most seniors wish to age in place for as long as possible, but many require additional support to do so. Finding the best in-home care starts by understanding your loved one’s care needs and budget. From there, you can either hire an in-home caregiver directly or through an agency. Meet with and interview your options to find the best fit for your loved one, then create a contract and develop a care plan. As you go, regularly evaluate whether your loved one’s needs are still being met, and communicate with your care provider to make any necessary adjustments.

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Determine your loved one’s needs and budget

The first step in hiring an in-home caregiver is knowing what you’re looking for. Take stock of your loved one’s daily needs and make a detailed list of the tasks they require help with. The more specific your list is, the easier it will be to find home care that checks all the boxes.

Knowing your loved one’s needs will also help you estimate how much in-home care will cost, which is typically charged by the hour. While rates vary from state to state, the national median cost for an in-home caregiver is $30 per hour.[01]

Home care offers opportunities for personalization, explains Lori Eberly, a consultant for A Place for Mom and former owner-operator of a home care franchise. From part-time companionship to 24/7 assistance, in-home care aides provide different services based on each family’s unique needs.

To help determine your loved one’s care needs, consider the following questions:

  1. Does your relative need help with activities of daily living(ADLs)? If so, which ones? Needing assistance with ADLs is a major sign it’s time for home care. Some seniors who’ve chosen to age in place only require help with a few daily activities, like dressing, bathing, and meal prep. Others may need full-time assistance using the restroom, eating, and drinking.
  2. Do they need transportation? If your aging parent can’t drive, they may require help getting to and from doctor’s appointments, family visits, events, and activities.
  3. Can your loved one move independently? If they have impaired mobility, your relative will need a caregiver who can safely assist with transfers and manage mobility aids.
  4. Do they need housekeeping? If so, which tasks should be completed? Does your aging loved one just want help with basic tasks, like laundry, or are they looking for an aide who will perform all household chores? Take special note of all housekeeping preferences and needs.
  5. Does your aging parent have pets to care for? It’s important to notify home care aides and agencies about pets, due to possible allergies and phobias. You should also clarify your expectations for pet care.
  6. Do they need companionship? If your aging relative is independent but experiencing loneliness or isolation, home care can be a way to increase social interaction. If their primary need is companionship, include your loved one when interviewing potential care providers.
  7. Do they need medical care? Home care aides generally don’t have nursing degrees and aren’t able to provide injections, wound care, or other medical assistance. If your loved one has a chronic condition or requires medical care, look into home health care instead of home care.

Is home care the right fit?

Let our free assessment guide you to the best senior living options, tailored to your needs.

Decide if you want to hire an in-home caregiver directly or through an agency

There are two ways families hire an in-home caregiver — through a home care agency or privately through independent caregivers. Agencies simplify the process by taking care of the hiring and administrative tasks such as payroll and scheduling. Families who hire a private caregiver act as the caregiver’s employer and are responsible for all hiring and management tasks.

Hiring a caregiver through a home care agency

When choosing a home care agency, it’s important to leverage your local network of trusted sources, friends, and family for referrals. Additionally, A Place for Mom’s Senior Living Advisors can provide you with a list of local agencies that fit your loved one’s budget and care needs. You can then speak with home care agency representatives to learn more about their services, procedures, and availability.

Hiring an independent caregiver

Independent caregivers work independently from a home care agency. Families often find these caregivers through personal connections, staffing services, and private registries. Hiring an independent caregiver may give you more control over personality and schedule, but it can also add an extra level of responsibility and present some risk and liability.

Writing a job description for hiring a private caregiver

Agencies take care of all caregiver hiring tasks, but if your family decides to hire a private caregiver, writing a job description will help you communicate what you’re looking for in a caregiver. Consider including the following topics and requirements in your job description:

  • Certification and licenses. Would you like a caregiver to be a certified nursing assistant, have a homemaker certification, CPR certification, etc.?
  • Experience. Do you prefer an in-home caregiver who has five, 10, or even more years of experience in home care?Do they need experience in certain forms of care, e.g., mobility assistance or dementia care?
  • Housekeeping. What tasks need to be completed? If meal preparation is requested, what types of food can they cook?
  • Mobility assistance. Can the caregiver provide mobility assistance?
  • Vehicle operation. Will the caregiver be using their car or yours? Will you provide mileage reimbursement?
  • Wages. How much are you willing to pay?
  • Work schedule. Do you have specific hours or times of day that the caregiver is required to be present?

You may want to consult a local attorney as you draft your job description to learn more about legal requirements, rules, and local or state laws.

Interview or meet with providers and compare

If your family has chosen to hire a caregiver through an agency, you will likely meet with a director or care coordinator who will gather information about your loved one. This may include an assessment of your loved one’s needs and their living situation to help in matching them with a caregiver.

The process for hiring an independent caregiver differs, as the family is responsible for leading interviews and comparing caregivers to find a good match. This may include verifying the caregiver’s experience, certifications, and availability. The family will also be responsible for checking references and doing a background check.

Interview questions for hiring an independent caregiver

Before interviewing, it’s a good idea to speak to an attorney to understand laws and regulations related to fair hiring practices.

The Family Caregiver Alliance (FCA) recommends asking these specific questions when interviewing an independent caregiver:[02]

  • Why are you interested in this position?
  • Can you tell me a little about yourself?
  • Where have you worked before?
  • What were your duties?
  • What is your favorite kind of client? Are there any people you feel uncomfortable working with?
  • Is there anything in the job description that you are uncomfortable doing?
  • How do you deal with someone living with memory problems? Give an example.
  • Describe your experience making meals for other people.
  • How do you handle people who are angry, stubborn, and/or fearful?
  • Do you have a car? Would you prefer to drive your own car or our car while transporting? I’ll need to see proof of insurance and a current driver’s license.
  • What is your experience transferring someone out of bed or a chair and into a wheelchair?
  • What is your availability? Days? Hours?

In addition, you should request the following items from a potential caregiver:[03]

  • Two work-related references and one personal reference to contact
  • Driver’s license and/or a work visa documenting the caregiver can legally work
  • Proof of licensing or certifications
  • Personal information for a background check
  • Signed waiver allowing you to perform a background check

Write a contract for in-home care

This step will vary based on your choice to work with a home care agency or an independent caregiver. The process is usually more involved for those who have chosen an independent caregiver, as you may need to prepare your own contract.

Home care agency contracts

Agencies will most likely have a standard contract and other documents for you to fill out and sign prior to starting service. Make sure to read all documents in their entirety. You may want to have a lawyer review these documents for you prior to signing.

Independent caregiver contracts

The independent caregiver may have pre-written contracts of their own. Read over these contracts carefully or consult a lawyer before signing. If the independent caregiver does not have a template contract, you may have to create one.

A home care contract should typically include the following information:

  • A thorough description of job duties agreed upon by both parties
  • Full names of the caregiver, care receiver, and employer
  • Contact information of the caregiver
  • Wage information, including hourly rates, holidays, sick days, and insurance
  • Reimbursement policies for mileage, groceries, etc.
  • Expectations for behavior, such as smoking, being on time, etc.
  • Paperwork requirements, like daily updates, medication logs, and other reports
  • A thorough description of any grounds for termination and severance information
  • Dated signatures from all parties

The contract formalizes your agreement and defines both parties’ obligations. It should be signed by both you and the caregiver, and it should be notarized. If disputes arise, the contract can offer potential solutions which may save you from having to go to court.

If you’re unsure about creating a contract yourself, consider hiring a local attorney to draft a contract. Legal experts may be able to provide specific suggestions to protect yourself and your loved one.

Families should also consider consulting with an accountant to learn about the tax procedures when hiring and paying an independent caregiver.

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Create a care plan

A care plan summarizes a person’s specific care needs and highlights their current services. It can help organize and prioritize caregiving activities and create clear expectations between the caregiver, the care recipient and their family.

In many states, home care agencies are required to create a care plan, which may take place during the first meeting. The agency will provide all the necessary care plan documents and many will write care plans in partnership with the client and their families.

Care plan requirements differ for independent caregivers depending on where your loved one lives. As the caregiver’s employer, you will be responsible for providing all necessary care plan documents. Consulting with a lawyer will help to ensure you have the correct documents.

Whether you’re using an agency or an independent caregiver, a care plan should at minimum include the following information:

  • Schedule
  • Caregiver duties and expectations
  • All health conditions the client may have
  • Client’s medications, dosages, and how often they are taken
  • ADL support needs
  • Home chores to be completed, if relevant
  • Information about the senior, such as preferences, likes, and hobbies
  • Contact information for health care providers and family members
  • Emergency contacts

Communication and trust between families and caregivers are essential to building a strong relationship. A care plan should clearly outline when and how updates will be communicated with the family and their loved one. It’s also important to make sure the care plan is updated annually or more frequently, if your loved one needs changes.

Start care, evaluate, and adapt as needed

If your family chooses to use a home care agency, it’s important to maintain regular communication with the caregivers and the agency. This is an important step because it helps ensure that everyone involved is on the same page. It will also help to maintain organization and keep everyone informed of any changes that may have occurred with your loved one.

Families who hire an independent caregiver will begin by orienting and training the caregiver. It is important to keep in mind that hiring a private caregiver makes you their employer. Regular communication is essential to ensure expectations are clear and any questions are addressed.

Who can assist me with finding an in-home caregiver?

It can be overwhelming to navigate the many in-home caregiver options available yourself. You don’t have to walk this journey alone. Reach out to the Senior Living Advisors at A Place for Mom for a free consultation about your loved one’s unique care needs. These advisors can provide local solutions and personalized in-home care referrals, all at no cost to you or your family.

SHARE THE ARTICLE

  1. A Place for Mom. (2023). A Place for Mom proprietary data.

  2. Family Caregiver Alliance. Hiring in-home help.

Meet the Author
Kevin Ryan, senior living writer

Kevin Ryan is a content specialist at A Place for Mom, focused on home care topics that include defining the differences between home care and other senior care types, home care costs, and how to pay. Kevin’s desire to support seniors and their families stems from his previous career as a teacher, plus his experience as a writer and community journalist.

Edited by

Marlena Gates

Reviewed by

Maureen Bradley, senior care expert and former community director

The information contained on this page is for informational purposes only and is not intended to constitute medical, legal or financial advice or create a professional relationship between A Place for Mom and the reader. Always seek the advice of your health care provider, attorney or financial advisor with respect to any particular matter, and do not act or refrain from acting on the basis of anything you have read on this site. Links to third-party websites are only for the convenience of the reader; A Place for Mom does not endorse the contents of the third-party sites.

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