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Hiring Your Own Home Care Helpers 101


If you do not require skilled professional services such as nursing or rehabilitation therapies (as is required for coverage by most insurers) you may choose to hire a home attendant yourself, rather than going through a home health agency.

Consider both the advantages and disadvantages to hiring an aide yourself.

Home health agencies generally have doctors who can visit you at home if necessary. If your doctor doesn't make house calls, there are doctors who do that you can access on your own.

Advantages Of Hiring Your Own Health Aide

  • The worker tends to be better paid which can attract more qualified people.
  • You will make the decision about the person who will provide your care according to your personality and particular needs.
  • You will have more control over the duties that are to be provided.
  • You will have more control over the scheduling of work hours.
  • There is greater likelihood of long term continuity of care.
  • The worker's loyalty is unambigouously to you (instead of divided between you and an agency).
  • In most cases the cost will be less.

Disadvantages Of Hiring Your Own Health Aide

  • Workers are not screened and background checks are not provided, as they usually are with home health care agencies. You or your caregivers will have to do the screening and background checks on your own.
  • It will be difficult to know whether the person received any special training that you need. And, if so, whether he or she is good at it.
  • Securing personnel will require more effort on your part. For example, you will be responsible for locating, interviewing, and hiring the helper.
  • You will also be responsible for locating providers for all services you need that the home care person doesn't provide.
  • Once hired:
    • All supervision of services will be your responsibility. For example, arrangements will need to be made if the employee is sick or does not show up for work.
    • You will have to handle problem employees.
  • As the employer you will be responsible for any applicable state and federal labor, health and safety regulations. Depending on the terms of employment, this may include withholding payroll taxes including social security, and providing Workers Compensation insurance. To determine your responsibility contact your accountant or attorney. (There are agencies and bookkeeping services that manage payroll requirements at a reasonable cost).

How To Determine Your Care Needs

Make a list of all the services that you think you will require. Your list should be very specific. Use this list as your job description when interviewing potential employees.

The following provides some examples of needs to consider:

  • Assistance with hygiene, including bathing, toilet and dressing.
  • Assistance with mobility such as getting in and out of the bathtub. You may need someone who can safely lift or transfer a person of your body weight.
  • Someone to do housework, include the exact duties such as cooking meals, washing dishes, vacuuming, mopping floors, dusting furniture, or doing laundry.
  • Shopping and running errands.
  • Providing transportation to doctor and other appointments.

What Kind Of Aide To Look For There are no standardized names for home care workers. However, in general the following are the types of home care aides:

  • Personal Care Attendant or Home Attendant Is a person who:
    • Bathes, grooms, feeds and toilets patients.
    • Prepares meals.
    • Does housework.
  • Home health aide Is a person who:
    • Provides limited personal care.
    • Does light housework including laundry.
    • Does shopping.
  • Homemaker or housekeeper
    • Is a person who does house work, cooking and similar chores.

How To Locate Independent Home Care Workers  The following are possible sources to help find home health workers:

  • Registry
    • A registry will match patients with home health care workers.
    • There is a fee involved for this service.
    • Registries are not generally subject to federal regulations or licensing requirements.
    • Registries are not required to perform background checks on employees (although some do). If you use the service of a registry, ask what sort of background checks and references they require of employees.
    • To locate a registry: ask your doctor or a social worker in the hospital you use. You can also search through your favorite search engine or engines: type in Home Health Care Registry and your state.
  • Doctor's Office Ask the staff at your doctor's office for a recommendation. They often become acquainted with home health workers from time spent with patients in the office waiting room or dealing with them on the telephone.
  • Friends and family Ask friends, family, or other people that you trust if they know of individuals who provide home health care services.
  • Disease specific non-profit organization Your local disease specific non-profit organization may be familiar with reliable individuals who provide home health care services.
  • Support Groups A support group can be an excellent source of information about individual home health workers. To learn more, see: Support Groups.
  • Local college or university Consider offering a spare room rent free to a younger person in exchange for detailed duties.
  • Religious Organization Contact local religious organizations. Membership is generally not required. A religious organization may also be a source of volunteers if you need them to supplement your caregivers.
  • Senior Community Centers Local community centers which specialize in services for older people are likely to be familiar with home health workers. Some centers even have employment/ bulletin boards with contact information.
  • If You Need A Visting Nurse Find a visiting nurse in your area through the Visting Nurse Associations of America: offsite link

Check References And Background Before Having An Interview Before even agreeing to an interview, do a criminal background search and contact the potential helper's references.

  • Criminal background search.When searching, look for states in which you know the person lived in addition to your current state.
  • References When you contact the potential helper's references, at least ask the following questions:
    • How long did the aide work with the person?
    • Was the situation similar to your own in terms of physical condition, patient needs and physical surroundings?
    • Was the person reliable?
    • Trustworthy?
    • Was there anything the person wouldn't do?
    • Would the reference hire the person again?
    • How much was the person paid?

Tips For The Interview

  • Consider interviewing at least several applicants. If a homecare worker has been highly recommended by a reliable source, and you find that you "hit it off," it may not be necessary to interview other applicants.
  • It is recommended that you first speak by telephone. This will help you get a feel for the individual, and assist in narrowing down the field.
  • Following are some of the issues that should be covered in the interview:
    • How much experience has the applicant had? For how many years? How many patients?
    • Has the applicant ever worked for someone with your specific health condition?
    • What type of work related training has the worker received?
    • Is the applicant available during the hours you need help? Is his or her schedule flexible enough to accommodate your needs during special circumstances?
    • Review all your needs. Does the applicant understand what you need? Is he or she agreeable to filling your needs?
    • Can you come to a mutual agreement about time off, holidays and other work related issues?
    • Can the two of you come to a mutually agreeable salary?
    • Does the person have adequate transportation to get to work? Even if weather conditions get rough?
    • If you will require that someone run errands using your car, does the applicant have a valid drivers license? A safe driving record?
    • Can the person supply at least two current references from other patients/employers? If so, call the references.
    • Determine how and when the applicant can be contacted. Insist on a home phone number as well as a mobile if the person has one.

For safety reasons, you or your family may wish to conduct the interview in a public place like a coffee shop, rather than in the home. This may be especially important if you have never spoken with or met the individual, or the person did not come recommended from a reliable source.

Learn How To Maximize Use Of A Home Care Aide. Click here.

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