How to Hire the Right In-home Caregiver

Many boomers must hire someone to assist them or their parents with the daily activities of life, such as meals, laundry, and transportation. Others may also need more personal tasks, such as bathing, dressing or incontinence. There is also a plethora of home care agencies and private pay persons offering these services. It’s useful to arm yourself with a little extra knowledge to ensure you hire the right in-home caregiver. You can even download some handy forms at the end of this article that will help you find the right in-home caregiver for you.

1.) Companion Care is generally the first level of care that is needed. It covers tasks, such as:

• Light Housekeeping
• Laundry and Changing Linens
• Running Errands
• Medication Reminders
• Incidental Transportation
• Home Organization Assistance
• Shopping (Groceries, Clothes, Gifts)
• Gift Wrapping
• Meal Preparation and Cleanup
• Monitoring Bathing Safety
• Supervise Dressing and Grooming
• Companionship

A person or agency offering Companion Care is not trained or qualified to assist with dressing, bathing, or feeding. The state of Virginia does not require licensure or certification of persons or agencies offering services known as “companion” care. A Companion Caregiver cannot provide Personal Care. If they do, they are skirting the law. They are also putting your loved one in danger.

2.) Personal Care is typically the second level of care that is needed. It extends Companion Care to include the following tasks:

• Bathing
• Dressing
• Transferring
• Incontinence Care
• Assistance with Eating
• Mobility

Personal Care is also technically classified as non-medical care, but a person or agency providing Personal Care Aide services must be licensed by the state and specific training is required. Training must be supplemented with continuing education every year to maintain the classification of Personal Care Aide (otherwise known as a PCA).

Since considerable harm can come to the person who receives Personal Care (PCA) from an untrained person; it is essential to understand the difference between Companion Care and Personal Care (PCA).

In the state of Virginia you may hear the term CNA (certified nursing assistant) or HHA (home health aid) used interchangeably with PCA. PCAs, CNAs, and HHAs can provide the Personal Care tasks discussed here. If you would like a more detailed view of Virginia’s requirements for a PCA, you can read the official training curriculum required by the State of Virginia. A quick glance at the document will demonstrate why a Companion Caregiver is not qualified to deliver the level of care provided by a PCA/CNA/HHA.

For most in-home care situations, a registered nurse(RN) or licensed practical nurse(LPN) is not necessary unless you require medical treatment for health conditions such as tracheotomy,  wound care, catherization or any treatment that requires subcutaneous (or under the skin) treatment or injections. RNs and LPNs typically work in conjunction with PCAs/CNAs/HHAs to provide the personal care.

Legal Guidelines to Consider to Hire the Right In-Home Caregiver:

1. You may hire a caregiver through an agency or on your own. If you do hire a caregiver on your own that is referred to as a Private Caregiver. If you hire a Private Caregiver, the law classifies them as an employee and not a contractor. As an employer, you must collect and match federal taxes based on their rate of pay. At the end of the year you provide them with a W2 and not a 1099.
2. Agencies should provide their employees with Worker’s Compensation insurance. In most cases, the law requires Workman’s Compensation Insurance because it covers employees if they get hurt on the job, and it protects you. If you hire a private caregiver, you will need to provide Worker’s Comp insurance yourself or find some other way to protect yourself should they get injured on the job in your home. Typically, homeowner’s insurance does not cover injuries incurred by someone who is working for you.
3. If you hire a Private Caregiver, rather than use an agency, be aware of federal law when interviewing someone for the position. The law considers you an employer. As an employer you must stay clear of illegal questions, such as marital status, race, religion, and a whole host of other subjects.

Protect Yourself  Further
by Completing the Following Items:

1. Background checks*. Not only state background checks but nationwide background checks on anyone who is going to come into your home and provide care. If you only do a state background check, you could be dealing with someone who has a criminal record in another state. Do not go by your impressions about the person. Unfortunately, scammers and other criminals ability to be perceived as very “likable” and “nice” is how they successfully take advantage of their victims.
2. DMV report is essential if the person is going to be driving for you. If they are going to be driving your vehicle, you’ll also want to get a rider on your car insurance policy. Without the proper rider, you could be left financially responsible for injuries and damages in an accident.
3. A drug test should be conducted to ensure that the person is drug-free. There is no way to tell if someone is a drug user by looking at them. Drug tests should also be given randomly during employment.
4. It is essential to ask for and check references. Those references should not be friends or relatives. Ideally, they should be past employers, supervisors and coworkers. When checking references also be sure to avoid questions in violation of federal law. There are many questions you cannot ask.

Proper scrutiny of potential caregivers requires completion of the steps above and increases your opportunity to hire the right in-home caregiver. Since that person will be alone with you or your loved one, these steps help you find out if that person is all that she represents herself to be.

If You Hire an Agency, they Should Take Care of all the Previous Requirements.

However, not all agencies are the same, and you must scrutinize agencies. Be sure the company you select is licensed to perform the duties that you or your loved one will need today and maybe tomorrow.

Inquire whether they are completing all the above requirements, such as drug tests, nationwide background checks, etc. Do they have a good reputation? How long have they been in business? If they are
offering Personal Care, are they licensed by the state? Do they have actual employees, or do they use “contractors”? Check their reviews online. Ask for references or hand-written letters of thanks from customers. What are their policies? What kind of training and supervision of employees do they provide? What are their business practices, such as minimum hours, higher weekend rates, schedule changes, etc.?

Equipping yourself with this knowledge ensures that you hire the right in-home caregiver. We, at Covenant Home Care, take the responsibility of sending someone to your home very seriously. We provide you with a flexible schedule and care coverage that compensates for employee vacations, illnesses, or emergencies. With Covenant Home Care, you are never alone and always receive reliable and qualified care.

We have even created a checklist you can download and use when checking out agencies in your area and a worksheet on getting prepared to bring a caregiver into your home. Click to download our In-Home Care Preparation Worksheet and In-Home Care Agency Checklist. You will need a PDF reader to use these forms. If you do not have one, you can download Adobe Reader (which is free) here.

*Background checks have to be legal checks, which are more costly and reliable than your average “internet” background check. There are laws that cover background checks and how you can use them. Here is a page the covers laws state by state. Here’s a link to the USEEOC site for employers.