Your role in hiring
You are likely the advocate for bringing in extra hired help, while your parents are either opposing it or benefiting from it. Keep your parents as involved as they can be. You are bringing someone into their home for many hours per week, so they should get some say. Ask your parents what a good match looks like and use those goals and preferences to choose help. Try to present them with multiple choice options, not Yes/No. They don’t get veto power over a line of candidates; they get to choose which they want best. You bring them options; they choose from within those options.
Types of in-home help
Before you start looking to hire, give some thought to what support your parents need, want, and can afford. Experienced helpers will have different experience and job titles, and it is useful for you to know these when you’re looking to hire.
- Personal care aides / homemakers help with bathing, dressing, meals, light housekeeping, and errands. This is rarely reimbursed by health insurance, and many people work in these roles without formal licenses or certifications.
- Home health aides provide personal care plus some health-related help under professional supervision. These folks are more likely to wear scrubs and have credentials. Your parents may get some of these services reimbursed, but your parents and the aides may prefer to have them work longer hours for more pay and greater continuity of care.
- Skilled home health care (nursing or therapy) is ordered by a doctor and may be covered by Medicare for a limited time after a qualifying event. It is best to go through an agency to ensure the provider of these services is eligible for reimbursement.
Most non-medical in-home help is paid out of pocket or, for those who qualify, through Medicaid or VA programs.
Agency versus hiring directly
If you can afford the extra work and occasional gaps in coverage from hiring directly, it is a good option that will get more of your parents’ money going directly to their caregivers. I would do this, first, if I had any candidates in mind. If I ran out of personal options, I’d go to an agency.
- Through an agency: the agency screens, trains, insures, and can replace workers, and handles payroll and taxes. It usually costs more but adds oversight and backup.
- Hiring directly: often lower cost and more continuity, but you take on screening, background checks, taxes, and coverage if the person is unavailable.
Hiring safely
Whichever route you choose, interview candidates, check references and (for agencies) licensing, and confirm background checks. Or get your sibling to do this; it doesn’t have to fall on one person. Be clear about duties, schedule, and pay, preferably capturing these all in writing. (If you don’t know where to start, ask the internet for sample contracts and terms.) If possible, start with a trial period for the new worker. Do not ask them to do more than they are comfortable, and do encourage them to reach out to you if any problems arise.
Trusted resources
Next step
Prepare provider interview questions.