Finding a Geriatric Caregiver

If the time has come for you to find a caregiver for your aging relative, Shelly Sun, founder and CEO of BrightStar Care (a national caregiving franchise) has the following recommendations:

Start with the Basics

Begin your search with the fundamentals every provider must have:

  1. Insurance
  2. Licensing from the state in which the caregivers serve
  3. A thorough screening procedure for all employees

Potential caregivers should be screened via:

  1. Drug testing
  2. Personal interviews
  3. References
  4. Customary background and criminal checks

WHN TIP – Who Does What: Ask if the same caregiver will provide all the services or if the caregivers rotate. If the latter, try to meet each caregiver beforehand and then check with your relative receiving care if he or she was satisfied with the provider.

At a minimum, caregivers should be Certified Nurse’s Assistants (CNA) under the direction of a Registered Nurse (RN.) CNAs help with the tasks of daily living – bathing, dressing, and monitoring vitals, i.e. blood pressure, temperature, heart rate – but they cannot administer medication or offer medical care.

People who require on-going, in-home medical care should work with an agency that has nurses available.

Determine Your Loved One’s Needs

One of the biggest decisions you have to make is choosing medical versus non-medical care. Non-medical care is a great option for clients who need some help running errands or someone to keep them company during the day.

WHN TIP – Multi-Situational Agencies and Aides: Keep in mind that a non-medical client may turn into one who needs medical assistance. In order to offer continuity of care, look for an agency that provides aides qualified to work in all situations.

You also need to determine if your loved one will receive care in the home or will need to spend time in an adult daycare-type setting.

WHN TIP – Choose Agency-Employed In-Home Caregivers: It’s better to select in-home caregivers who are employed by an agency, rather than working as an independent contractor. Why? If your independent contractor gets hurt on the job, you could be sued and most homeowners’ policies do not cover a claim like that. There may also be tax implications. For more information, read Household Employer’s Tax Guide and Family Caregivers and Self-Employment Tax.

According to Loretta Worters, Vice President, Insurance Information Institute (I.I.I.), “The big issue for a caregiver would be any liability if he or she were injured on the homeowner’s premises. Although a homeowner’s policy covers a guest’s injuries, caregivers are excluded from coverage because they are employees. While most homeowners’ policies cover the people you pay to occasionally work for you, such as a teenager who baby-sits or cuts your grass, they specifically exclude anyone eligible for workers compensation coverage, including caregivers (it is mandated in some states, such as California).”

Worters recommends when using caregivers unaffiliated with an agency, purchase a workers compensation policy to pay the medical bills relating to injuries the caregiver receives on the job as well as coverage for lost wages if the caregiver is temporarily or permanently unable to work due to the injury. The policy will also prevent the caregiver from suing you for pain and suffering.

If you are planning to hire a caregiver, call your insurance company first because there may be other aspects (such as the caregiver residing in your home or using your car) that could impact your insurance. To be on the safe side, adds Worters, ask your insurance agent to add a liability rider to your existing policy, to cover any claims the caregiver may make in case of accident or injury.

For more information, read our 6 Senior Living Services Options article.

Interview the Agency

Questions to ask

  • What is the contract duration? Some agencies request a weekly or monthly commitment, which can be a costly decision if a patient decides to stop receiving care or enters a nursing home or hospital.
  • How can it be canceled? Is there a penalty for cancellation? Health needs can change weekly, especially when in elder years.
  • What type of forms must be signed and who must sign it? Note: Expect to sign a consent for care or service agreement. If you have power of attorney, you should be able to sign on your loved one’s behalf. Not sure? Check with your attorney first.

WHN Expert TIP – Consent Agreement: “The consent for treatment/service agreement typically entails the payment arrangements, whether a DNR (do not resuscitate) is in place, how holidays and overtime are handled, insurance coverage, cancellation less than 6 hours in advance, live-in work conditions required, patient’s rights and responsibilities, and advance directives,” says Shelly Sun. “The biggest items to be aware of are clauses that require long periods of time of advance notice for cancellation or minimum usage clauses.”

Meet the Caregiver

Your gut instinct is an invaluable factor in selecting a caregiver. Sometimes the first candidate is the right choice, and other times finding the best person can take time.

You should never be charged for interviews or limited to a certain number. If for some reason the first person doesn’t work out, you should be able to request a different caregiver.

If possible, arrange to spend some time together with your loved one and the caregiver, while allowing the caregiver to provide services. If care is provided at an adult daycare center, arrive a little earlier than expected to check on care and on the conditions of the facility in general.


For More Information

The following sites provide more information about hiring caregivers and caregiving resources.

  • Family Caregiver Alliance: Hiring In-Home Help — This fact sheet will help guide you through the process of hiring help at home. Founded in the late 1970s, Family Caregiver Alliance is the first community-based nonprofit organization in the country to address the needs of families and friends providing long-term care for loved ones at home. FCA, as a public voice for caregivers, shines light on the challenges caregivers face daily and champions their cause through education, services, and advocacy. The services, education programs, and resources FCA provides are designed with caregivers’ needs in mind and offer support, tailored information, and tools to manage the complex demands of caregiving.
  • AgingCare.com: Tax Implications of Hiring an Independent In-Home Caregiver — This article covers the tax rules on hiring non-agency caregivers. AgingCare.com provides families with the necessary information and support to care for their parents, spouses or other elderly loved ones.
  • AARP: How to Hire a Caregiver — This article covers the various types of in-home care workers. AARP is a nonprofit, nonpartisan, social welfare organization with a membership of nearly 38 million that helps people turn their goals and dreams into real possibilities, strengthens communities and fights for the issues that matter most to families — such as health care, employment and income security, and protection from financial abuse.