Choosing a provider to assist you or your loved one at home is never easy.  Often, the home health aide will be in full charge of the household for their care recipient in addition to providing personal care.  So how do you find the right provider?

The first step is to correctly identify the needs of your particular situation. Does the care recipient need a companion, driving to appointments or on errands, or help with meal preparation?   Or does the individual require skilled services such as wound care or managing a feeding tube? Or are their needs somewhere in between with help required for activities of daily living such as bathing, dressing, and safely moving about?   It is important to understand that there are several levels of licensure for caregivers.  So, the first step is to obtain a professional assessment from a licensed home health provider or a geriatric care manager to determine the specific needs and the appropriate level of licensure required.

Once you have an understanding of the license that will be required to meet the care needs, you are ready to begin your search for the right person.  The first decision you must make is whether to work through a licensed agency or registry or whether you plan to try to find someone privately.  I have a strong bias toward working with a licensed care organization because it puts a professional in the position of selecting candidates for you and because it creates a backup plan in the event that the caregiver you hire quits, is ill, or doesn’t show up one day.  However, if you choose to work with a licensed care organization, be sure that you understand the differences between the agency model and the registry model in general and for the particular provider you are engaging.  Generally speaking, agencies employ their caregivers whereas caregivers working with registries are treated as independent contractors.  This has implications for insurance, liability, pricing, and supervision.  However, that does not mean that you should only work with one or the other because it is the ownership and management of the entity that determines the quality of the operation.

As with so many services, it is critical that you obtain recommendations from people you trust to narrow your search down to a few registries or agencies.  Meet with the ownership or local management and get comfortable with how they do business.  Don’t be afraid to ask lots of questions, such as “What happens if the caregiver and care recipient isn’t a match?”  Or, “How are issues that arise over the weekend handled?”  Find out about how the company selects, trains, supervises, matches, and disciplines its caregivers and management team.   Make sure you understand what will happen if your care needs exceed their license in the future, as well as all contractual obligations such as minimums, cancellation notices, and extras.

Once you have settled on a care provider, it’s time to match up your needs with a caregiver.  If there are any special requests or concerns, the time to mention them is before a caregiver is matched to you.  For example, one of my clients had several exotic pets and we wanted to be sure that this wouldn’t become an issue for a caregiver.  In another case, the client was quite large and we wanted to be sure that the caregiver would be strong enough to properly assist her.  Such requests might be directly related to the ability to provide the care or simply personal preferences, but it is always best to disclose and discuss them upfront.

Request to interview at least two potential caregivers for every shift.  In other words, if you will have someone coming in three days each week, make sure that it will generally be the same person each time, and then interview two candidates for that job.  If you are looking for a live-in, try to meet a couple of possibilities before agreeing to a placement.

Once your caregiver is on the job, it is important to give everyone a chance to settle into the arrangement.  It will probably take at least a few days or visits to have an idea regarding how well the situation is working.  It is not unusual to have to tweak things a bit and using a licensed organization to source your caregiver should facilitate this.  Change is hard for all of us, so give it a chance and don’t jump too quickly to make a change unless you feel that the situation is dangerous.