How to Hire Urgently Needed In-Home Care

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If you need help at home right now, the ideal solution may be to hire an in-home caregiver. These steps can help with this sometimes-daunting task.

1. Begin with a doctor's assessment for in-home care.

To help you understand what kind of caregiver to hire (such as someone with a nursing background versus more of a personal assistant), have the person in your care checked by his doctor. A doctor can also help determine whether in-home care is the best route or whether he really needs to move temporarily to a skilled nursing facility.

Helpful hint: If the person is acutely ill or recovering from surgery or another medical procedure, be sure to ask his doctor whether he's eligible for in-home care as part of his treatment, which may be covered by his insurance plan.

2. Determine your in-home care budget.

Before you can hire someone, you'll need to know how much money is available to spend for a caregiver. This will help you make important decisions about the salary and number of hours you can afford. Talk with the individuals and other family members to nail down roughly how much money you can pool to pay for in-home care to get started. Then you can start looking at other options for ongoing care.

If ongoing care is necessary, you can consider cashing in a life insurance policy or annuity, selling a home, or getting a reverse mortgage -- but none of these moves will get you cash in a hurry.

Helpful hint: The person may be eligible for some degree of in-home care coverage through health insurance, long-term disability insurance, Medicare, or Medicaid.

3. Plan an in-home care schedule

Once you know how much money is available for in-home care, and you have a sense of their needs, you can draft a caregiver's schedule. This is basically an outline of how many hours per day you want (or can afford) to hire someone to work, and what times and days work best for everyone involved. Then it's a matter of finding a caregiver to fit this schedule.

Helpful hints: When planning a caregiver's schedule, consider which needs can be reliably covered by you, family, or friends. This is an especially useful consideration if you're on a tight budget.

Then cluster caregiver tasks within a limited time slot, such as a morning shift for personal care -- bathing, dressing, grooming, and helping with breakfast or lunch.

4. Start your in-home care search.

Once you know how much money you have and the hours you hope to fill, you can start looking for a caregiver. The main ways to find in-home caregivers include word of mouth (asking for referrals from everyone you know, including medical staff, senior organizations, and religious communities), checking with online or newspaper classified ads, and using an employment agency that specializes in in-home caregivers.

The main difference between hiring independently and going through an agency is that agencies are usually more expensive but handle most of the paperwork, such as tax and social security forms. Agencies also screen employees. You can find agencies through the Internet (use search terms home health care or in-home senior care) or the telephone book.

Helpful hint: A great way to find in-home care and learn how much caregivers in your community are paid per hour is to go to your local Area Agency on Aging, which can link you to local senior agencies that provide a range of assistance, including finding in-home care.

5. Identify the right in-home caregiver.

When you're working fast, a few things can help you make a good caregiver match. First, weed out caregivers or agencies over the phone if they don't meet your scheduling or financial needs. Trust your instincts, ruling out anyone or any place you don't feel good about. Narrow down an "interview" list and meet these people in person, with the person in your care if this is appropriate.

Helpful hint: Brief yourself during the interview process, whether you're hiring an independent care provider or working through an employment agency.

6. Use an agency for in-home care, or hire a geriatric care manager.

If you can't find the right person and time is running out, consider using an agency that comes well recommended. Most agencies can accommodate urgent or short-term needs. This solution may be pricey, but it's an efficient way to get someone in to help immediately, buying you time to explore other options.

Another option, if you can afford it: Consider hiring a geriatric care manager to take over the in-home care reins -- it's often one of their specialties. While this can be expensive, it's an efficient way to get care right away and relieves you of much of the hiring hassle.

Helpful hints: Discuss the choices you're facing with friends and family. Get input from others. If the person in your care is up to it, include him as much as you can. After all, he's the one who really needs to be comfortable with the caregiver. You can find geriatric care managers through word-of-mouth referrals or by going online, to the yellow pages, or to your local Area Agency on Aging.

And remember, your decision isn't irreversible. If the caregiver doesn't work out, you can find another one. It's a disappointment and a hassle, but if you're persistent, you'll find the right person.

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By Kate Rauch, Caring.com senior editor