Finding the Right Support for Your Loved One’s Care Needs

When the time comes to bring professional caregiving support into your loved one’s life, the process can feel overwhelming. Whether you’re hiring a caregiver for home care or to complement care in a community setting, understanding how to find, evaluate, and select the right person is crucial for both your peace of mind and your loved one’s well being.

We are Nancy Treaster and Sue Ryan, we’ve developed five essential tips for hiring a paid caregiver, based on real experiences and practical advice from caregiving experts. These insights will help you navigate this important transition with confidence and clarity.

The Importance of Planning Ahead

Before diving into our tips, it’s worth emphasizing one critical point: the best time to start this process is before you need help immediately.

Nancy Treaster explains:

The best thing you can do is get through as much of this process as possible before you desperately need a caregiver. Understand if you’re going to use an agency, understand if you’re going to go private, and have an idea of who those caregivers might be because you never know when you’re going to get in a situation where you’re not going to have time to go through this process in the ideal order and over the ideal period of time.

This proactive approach allows you to make thoughtful decisions rather than rushed ones during a crisis. We’re sharing five essential tips for hiring a paid caregiver.

Tip 1: Assess Your Loved One’s Needs

Before you begin searching for a caregiver, it’s important to thoroughly understand what kind of support your loved one requires. This assessment will guide all your subsequent decisions about the type of caregiver, frequency of care, and specific qualifications needed.

Consider these key areas when assessing needs:

Activities of Daily Living (ADLs)

• Can your loved one dress, bathe, and feed themselves?
• Do they need help with mobility, such as sitting down, getting up, or moving through the house?
• Can they use the phone in case of an emergency?

Medical Needs

• Do they require assistance with medication management?
• Is wound care needed?
• Do they need specialized health monitoring?

Household Management Tasks

• Do they need help with laundry, housekeeping, or meal preparation?
• Can they manage basic household functions like adjusting the thermostat or turning lights on and off?

Safety Concerns

• Are you worried about their safety when they’re home alone?
• Do they remember to unplug appliances like irons?
• Do they leave the stove on?
• Can they safely use knives, cleaning products, and personal care items?

Transportation and Mobility

• Can they drive safely during the day and after dark?
• Is their mobility stable enough for them to move around independently?

Companionship Needs

• Are they becoming socially isolated?
• Do they need more social interaction or activities?

Deal Breakers

Consider these “deal breakers” that might indicate your loved one shouldn’t be living alone*:

1. Can they contact someone in an emergency (either by pressing a button or making a phone call)?
2. Can they take their own medication?
3. Can they prepare a meal and feed/hydrate themselves?
4. Do you feel they’re safe when home alone?

A thorough needs assessment will help you determine if you need a caregiver and also what specific type of care is required.

*We cover these in more detail in our podcast episode #6: Leaving Your Care Receiver Alone: Six Essential Tips / Alzheimer’s and Other Dementias.

Tip 2: Determine the Type of Caregiver and Frequency Needed

Based on your assessment of needs, the next step is determining what kind of caregiver will be most appropriate and how often they’ll need to provide care.

Types of Caregivers

There are three main categories of paid caregivers, each with different training levels and capabilities:

Companion Care

Companions provide basic assistance and social interaction. They typically:

• Offer companionship and social engagement
• Perform light housekeeping
• Help with meal preparation
• Provide transportation to appointments or activities.

Certified Nursing Assistant (CNA)

CNAs have specialized training to provide more comprehensive personal care. They can:

• Assist with activities of daily living (ADLs)
• Help with bathing, dressing, and grooming
• Manage incontinence and toileting needs
• Administer some medications
• Provide companion services, including housekeeping and meal preparation.

Skilled Nursing

Skilled nurses include registered nurses (RNs), licensed practical nurses (LPNs), and other licensed healthcare professionals like physical, occupational, and speech therapists. They have advanced medical training to handle complex health needs:

• Provide wound care
• Manage specialized medical equipment
• Administer medications
• Monitor health conditions requiring medical expertise
• Perform certain medical procedures.

Frequency and Scheduling

After determining the type of caregiver needed, consider how often you’ll require their services:

• Daily care (part-time or full-time)
• Several days per week
• Specific times of day (mornings, evenings, overnight)
• 24/7 care.

As Sue points out, you can mix different types of caregivers based on specific needs:

Maybe you need skilled nursing twice a week for wound care, but you don’t need it every single day. You can mix these kinds of caregivers together because there is a difference in the types of care they provide and how much you’re going to pay for the kind of caregiver based on your needs.

Consider Preferences and Practicalities

While assessing the type and frequency of care, it’s also worth considering any preferences you or your loved one might have regarding:

• Gender of the caregiver
• Cultural background
• Age range
• Specific experience with your loved one’s condition.

Be prepared to be flexible with these preferences. As Nancy shares from her experience:

I thought I wanted a male companion. That’s what I had in mind. Well, when I finally got down to who could come to my house, it was a female CNA. My first reaction was, “Well, that’s not what I need, but fine, I’ll try her.” She came and honestly, it didn’t take but a few opportunities for her to interact with my husband and help participate in his care for me to realize this was perfectly fine.

Remember that finding the perfect match might require some compromise, especially given the realities of caregiver availability and scheduling constraints.

Tip 3: Understand Your Financial Resources

Before actively seeking paid caregiving support, it’s important to get a clear picture of what you can afford and what financial resources are available to you.

Review Your Financial Resources*

Start by examining:

• Savings and investment accounts
• Long-term care insurance policies
• Regular income sources
• Family financial contributions.

*We cover these in more detail in our podcast episode #28 Time for a Change? Tips When Considering Home and Community Living Options: Five Essential Tips / Alzheimer’s and Other Dementias.

Explore Available Benefits*

Several programs might help cover caregiving costs:

Medicare

While Medicare generally doesn’t cover long-term custodial care, it may cover some home health services under specific conditions, usually for a limited time following hospitalization.

Medicaid

Medicaid programs vary by state but often cover home care services for eligible individuals. Working with an elder law attorney can help navigate Medicaid planning and eligibility.

Veterans Benefits

If your loved one is a veteran, they might qualify for various benefits:

• Aid and Attendance benefits for veterans and surviving spouses who need assistance with daily activities
• VA-approved in-home care services
• Respite care benefits.

*We cover these in more detail in our podcast episode #31 They Know What We Don’t, Elder Law Attorneys: Four Essential Tips / Alzheimer’s and Other Dementias.

Nancy’s experience with her father-in-law:

He was a veteran, so we were able to leverage Veteran’s Administration (VA) benefits. The VA came to him and evaluated how much care they were willing to pay for. He was granted 16 hours a week. We split that into four, four-hour days of care paid for by the VA, and we used an agency that the VA approved of.

Consider Family Contributions

Family members who can’t provide hands-on care might be able to contribute financially.

Sue explains:

For some people who may not be able to physically be there, a financial contribution is something that helps them feel part of caregiving support.

Think Long-Term

Caregiving needs often evolve over time. Sue shares:

Our caregiving journey is a marathon. It is not a sprint. When we’re looking at what our costs are now, it’s for this phase of our journey. It’s very important for us to also be considering what costs may be coming down the road.

Planning for potential future care needs, such as assisted living or skilled nursing care, can help you make important and sustainable financial decisions now.

Tip 4: Decide Between Agency or Private Hire

One of the most significant decisions you’ll make is whether to hire a caregiver through an agency or directly as a private caregiver. Each approach has distinct advantages and challenges.

Agency Benefits

When you work with a caregiving agency:

They Handle Administrative Tasks

• Background checks and screening
• Payroll, taxes, and insurance
• Verifying qualifications and credentials.

They Provide Backup Coverage

• If your regular caregiver is sick or unavailable, the agency typically provides a replacement
• This reduces the risk of being left without care unexpectedly.

They Offer Training and Supervision

• Most agencies provide specialized training for their caregivers
• They usually offer supervision and quality monitoring.

They Assume Liability

• The agency is responsible if something goes wrong
• They carry insurance to cover potential issues.

Private Hire Benefits

When you hire a caregiver directly:

It’s Usually Less Expensive

• Private caregivers typically cost less, sometimes up to $10 per hour less than agency caregivers
• You avoid agency overhead and administrative fees.

You Have Complete Control

• You select exactly who provides care
• You establish the relationship and care plan directly.

There’s Often More Flexibility

• Private caregivers may be more willing to work shorter shifts (less than the typical 4-hour minimum)
• They might be more adaptable to changing schedules or duties.

You May Find Through Word-of-Mouth

• As Nancy notes: “Often you can find private caregivers through word of mouth. And so they come sort of pre-recommended.”

Private Hire Challenges

Private hiring does come with responsibilities:

You’re the Employer

• You’re responsible for taxes, insurance, and legal compliance
• You’ll need to handle paying them and any required paperwork.

No Backup Coverage

• If your caregiver can’t work, you’ll need to find a replacement
• You’re responsible for ensuring continuous care.

Limited Screening Resources

• You’ll need to conduct your own background checks
• You’ll have to verify credentials and experience yourself.

A Mixed Approach

Many families find that a combination works best: Nancy shares:

I did a mix at my house. Part of that is figuring out if some care will be paid for by either Medicaid or the VA or some other long-term care insurance. Where the contributions are going to come from may help you make that decision.

Agency Considerations

If you do choose an agency, remember that not all are equal: Nancy explains:

You can’t assume that the training is the same across agencies, and you can’t even assume it’s the same based on price. We had one agency that we used that it was clear to me that their caregivers were much less trained than another agency we used. And when I went to increase the number of hours because we needed to go to 24/7 care, the agency that had less trained caregivers actually costs more than the other agency did.

Tip 5: Evaluate potential caregivers thoroughly

Once you’ve determined the type of caregiver you need and whether you’ll hire through an agency or privately, it’s time to interview potential caregivers. This step is extremely important for finding someone who will be a good fit for your loved one.

Key Questions for Interviews

Whether interviewing an agency representative or a private caregiver, ask about:

Scheduling and Availability

• What hours and days are they available?
• What are their minimum hour requirements?
• How much advance notice do they need for schedule changes?
• What’s their backup plan if they can’t make a scheduled shift?

Qualifications and Experience

• What specific training do they have?
• What certifications or credentials do they hold?
• How much experience do they have with your loved one’s condition?
• Can they provide specific examples of how they’ve handled similar care situations?

Approach to Care

• How do they typically handle difficult behaviors?
• What’s their philosophy on providing care?
• How do they balance promoting independence with ensuring safety?
• How do they handle emergencies?

Communication Style

• How will they keep you updated about your loved one’s condition?
• How do they prefer to receive instructions or feedback?
• How responsive are they to calls or messages?

Background Checks and References

Verify:

Professional Background

• Previous employment history
• Certification verification
• Criminal background check.

For private caregivers, Nancy advises:

Make sure you ask for at least three references. Make those calls and talk to the people about the caregiver.

Ask for the pros about this caregiver as well as the cons about this caregiver, ensuring they’re sharing some negative things about this caregiver. You get more insight out of this than probably anything.

Conduct a formal background check (available through online tools for approximately $50).

Set Clear Expectations

Especially for private hires, establish from the beginning that the arrangement is on a trial basis.

If you hire a caregiver through an agency, by default they’re on a trial basis. Meaning, if you’re not happy with the caregiver, you call the agency and say, don’t send this person to my house again. You don’t have to have a conversation with the person. So you’re off the hook for the confrontation and the difficult conversation.

If you hire someone privately, and don’t want them to come back to your house, you’re the one making the call and telling them that.

Setting expectations up front makes any potential termination conversation easier.

Include Your Loved One When Appropriate

For the final interview of your top candidates, consider including your loved one if appropriate:

Sue recommends:

When we’ve completed our research and we’re now down to the finalists, if it makes sense, we want to have a final interview and include our care receiver.

This gives you an opportunity to observe how the caregiver interacts with your loved one and gauge compatibility, while also giving your loved one some input in the decision-making process.

Next Steps: Care Plans and Integration

Once you’ve hired a caregiver, two important steps remain to ensure a successful caregiving relationship:

Create a Documented Care Plan

Develop a written plan that clearly outlines:

• Daily routines and schedules
• Specific care tasks and how they should be performed
• Medication instructions
• Emergency procedures
• Important contacts
• House rules and preferences.

Develop an Integration Strategy

Plan how to introduce the caregiver to your loved one and help them build a relationship:

• Start with shorter shifts if possible
• Be present initially to facilitate the transition
• Establish clear communication channels
• Schedule regular check-ins to address any concerns.

These steps help set the foundation for a successful caregiving relationship.

Conclusion: You’ve Got This

Hiring your first paid caregiver is a significant step in your caregiving journey. It can feel overwhelming, but breaking it down into these five manageable steps makes the process more approachable:

1. Assess your loved one’s needs
2. Determine the type and frequency of care required
3. Understand your financial resources
4. Decide between agency and private hire
5. Evaluate potential caregivers thoroughly.

As Nancy reassures:

Hiring your first paid caregiver can be an overwhelming experience, but you’ve got this.

This process doesn’t have to be perfect the first time. You may need to try different caregivers before finding the right fit, and your needs may evolve over time. The most important thing is taking that first step toward getting the support both you and your loved one need.

Connect with us and share your tips:

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We’re all on this journey together.

Frequently Asked Questions

How do I know when it’s time to hire a paid caregiver?

Consider hiring a caregiver when you notice your loved one struggling with daily activities, when safety concerns arise, when your own caregiving responsibilities become overwhelming, or when a medical professional recommends additional support. Ideally, begin exploring options before you’re in a crisis situation.

How much does a paid caregiver typically cost?

Costs vary widely based on location, type of care (for example, skilled nursing care costs more than companion care), and whether you hire through an agency or privately. Be sure to check multiple sources in your area.

What’s the difference between a companion, CNA, and skilled nurse?

Companions provide basic assistance and social interaction. CNAs (Certified Nursing Assistants) have specialized training to help with personal care like bathing and toileting. Skilled nurses have advanced medical training to handle complex health needs like wound care or managing medical equipment.

How do I verify a caregiver’s qualifications?

Ask for copies of certifications, contact their training program to verify completion, check references from previous employers or clients, and conduct a background check. If hiring through an agency, ask about their verification procedures.

What should I include in a written care plan?

A comprehensive care plan should include daily schedules, detailed care instructions, medication information, dietary requirements, emergency procedures, important contacts, and personal preferences. The more specific you can be, the better.

What’s the minimum number of hours most caregivers will work?

Most agencies require a minimum of 4 hours per shift. Private caregivers may be more flexible, but many still prefer shifts of at least 2–3 hours to make it worth their time and transportation costs.

How do I introduce a new caregiver to my loved one?

Plan a gradual introduction if possible. Be present during the first few visits, provide a detailed orientation, focus on building rapport between them, honor your loved one’s feelings about the transition, and maintain open communication with both your loved one and the caregiver.