Hiring a home health aide for a loved one? Do your homework first

It was supposed to be a simple knee replacement surgery, but in an instant, life turned upside down for Chester Routt and his family.

“He went into surgery a perfectly healthy man and came out unable to talk or function,” said Sandy Batson of her beloved brother, Chester. “He suffered a stroke during or after surgery.”

Anger and utter sadness overwhelmed Batson, who lives in Rittman, Ohio. Yet sibling instinct fueled her next move. There was no other family member to step in, and she didn’t want a stranger in his house.

Batson’s self-determination thrust her into a life of caring for her brother around-the-clock. It was a life, however, that she soon realized she could not handle alone.

“Outside help was the only alternative,” she recalled.

The demand for home health aides and personal care aides  is set to jump 41 percent through 2026 as the Baby Boomers age. That’s nearly six times faster than the average growth rate of a U.S. job.

Batson eventually broke down and hired a home health aide—a rapidly growing trend in the United States. According to the Bureau of Labor Statistics, the demand for home health aides and personal care aides is set to jump 41 percent through 2026 as the Baby Boomers age. That’s nearly six times faster than the average growth rate of a U.S. job.

But knowing where to turn first for help can be daunting. Here are some tips based on interviews with experts in the industry.

First, figure out the type of care you need for your loved one and how you can pay for it, said Roberta Woodard, a human resources manager for Home Instead, a home health care agency in Fairlawn, Ohio. “Do they need companionship? Or do they need medical help throughout the day as well?”

If medical help is needed, a doctor’s order is required to hire skilled care. Medicare, Medicaid and most private insurance plans normally pay for such services. If it’s custodial or personal care you’re looking for (bathing, dressing, preparing meals, etc.), Medicare will also cover, but for a limited time. Insurance carriers may also provide coverage for some amount of custodial care, but it’s important to note that individual consumers usually pay at least a portion out-of-pocket every month as many health care plans don’t cover everything.

When paying out of pocket, the cost of home health care varies greatly based on the amount and type of care needed as well as geographic location. According to Genworth Financial, a global insurance holding company which conducts an annual cost of care survey, the median hourly rate in 2018 for a home health aide was $22. Yet, the Bureau of Labor Statistics estimates $11.57/hour for the same year.

Next, decide whether you want to hire help through an agency or on your own. An agency allows you access to pre-screened caregivers, back-up care in case your primary caregiver is sick or on vacation, and the comfort of knowing that an agency is often bonded, insured and assumes liability of the caregiver. Yet, an agency can be a more expensive route to go and may offer you less flexibility in the type of caregiver you want.

If you go solo in this endeavor, it’s up to you to act as the employer. That means performing background and reference checks, discussing duties and salary, providing the necessary training and supervision, assuming liability of the caregiver in case of injury, and taking care of payroll taxes.

Hiring through an agency

If the next step is hiring help through an agency, ask friends, family and community agencies for recommendations. Then, interview each one, asking about the following: Do they perform background checks, reference checks, and do they fingerprint employees? What is their standard operating procedure if there’s an accusation of theft in the home?

“If an agency says they’ve never experienced an accusation of theft, walk away,” added Woodard. “A reputable agency will be honest. Accusations are extremely common, particularly as elderly forget where they’ve placed their belongings or put things in peculiar places.”

Other questions to ask agencies: Do they continue to bill if the loved one goes to the hospital? What is the back-up plan if a caregiver doesn’t show up on a given day? How do they train caregivers?

“When it comes to training, performing skills assessments is much more effective than watching training videos,” said Woodard.

Hiring on your own

If you go solo, you will want to post a job description online or at your local senior center. Call your area agency on aging, or check out state and local registries. Registries list caregivers to hire.

Consider hiring two caregivers, in case one is sick or goes on vacation.

Prepare for the interview

Whichever route you go, prepare a detailed job description, write questions out ahead of the interview process, and have your loved one present throughout that process. Allow him or her to ask questions and interact with the candidate.

“You have to ensure the best possible care for your loved one,” said Woodard. “Most people wait entirely too long. So, it’s important that when your loved one’s safety becomes an issue – maybe they’re leaving the stove on or a candle burning, or you find out they’re being taken advantage of – you start the process of figuring out what’s next.”

Looking back, Batson has no regrets hiring a home health aide for her brother. He died a few years ago, about the same time her life took a downturn once again. Batson’s husband started to show serious signs of aging.

“He is more like a child now than a 94-year-old man,” said Batson.

Batson now has a part-time aide for her husband, costing the couple about $500 per month. But, for her, the money is worth it. In return, she gets a much-needed mental and physical break and peace of mind.

“Our caregiver is a gem and a wonderful person,” said Batson.


Additional tips when hiring help through an agency

  • Ask if management does routine quality assurance visits. If not, that’s a red flag.
  • Check if an agency representative is available at all times in case of questions or concerns
  • Make sure the agency is a member of the Better Business Bureau

Additional tips when hiring help solo

  • Do your homework on candidates and check to make sure the individual has a home health aide license
  • Ensure the caregiver has been screened for communicable diseases
  • Aides aren’t friends. Keep it professional.

This article first appeared on MemoryWell.

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