Hiring a home health care worker without an agency

What it is

If you want to hire a home health care aide for your parent or older family member without using an agency, you will be assuming the role of an employer. This means that you are responsible not only for interviewing, hiring and managing the home health care worker, but also withholding, reporting and paying all appropriate taxes. This guide provides instruction on how to create a job description, interview and vet prospects, select the most appropriate caregiver and monitor care on an ongoing basis.

As you begin the process of hiring a home health care aide for your parent, keep in mind you want to find one whose skills and experiences match your parent's needs for help with routine tasks, as well as managing issues related to medical conditions. The following steps will help you to ensure you find the best possible caregiver.

Create a job description

Begin by thinking through what your parent's day is like and what kind of help she/he needs to get through it. This could include assistance taking medications, getting to and from the bathroom, preparing meals, taking a bath or shower, getting dressed or doing physical exercises. From a health care perspective, consider if your parent has any medical conditions that need special attention, as well as symptoms that the caregiver must be aware of so that she/he knows when to alert your parent's doctor.

Next, ask your parent to share what she/he would like a home health care aide to do. At this stage, you should also talk about your expectations. The goal is to have everyone in sync, so that you can create a good caregiver job description - one that is realistic, serves your parent's best interests and allows prospective caregivers to assess whether they are suited for the job.

Interview questions and tips

It is a good idea to interview candidates at a neutral place, like a local coffee shop. This way, especially if your parent lives alone, you won't be disclosing specific vulnerabilities to a stranger.

Inform the candidate of your parent's medical condition(s) and ask what he/she knows about these conditions and how to respond to them. Ask about previous experience caring for someone with the same conditions.
Share the caregiver job description and go over each item on the list. Ask how the caregiver would manage each of your parent's needs.
Ask the worker to describe any training he/she has received for each of the tasks described.
Ask the caregiver to show any certificates or educational degrees received.
Ask for a résumé that identifies schools or training programs, previous jobs and contact information for previous employers.
If your parent has dementia, find out what specialized training the caregiver has received to work with cognitively-impaired adults.
Ask if the caregiver has received training on how to lift people and assist with a bath. What safety measures are used?
Ask the worker to identify any physical demands of caring for your parent and how they will be addressed.
Ask the caregiver to provide you with a copy of the results of a police background check.
Request a list of references - and call them. Make sure that at least two references are from families who have used the caregiver's services. If you're hiring a certified nurse aide, check references with your state's Certified Nurse Aide Registry, which is usually run by the state's department of health and/or human services.

After you've narrowed down your search and checked references, you can then invite a potential caregiver into the home and see how he/she interacts with your parent.

Stay involved

Once you've hired a home health care aide, ask for a daily phone call to update you on how your parent is doing. As time goes on and you feel secure with the services, then an update every few days or even once a week should be sufficient.

At the beginning, it's also a good idea to stop by occasionally to see how things are going and check on how your parent and the caregiver are interacting.

Caregiving is a dynamic and evolving process that must constantly adjust to changes in your parent's health and care needs. It's important for you to stay involved and monitor the effectiveness of caregiving services.

The bottom line

If you want to hire a home health care aide for your parent or older family member without using an agency, you will assume the role of an employer. This means that you are responsible not only for interviewing, hiring and managing the care worker, but also withholding, reporting and paying all appropriate taxes.
Use a thorough interview process to find a caregiver whose skills and experiences match your parent's needs for help with routine tasks, as well as managing issues related to medical conditions.
It is vital for your parent's safety to conduct background and reference checks on potential caregivers.
Caregiving is a dynamic and evolving process that must constantly adjust to changes in your parent's health and care needs; stay involved and monitor the process on a constant basis.