By Nicole Levison

You have heard the horror stories about abusive aides and financial nightmares due to lawsuits by home health care professionals.

And although these frightening incidents are rare, you certainly don’t want to win that lottery.

Whether your caregiving experience is a short-term or long-term situation, help is always welcome. If the person you care for requires substantial care, hiring support is an absolute must for your own sanity and the sake of your loved one receiving professional care. While you are sacrificing a tremendous part of your life to be a caregiver, you should not surrender your own health and well-being, or what good are you to the one you love?

What to Look For

If you have decided that a care facility, such as a nursing home or assisted-living facility, is not appropriate for your situation, consider employing a solid in-home worker who is experienced in a situation similar to yours.

• Assess your needs.
  
  Would a visiting nurse or someone with a therapy background be appropriate? Or maybe you need to invest in a case manager to help determine which home-care worker suits your requirements? Possibly a maid service or companion (non-medical) could be enough? Once you have identified what sort of assistance you need, you need to decide if you’re going to hire an individual (and be an employer) or use an agency’s services.
  
• Decide on an agency or an individual.
  
  One benefit of choosing an agency is that it is liable for the worker and generally manages the details like screening, paying state, federal, unemployment, social security, and disability taxes, workers’ compensation, and paperwork like the I-9 employment eligibility form (all of which are enormous responsibilities). An agency will also send a replacement if your worker needs time off, and insurance or government funding may cover an agency employee. The disadvantages of using an agency include that fact that you are not guaranteed to get the same person each time and you have less choice in the person the agency sends. Also, an agency is usually more expensive than hiring a private person.
  
• Find the right person.
  
  Obviously referrals from people you trust are valuable. Other valuable resources include colleges, places of worship, senior centers, hospitals, and organizations that have nursing or social-work programs. If you choose to advertise through a local registry (basically an employment service for home health aides and nurses)expect to pay fees.
  
• Conduct an interview.
  
  After you have narrowed down the candidates via phone or email, it is a good idea to have another person present at a face-to-face interview (possibly the person who will receive care) to offer another view. After reviewing the job description, ask the applicants if there are any tasks they cannot or do not feel comfortable doing, question them on past work experiences that relate to the position they are applying for, and get at least a couple of work-related and one personal reference. Once you recieve the person's references, check them—all of them.
  
• Go with your gut.
  
  Besides picking the most qualified individual and the one with the best references, choose the person with whom you and, if possible, the person receiving care are most comfortable. Whether the care recipient is more relaxed with someone of the same gender, culture, background, or age group, his/her wishes are a priority. If one job applicant has a demeanor that better suits your loved one, this is important!
  
• Sign a contract.
  
  Handshakes don’t really cut it in the real world. For an in-home care situation, you must sign a contract that includes:  
  • Job description (include duties and hours)
  • Wage information (include a payment schedule and particulars on howyour employee will be paid)
  • Benefits (paid time off, holidays, meals, etc.)
  • The individual’s tax identification number (Social Security number)
  • Any other expectations (such as no smoking in the house, how you wish the person to dress, termination terms, transportation needs, and dietary requirements)
  • Employment eligibility (I-9 form) and taxes. To find out more about your state’s regulations, call the employment department. To be safe, consult with an attorney or accountant.
    
• Establish mutual respect.
  
  Your employee will be spending a great deal of time and energy caring for someone you love dearly. Thus, it pays to stay in constant communication and voice expectations and concerns throughout your growing relationship. But be careful not to befriend this person completely—this person is someone whom you have hired. Establish that boundary early on for a better manager/employee relationship, and have weekly chats about what each of you needs and any concerns that arise. The old adage “nip it in the bud fast” is appropriate in these situations.

Many in-home employment options exist, but don’t become overwhelmed by the choices and fail to hire help when you need it most—before a crisis. If an emergency situation occurs, your judgment may be impaired and you will be looking for help as fast as possible. It’s rare in those cases to find the best person!

And remember to always give yourself a break—both literally and figuratively—and realize you are doing the best you can by educating yourself and making the best decisions you can for you and yours.