How to Hire a Home Care Aide

Hiring a home care aide can be a daunting experience. This article takes you through the
process step-by-step.

Whether you are looking for a home care provider or have utilized home care services previously, United Spinal Association offers the following tips on locating, training, and managing a personal home care provider. This information will be applicable to you whether you pay out-of-pocket for services or receive funds for home care through a state program. You have a right to choose a home care provider that best matches the qualities and experience you decide on. At the end of this article, there is a sample Employment Contract you may use to help you in hiring an attendant or aide.

Getting Specific About Care Needs

The term “home care” covers a wide range of services. It can mean help with your complex medical procedures, such as changing catheters and inserting feeding tubes and breathing devices, or with your personal care, such as helping you to bathe, eat, dress, and use the toilet. It can also mean help with simple procedures, such as household tasks, grocery shopping, meal preparation, and accompanying you to your doctor’s appointments.

Your doctor and/or hospital discharge planners can help you develop a list of tasks for which a home health aide is needed. You need to have full input into this process, however, for only you know the amount of available support you can expect from your relatives and friends.

Interviewing Job Candidates

You can place an ad in a local paper or post an ad on bulletin boards at churches or synagogues, senior centers, or local shops. Other sources for finding home health attendant job candidates include personal referrals, the job-placement centers of colleges, universities, or schools of nursing, and queries to adult daycare centers and local departments of aging.

Step 1-Assess Your Needs

• What tasks will you need assistance with from a home care provider?
• Is the task considered a health-related task?
• When do you need the assistance and how long will each task take?
• What skills and qualifications would you like your home care provider to have?
• What equipment will you need to use?

Step 2-Determine Employment Arrangements Based On Your Needs and Resources

You will need to know what kind of care you can afford that best fits your needs, and whether you can receive whole or partial reimbursement. Some options include:

• Arrange for in-kind payment, such as room and board, for home care provider services
• Arrange for in-kind payment, such as free rent, plus salary
• Pay a flat hourly rate
• Share in a fixed cost or hourly rate with another consumer
• Receive financial assistance from a state or federal program such as Medicare or Medicaid

Step 3-Recruit and Advertise

When recruiting a home care provider, it is important to determine what qualities or training level you would like in a personal assistant and find someone who is able and willing to perform the job. If you receive financial assistance from a state or federally funded program, state agencies typically contract with a provider agency for direct services. If you find individuals you wish to hire for regular and back-up assistants, however, they must be willing to become an employee of the provider agency.

The more complete your information, the more confident you can be that the prospects that contact you are truly interested and potentially qualified for the job. It is a good idea to include your name, and contact telephone number, a job title, and a short description of the job you’re seeking to fill. You might also include the hours of the job, the qualifications of the ideal employee, details of compensation and benefits offered, and your location.

There are many ways you can advertise and recruit a personal home care provider:

• Newspaper advertisements/classified ads
• Local company newsletters—contact disability and community-based organizations
• Colleges—contact student career placement office, request health majors
• Word of mouth—ask family, friends, and neighbors
• Local agencies—contact social service organizations
• Home health care agencies
• Bulletin boards in high traffic areas—grocery stores, banks, churches
• Local employment offices/rehabilitation agencies—local Department of Labor

Step 4-Screening Applicants

The Initial Telephone contact

• Ask for the applicant’s name, phone number, and address
• Give a brief description of the duties of the job, hours, and pay
• Ask if they have ever assisted or worked for a person with SCI before
• If the job includes bowel/bladder care, and there are times when you will not be wearing clothes, be sure to tell the applicant
• Ask if they have any experience in lifting, transferring, and positioning
• Ask if they smoke or are allergic to pets
• Ask if there are tasks they object to performing
• Ask if they can cook and would mind doing light housework if necessary
• Ask what days and hours they are available for work
• Ask if there are days they definitely cannot work
• Ask if they have reliable transportation
• Close the call by telling the applicant you will call back for an appointment for a face-to-face interview
• Even if the person is unsuitable for the job, always thank them for their interest

The Personal Interview

Call all of the applicants that appear to be good prospects and schedule each for a face-to-face interview. About one hour for each interview is usually adequate. Some things may need to be repeated from the telephone contact for clarification purposes.

• Help the person feel as comfortable as possible and get to know each other a little
• Tell the person about your disability
• Ask the applicant to fill out an application if you have one
• Explain the job description, duties, and responsibilities thoroughly
• Ask them to tell you about him/herself
• Ask about past work history, reasons for leaving last employer
• Describe the work schedule, pay method, and any benefits and leave plan
• Allow the applicant the opportunity to ask questions
• Tell the applicant you will call as soon as you make a decision
• Thank them for their interest and time

Step 5-Back-Up Assistants

Back-up or substitute assistants are the persons you can call in the event that your regular personal home care provider cannot work. Substitutes can be used when your attendant is on vacation, is ill, or quits without notice. It is recommended to keep a minimum list of three back-up assistants to guarantee you get the help when you need it. You can find substitutes in several ways.

• The best method is to recruit and hire back-ups just as you would your “regular” assistant. Keep names and phone numbers of applicants willing to serve as back-ups.
• Friends, neighbors, and family members can be on stand-by for emergencies.
• Requesting that your assistant find his/her own replacement when unable to work could be helpful as well.
• Hiring two assistants on a split schedule has worked for many individuals, as well.

Sample home health aide contract .

Employment contract between:

Employer (your name) _________________________________

and Employee (personal care provider’s name) _________________________________

Salary $ __________per hour

Fringe benefits_________________________

Terms of payment: when_____ how_____

Schedule of work hours: from_____ to _____ on: _______________________

Employee’s Social Security Number________________

HOUSEHOLD TASKS:

__Light Housekeeping __Bedmaking __Cooking __Laundry __Escort on Trips __Take Out Garbage __Errands __Shopping __Washing Dishes __Companionship __Support

PERSONAL CARE TASKS:

__Bathing __Grooming __Dressing __Feeding __Getting Around __Getting In Bed __Getting Out of Bed __Exercise __Medication Reminders __Diet Planning

SCHEDULE FOR DUTIES TO BE PERFORMED:

Household Tasks: dust and vacuum ___x week; wash laundry once a week; change sheets ___x week; mop kitchen ___x week; shop for food ___x week; washes dishes after each meal

Personal Care Tasks: Assist with bath and shampoo ___x a week; Cook breakfast and lunch daily; Set-up dinner daily; Provide some conversation; Transport to doctor’s appointment once a month

Non-Acceptable Behavior: Smoking at work, using foul language, evidence of intoxication, coming to work late.

TERMINATION:

Each party will give two week’s notice before termination of this contract.

Reasons for termination without notice include theft, failure to carry out duties, evidence of non-acceptable behavior, and endangering employer’s health or safety.

For unsatisfactory work, the employer will give two warnings. If the work continues to be unsatisfactory, a termination date will be set.

Signed: ______________________________ (Employer)
Date: ______________________

Employee ____________________________ (Employee)
Date: _______________________

Additional Resources

American Association of Retired Persons, 601 E. St., NW, Washington, DC 20049. Call (202) 434-6030 or write for free pamphlets:
• A Handbook About Care in the Home
• A Consumer’s Guide to Homesharing
• The Doable Renewable Home: Making Your Home Fit Your Needs
• Your Home, Your Choice

National Association for Home Care, 519 C St. , NW, Washington, DC 20002. Call (202) 547-9559 or write for free pamphlet:
• How to Choose a Home Care Agency

National Association of Area Agencies on Aging 1112 16th St., NW, Washington, DC 20036. (202) 296-8130

Eldercare Locator (800) 677-1116. Call Eldercare Locator for assistance in finding the most appropriate information source for home care anywhere in the country.

Suggested Reading

Home Care for Older People: A Consumer’s Guide, by Anne P. Werner and James P. Firman (United Seniors Health Cooperative, 1994)

The Caregiver’s Guide: Helping Elderly Relatives Cope with Health and Safety Problems, by Caroline Rob and Janet Reynolds (Houghton Mifflin, 1991)

A Consumers Guide to Home Health Care, by Barbara Coleman (National Consumers League, 1985)

Golden Opportunities: Hundreds of Money- Making, Money-Saving Gems for Anyone Over Fifty, by Amy Buddish and Arnold Buddish (Serif Press, 1994)

Home Safety Guide for Older People : Check It Out/Fix it Up, by John Pynoos and Evelyn Cohens (Serif Press, 1990)

Retirement Income on the House: Cashing in on Your Mortgage with a Reverse Mortgage, by Ken Scholen (Serif Press, 1998)

Home Health Care, by Jo-Ann Friedman (W.W. Norton, 1986)

Caregivers and Personal Assistants: How to Find, Hire and Manage the People Who Help You (or Your Loved One!), by Alfred H. DeGraff, M.A., S.E.A. (Saratoga Access Publications, 2002)

The Medicare Handbook (U.S. Department of Health and Human Services)

Safety for Older Consumers: Home Safety Checklist (U.S. Consumer Product Safety Commission, 1991)

Charlotte Bethune-Fisher is a case manager at United Spinal.