Hiring a Live-in Caregiver entails similar decisions about hiring hourly workers, and whether or not you wish to use an agency, or go it alone. These include how much responsibility you wish to take to run and oversee the caregivers, the tasks you want done, how the person receiving care will be introduced to the caregiver (assuming that you who are reading this is not the same person who needs care).
If you are thinking about using an agency, please see our article (Using an Agency for Hiring Home Caregivers). Some home care agencies place caregivers for 24 hour shifts. Other agencies, often nanny agencies, specialize in hiring and placing of people who live-in on an ongoing basis. It may be easier to find someone on a 24 hour shift basis, but it can end up being a lot more expensive. This solution, as opposed to hiring a long term live in, is often best used in an emergency or short term situation.
Be careful that you do not set up your situation to fail. Make sure you are really comfortable with the person, and with the idea of having someone take care of your relative. If you are feeling guilty or burned out you can unconsciously take out your feelings on the caregiver. Also make sure they have the skills you need, and if they don’t be ready to help them acquire them. If it is long term, remember that often the needs of your relative will increase, so the person may need additional training.
Skills and knowledge they may need include the following:
- Knowledge of dementia and specifically Alzheimer’s Disease
- How to communicate with someone with dementia
- How to help toilet and use adult incontinent products
- How to lift and transfer someone who has mobility problems
- Medication administration
- Feeding and how to deal with swallowing and choking risks
Once your caregiver has started, you will want to know what they are doing. You will also want to know how they are meeting the particular needs or risk factors for which you hired them. You may want them to keep some records depending on the type of care they are providing, their training, and their job description. These could be a record or activities, food intake, sleep patterns, fall patterns, bowel movements, agitation or aggression.
Some of the things to consider when hiring a live in caregiver are:
- What will be the exact hours of work?
- What will overtime pay be, and how and when will it start to be figured?
- What benefits are you going to pay, and what are you required to pay by law? This includes holidays and time off.
- Remember you are an employer, and you must conform to labour standards in your jurisdiction.
- Be clear about the pay you offer, and make sure that it is understood: are you quoting net or grow? What will you be taking off the gross?
- Caregivers are often from different cultures. What are the language problems going to be? How will the different cultural orientations play out?
- What are the exact tasks you are asking the person to perform? List them out and have both parties sign it. Remember they are not a domestic servant, unless they have agreed to that. They are caregivers.
- How will you monitor what they are doing?
- Do they really have the skills that you need?
- How will they handle money needed for caregiving? How will you monitor that it is spent?
- If you are not using an agency, are they bonded? Police checked?
- Do their certifications stand up?
- Be clear about the accommodations you are supplying.
- If there is a problem, when should they call you?
- Make sure they have a schedule of what should happen, and contacts and emergency numbers.
When you are interviewing a live in caregiver or anyone you hire independently try to get a picture of what their skills and knowledge are.
- If there was a fire, what would they do?
- If Mum fell often, what would that say? What would they do?
- Give them a few scenarios of things that might happen, and ask how they would handle it? Look for signs of potentially neglectful or abusive responses.
- What do they know about dementia, or the other concerns that they have to deal with?
- Have them describe some of the other work they have done with older people—what was hard, what was easy, what were the challenges?
- Ask them to tell you about their experience with their own aging relatives.
- Ask them to describe their training. Ask for details about the parts that you pick up on.
- If they will be driving, ask to see their license, and ask about/check on accidents, license suspensions, etc.