The Challenge of Hiring Private Caregivers

July 28, 2011; By: Audrey Miller
All About Estates

Last week I blogged on the important role of professional care providers. This blog discusses the challenges of hiring a care provider. This article has been reprinted from CARP and I have attached a link to the original article.

Along with the decision to explore caregiving assistance, there are many questions that usually follow. What assistance is needed? Will it be few hours per day, a few hours per week, or is it full time 24 hour assistance that we need?

For families wanting to proceed on their own, here is a list of questions/issues to consider:

1. What type of care is required? Do I need a:

Registered Nurse: Their typical duties include:
– Assess patients to identify appropriate nursing interventions
– Administer medications and treatments as prescribed by a physician or according to establish policies and protocols
– Monitor, assess, address, document and report symptoms and changes in patients’ conditions
– Operate or monitor medical apparatus or equipment
– Assist in surgery and other medical procedures

Registered Practical Nurse: Their typical duties include:
– RPNs assess clients’ conditions and chart progress.
– They care for wounds, change dressings and give medications.
– They care for clients as disease progresses and through the palliative stages.

Personal Support Worker: Their typical duties include:
– Observes and reports clinical and treatment information, behavioral changes
– Assists with range of motion exercises and other rehabilitative measures
– Takes and records blood pressure, temperature, pulse, respiration, body weight and height
– Assists with ambulating and mobilization of patient
– Assists with personal hygiene
– Assists with meal preparation, grocery shopping, dietary planning, food and fluid intake

Companion: Their typical duties include:
– Non-medical assistance
– Assists with meal preparation, shopping, pet care, letter writing
– Providing conversation

2. What do I need?

– -home respite care during the day only?
– Care away from home during working hours, such as participation in an adult day program?
– 24 hour full time care over a weekend or longer?

3. If I want to bring in care, do I want to hire from a home health care agency or do I want to hire privately?

Understanding the advantages of each option is important. Some issues to consider include:
– Making sure that references, experience and qualifications are in place
– Is the person bonded?
– Is there insurance coverage?
– Is there illness coverage for this caregiver should they get sick?
– Should I consider sponsoring someone?
– Can I pay by cash or credit card?
– How often does the person get paid and who bills me?
– Is the services tax deductible?
– Is the care provider supervised? If yes, by whom?
– What about confidentiality?
– What types of records will be kept?

4. If overnight care is required, do I want to have someone move into my home or would I prefer to have my loved one move into a facility for a short period of time? These options may include:

– If eligible, the Ministry of Health, may be able to provide respite care in a long term care facility.
– Short stays are available at many retirement residences and daily costs and amount of personal care varies.

5. What is the cost of care?
– If eligible, your local Ministry of Health Community Agency may be able to provide a few hours per week of a personal support worker at no cost.
– For Personal Support Workers hired through an agency, the cost is anywhere from $21.00 per hour upwards. HST is added. There may be a minimum time requirement.

6. How do I ensure that they will get along?
– Interview more than one candidate
– Speak to other families they may have worked with
– Suggest a trial ‘get to know one another’ afternoon.

7. What can I do to facilitate the process?

Provide the ‘new’ caregiver with personal information that will assist, such as:
– How would the older person like to be addressed; by their first name or by Mr.___ or Mrs _____?
– What does the care recipient likes to eat. What are their favourite or comfort foods.
– Do they have any food allergies or foods they don’t like
– Would they like the caregiver to eat with them
– Do they have a special seat at the table.
– How does the care recipient like their tea or coffee
– Identify activities that the older person enjoys doing so the caregiver knows this in advance.
– Whether the person likes to take a bath or shower and what is their preferred time.
– Clothes they are most comfortable wearing
– Areas where assistance is needed
– Their best time of day
– Their worst time of day

8. Where do I find a caregiver?
If hiring through an agency, there are several home care agencies in most communities. They are listed in the phone book and seniors directories. You can also speak to an elder care manager about reputable agencies in the community. They can also assist with screening candidates to ensure a good match is made.

If hiring privately, a referral from a friend or family is usually the preferred route. Note however that if someone’s previous experience has been looking after children, it is not the same as caring for an older adult.

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