Hiring a caregiver is a process that requires time, energy and thoughtful preparation — but it doesn’t have to be overwhelming. There are simple steps you can take to secure the best support possible, starting with prioritizing the senior who will be receiving care.
“Families should approach this journey with compassion and a deep understanding of their loved one’s unique needs, preferences and daily routines,” explains Jessica Corona-Irwin, a registered nurse and certified dementia practitioner at Remo Health, a virtual dementia care company. “By taking a strategic and empathetic approach, families can find the right caregiver and create a supportive environment that enhances their loved one’s quality of life.”
From determining the costs to writing a thorough care plan, here, experts offer a step-by-step guide for hiring a senior caregiver.
Key takeaways
- Hiring a senior caregiver can feel overwhelming, but it’s possible to find the right fit by taking a strategic, empathetic approach.
- Start by noting your senior loved one’s abilities and involving them in discussions about their care needs.
- Create a structured care plan to outline responsibilities, schedules and goals and to ensure consistency in care.
1. Observe and ask questions
If you’re setting out to hire a caregiver, you’ve likely witnessed situations where a senior is no longer able to look out for their health and safety on their own. Once you’ve made these observations, experts urge families to have an open and honest conversation.
“Simply observing or inquiring about their appearance, ability to perform activities of daily living, memory, mobility and social engagements can point you in the right direction,” explains Macie P. Smith, a licensed social worker and gerontologist at SYNERGY HomeCare with over two decades of senior care experience based in Columbia, South Carolina. “It’s important not to bombard [your older loved one] with questions but rather just to incorporate them into the conversation so you don’t threaten their independence.”
Including the person receiving care into this initial discussion can also facilitate a smoother transition, explains Kylie Meyer, a caregiving expert and assistant professor at the Frances Payne Bolton School of Nursing at Case Western Reserve University. Meyer knows firsthand how helpful this can be. Her father hired a caregiver only for her grandfather to promptly fire them, and this “was repeated several times.”
“Being able to describe functional abilities to a potential caregiver can help you communicate your family’s needs, though the caregiver or agency may do their own assessment.”
— Kylie Meyer, a caregiving expert and assistant professor at the Frances Payne Bolton School of Nursing at Case Western Reserve University
2. Determine how much care is needed
To determine the type and level of help needed by an older adult, Meyer recommends assessing if they can do these two types of activities independently, or whether they may need a little help or need help all the time:
- Activities of daily living (ADLs), including bathing, using the bathroom, grooming (e.g., brushing teeth), dressing, mobility (e.g., moving around the house), and eating.
- Instrumental activities of daily living (IADLs), including transportation, shopping, preparing meals, managing money, managing medications, housekeeping and using communication devices like a telephone.
“Being able to describe functional abilities to a potential caregiver can help you communicate your family’s needs, though the caregiver or agency may do their own assessment as well,” she says. “You can also ask your family member’s healthcare provider for advice.”
3. Assess caregiving costs based on your unique needs
There is no skirting around it: Hiring a caregiver is expensive. The average cost of an in-home caregiver is around $20 to $30 per hour based on where you live, according to Meyer, but costs vary significantly based on factors such as caregiver experience and services provided. That’s why it’s important to understand what you’ll be paying early on to ensure you have the right financial resources. Here’s a look at how costs compare, according to Corona-Irwin:
Most expensive caregiver options
- Registered nurses (RNs) and licensed practical nurses (LPNs): These professionals provide medical care, administer medications and monitor health conditions making them among the most costly.
- 24/7 live-in care: Live-in caregivers are expensive due to the high level of supervision and assistance required.
- Specialized dementia or Alzheimer’s care: Caregivers trained in dementia-specific techniques often charge higher rates.
Least expensive caregiver options
- Companion care: Specializing in emotional support and household assistance, companion caregivers are typically more affordable than medical professionals.
- Part-time or respite care: Families who only need occasional assistance can lower costs significantly.
- Family caregivers with supplemental help: Some families rely on unpaid family caregivers, hiring professionals only when necessary.
4. Weigh your options based on your budget and bandwidth
Families can choose between hiring an independent caregiver or a caregiver through a home care agency depending on their specific needs. “The level of support and oversight are some of the clear differences between hiring a caregiver from an agency and hiring a private caregiver,” Smith says. Here’s a snapshot of both options:
Agency caregivers
When a family chooses to use an agency, costs are generally higher due to administrative fees, Corona-Irwin explains, but benefits include ensuring reliability and legal compliance. An agency handles contracts, background checks, training and payroll and also provides backup care if the primary caregiver is unavailable.
Private caregivers
Hiring a private caregiver can be more affordable, but there is less oversight making it crucial to conduct thorough interviews and research. “With an independent caregiver, you have more control over who you hire and may pay a lower rate, but all responsibility falls on you,” Smith says. “That means you’ll need to handle background checks, payment and any concerns on your own.”
5. Search for candidates and conduct caregiver interviews
When working through an agency, families are often placed with a caregiver that meets your level of care needs. But if you are hiring an independent caregiver, this is when doing your own research will be required. “If you have friends who have gone through a similar journey, reach out to them for referrals but make sure to verify these recommendations with reviews from online platforms with verified backgrounds before reaching out to candidates to conduct thorough interviews,” says Corona-Irwin.
Once you have private caregiver candidates, you’ll need to conduct your own interviews to find the right fit. Start by communicating the care recipient’s needs and asking about the caregiver’s experience providing similar care, Meyer says. This will dictate how much training you will need to provide a caregiver. And when it comes to ensuring the quality of care?
“Look for caregivers who demonstrate initiative, patience and a genuine interest in enriching your loved one’s life,” advises Corona-Irwin. “Emphasize the importance of safety and reliability, and ensure the caregiver understands basic safety protocols and can handle emergencies.”
“Look for caregivers who demonstrate initiative, patience and a genuine interest in enriching your loved one’s life. Emphasize the importance of safety and reliability.”
— Jessica Corona-Irwin, a registered nurse and certified dementia practitioner at Remo Health
6. Set up a time for the caregiver and care recipient to meet
Before hiring a caregiver, experts recommend introducing them thoughtfully to the person they are caring for to build a positive relationship, preferably in the home where they will be working.
“Create a comfortable and relaxed setting for the initial meeting,” recommends Corona-Irwin. “Use reassuring language and frame the caregiver’s presence as a source of companionship and support.” She has also found it helpful to encourage the caregiver to engage a senior loved one through shared interests and personal stories.
7. Sign a care agreement or contract
You can think of a care agreement or contract as an official job offer both you and your new employee will agree to and sign. “An agency will already have a contract set that will list the responsibilities tailored to your senior’s care needs,” Smith says. “But when hiring a private caregiver, it’s important to list all the areas your senior will need help with and what the job responsibilities are. Setting up a fixed pay rate, schedule and time off will also be helpful in creating the contract.”
Being clear in your contract when it comes to hours and expectations will also help avoid surprises, Meyer adds. “Caregiving is hard work, and caregivers should have access to time off,” she says. “A care agreement can set expectations such as how to request time off, including how much notice is needed.”
8. Create a personalized care plan
While a contract covers legal logistics and job duties, a care plan is a personalized document outlining a senior’s needs, preferences and daily routine. “It serves as a roadmap for caregivers to provide consistent and effective care,” explains Corona-Irwin.
In order to build a strong care plan, here are the top things to document:
- Medical conditions
- Mobility concerns
- Dietary restrictions
- Medications and treatments, listing prescriptions, dosages and administration schedules
- Daily routines, including wake times, meals, preferred activities and bedtime schedules
- Emergency contacts, such as family members, neighbors and doctors
- Emotional and social needs
Along with a detailed list of your loved one’s needs, a care plan should also include clear goals for fulfilling these needs. “Setting a clear schedule of caregiving tasks will help you and your loved one keep track of what needs to be done,” says Smith. She also recommends informing your loved one’s care team, which may include doctors, specialists, insurance providers or social workers, of your plan and goals to keep everyone in the loop.
9. Conduct an in-person training session with your caregiver
Even if the person you hire has prior experience as a paid caregiver, they will need help getting to know your family member, especially if a dementia diagnosis is involved, Meyers explains.
“When the older adult has an issue affecting their cognition, you or another family member may need to be more involved initially,” she says. “Modeling how tasks are completed and providing written instructions can help ensure care is being tailored to your family member’s needs.”
10. Monitor the transition and make adjustments as needed
Stay closely involved at the start of a new caregiver-senior relationship, and regularly reassess your care plan at least once a quarter. To maintain ongoing communication, Corona-Irwin recommends scheduling regular check-ins to discuss your loved one’s condition and address any concerns.
The bottom line, according to Corona-Irwin: “By taking a compassionate and proactive approach, you create a caregiving experience that enhances your loved one’s well-being and fosters a fulfilling partnership.”
