If you’ve ever provided care for an aging, sick or disabled individual, you know how time-consuming — and often emotionally taxing — the role can be. In these situations, respite care — a form of caregiving that allows primary caregivers to take a break to avoid burnout and complete challenging tasks — can help.
“The primary benefit is the rest,” explains Ron Schulman, owner of SYNERGY HomeCare of Columbus, Ohio. “I always tell prospective clients: ‘[Caregiving] is hard work and it is not possible for one person to always be on. We are not going to replace the care you provide your husband, wife, mom or dad, but we will allow you to be 100 percent when you do provide it.”
Of course, allowing a stranger to provide intimate, hands-on help might feel a bit daunting.ow do you know if someone is the right fit, and how do you find them in the first place? Here, Schulman and other caregiving experts outline exactly how to hire in-home respite care, from determining the level of help required to finding great candidates to finalizing the caregiver-employer relationship.
Key takeaways
- Respite care is a form of caregiving that allows primary caregivers to take a break to avoid burnout and complete challenging tasks.
- Your first step in hiring in-home respite care? Determine what kind of help you actually need — and how much of it.
- Whether hiring independently or through an agency, set expectations regarding pay, responsibilities, scheduling and background checks.
1. Decide on the level of care you need
Your first step in hiring in-home respite care? Determine what kind of help you actually need — and how much of it. One of the most common reasons primary caregivers hire in-home respite care involves time — or a lack thereof, points out Laurel Wittman, the co-president of the Well Spouse Association, a non-profit focused on supporting spousal caregivers. “My husband needs 24-hour care, so I needed somebody who could be there for a certain set of working hours,” she explains. “Having coverage during business hours was really important for me.”
Beyond simply having someone present, Wittman says it’s helpful to draft a list of all the ways you provide care daily and the time it takes you to do them — or all the things you can’t do, but want or need to. Here are a few other ways that in-home respite caregivers can provide support:
- Physical assistance. “If you’re a small person, and you have a very large spouse, you may need help with another set of hands to help with the physical aspects of care,” Wittman explains. Perhaps, for example, you need help getting someone in and out of a bathtub or up and down stairs safely.
- Medical help. Wittman says you may need someone to administer more complex medications or treatments, who are trained to do so.
- Emotional support. You might need someone to assist with the more emotional aspects of care, like companion care, which includes non-medical physical, emotional and social support.
- Housekeeping and help with smaller tasks. As caring for her aging mother began to take up more time, Ruth Furman, a family caregiver from Las Vegas, realized she needed help with aspects of caregiving and taking care of the house. She found someone who could aid in both, allowing her to focus on more big-picture care — and offer some much-needed rest. “I was also sleep-deprived, and I learned that cumulative lack of sleep is not sustainable,” she notes. “I had to make sure I had people in different care categories, like cleaners, nurses, people who could run errands and at-home support.”
2. Map out a budget, and see if you’re eligible for financial help
Try to determine how many hours you’ll need care on a daily and weekly basis. Keep in mind that some more complex caregiving tasks — say, administering certain medical treatments or assisting in things like bathing — might require you to pay someone more. (It’s also helpful to note that the national median hourly cost of homemaker services is $30 and home health aides are $33, according to the latest Genworth Cost of Care survey.) You can also try an online calculator to determine your total cost of care.
While in-home respite care is primarily paid for out-of-pocket, there are a few ways to get financial help, per Kathrine Steele-Watson, executive director of Phoenix-based Arizona Caregiver Coalition. She says you can try contacting your local Area Agency on Aging (AAA) or a nearby VA Clinic to see if you’re eligible for benefits or financial support programs. Medicare and Medicaid might also sometimes cover certain services, but it’s important to check your plan details to know for sure.
3. Start with word-of-mouth referrals
“Ideally, you will be able to find someone that meets your financial and schedule needs, can provide the right care and that you and your care recipient personally enjoy.”
— Sicily Porto, program coordinator for the Arizona Caregiver Coalition
If you can, try asking around your social circles for in-home respite care referrals to kick off your search — you’ll save yourself the time and stress of weeding through candidates who might not be great fits from the get-go. “Start with friends and family,” Steele-Watson explains. “If you are part of a religious or social group, these can be great resources for support.”
Schulman agrees, adding, “I would start with trusted relationships that already relate to care being delivered in the home.”
4. Consider going through an agency
When Wittman began looking for care for her husband, a lack of time was her biggest obstacle. As someone working in finance, though Wittman could probably have handled things like caregiver payments, employment contracts and taxes, she opted to go through an agency instead. “They would do the screening, they would do the training, they would maintain the insurance coverage, they would do the taxes,” she explains. “So all I had to do was find the right agency.”
“If you have decided to work with an in-home care agency, they will have specific agreements unique to their contracts for families to consider,” explains Sicily Porto, program coordinator for the Arizona Caregiver Coalition. “This will include things like price, limitations of service provided and minimum hourly requirements. In this case too, background checks and potentially fingerprint clearance will already be established.”
Of course, Schulman notes, you have to find right organization first. He advises ensuring the organization you’re working with has the following:
- Mandated hiring and background checks
- Liability and worker’s compensation insurance
- Payroll with taxes
- Deep benches of in-home respite caregivers to draw from when primary workers cannot make a shift
- Specific caregiver training
5. Post on a job site
The downside to working with an agency, of course, is the price. Caregiver agencies (versus independent care) often require a fee. Wittman believes it’s a reasonable type of fee to pay, given that most in-home caregivers are stressed, tired and time-strapped as is. Of course, not everyone can afford this option — and if there’s no way to find word-of-mouth referrals, job postings can help, Steele-Watson says.
“Go see friends, go see a movie, go sleep, but go do it for you. Once you do, you will see you will be ‘on’ when you need to be with your loved one. That is the benefit.”
— Ron Schulman, owner of SYNERGY HomeCare of Columbus, Ohio
6. Interview candidates and screen for green — and red — flags
Whether you opt to use independent or agency respite care services, plan to interview both. “Ideally, you will be able to find someone that meets your financial and schedule needs, can provide the right care and that you and your care recipient personally enjoy,” Porto explains.
Though the specific types of interview questions you’ll ask will depend largely on your caregiving circumstances, here are a few overarching ones to ask:
- What is your experience in caring for others, and why did you pursue it? “If you ever get a sense of lack of interest, or they first ask ‘What is the pay?,’ sayonara baby,” Schulman notes.
- Do you have any credentials? You might not need a person with specific credentials if you’re looking for companion care, but Wittman says that folks in skilled nursing care (like an LPN or licensed practical nurse, for example) can help with more medical-specific tasks.
- What is your schedule and reliability? You might also ask about their means of transportation and other professional or personal commitments, as “if they cannot show up, nothing else matters,” Schulman says. Here are some other caregiver interview questions and tips to keep in mind.
Questions like these are important to ask for a hiring baseline, but for Furman, intangible personality traits — warmth, humor, patience, dependability, intuitiveness — were far more of a factor. They were qualities she was able to pick out over in-person conversations. “I would bake treats, and we’d have a one-hour sit-down,” she explains, adding that she’d compensate the person for that hour. “My mom thought I was crazy, but I think if you pay people, they feel valued and the relationship starts off on the right foot.”
Furman says the hour-long conversation helped her and her mother get to know each person on a deeper, more human level. “We did interview four caregivers for my mom and I ended up hiring two,” she adds.
7. If you’re not using an agency, be prepared to set up a formal employment situation
If you want to hire an independent respite caregiver and opt out of using an agency, you’ll need to either divvy out specific business tasks — background checks, pay, taxes, etc. — to other companies or individuals or take care of them yourself. Here’s a breakdown:
Conduct a background screening.
For independent caregivers, consider asking for professional resources and calling them. You should also ask for identification, like a driver’s license or passport, per the National Caregiving Alliance. You can request criminal records through your state Department of Justice (DOJ), but keep in mind that they won’t be released without the individual’s permission. Some job listing sites for caregivers, including Care.com, supply automatic background checks.
Decide on the pay rate.
You’ll need to land on a wage for the in-home respite caregiver you hire, whether hourly or salary-based, that’s fair and accurate to the work that person will be providing. That will largely depend on your individual needs and where you’re located.
Wittman offers her caregivers bonuses for things like holidays. Furman also tips for any extra tasks her caregivers do beyond the standard day-to-day help. “We also looked at the number of hours they would work and how far they had to drive,” she explains. “We discussed it all in advance, and we also factored in inflation from the time when we cared for my dad.”
Get taxes, payroll and insurance squared away.
Per the IRS, caregivers (including respite ones) are employees of the individuals for whom they provide services. That means you’ll need an employer identification number and will have to report the caregiver’s compensation on a W-2 form for withholding Medicare, Social Security and unemployment taxes.
Alternatively, you can also designate your caregivers as independent contractors (so non-payroll workers), which means they’ll file their own 1099-NEC form (or 1040-SR form for seniors, which you can learn more about here) when it comes time to file taxes. Schulman uses an online payroll company as again, setting up this aspect of the caregiver-employer relationship can get tricky if you’re not well-versed in employment law or taxes. Here are some steps to setting up caregiver payroll yourself.
In that same vein, if you work with an agency, they’ll automatically insure caregivers. But if you’re hiring solo, you may need to cover your employee (and workers’ compensation insurance is required in some states). You can learn more from the US Department of Labor, but it’s a good idea to check with a local insurance broker to understand your individual employee insurance needs by state.
Draft up an employment contract to set ground rules.
Crafting a document that explains the ins and outs of employment — from base pay to benefits to hours — can help both the future caregiver and employer (you) establish some ground rules and set expectations. (Here’s a sample caregiver contract to potentially base yours on.)
That said, Schulman notes that he didn’t use employment contracts when he hired private caregivers for his mother, as “they really have no authority and are not binding.” Neither did Furman, while Wittman, again, went through an agency.
“In my experience, most families are working with an informal respite provider such as a friend or neighbor and have no formalized contracts in place,” says Porto. Be sure to discuss with any potential respite caregiver the best, more clear option for both parties.
A case for being nimble when working with an in-home respite caregiver
When Wittman first hired in-home respite care for her husband, the primary emotion she felt was guilt — something which led her to be wary of leaving the house at first. Allowing a stranger to provide intimate care to someone she loved, Wittman acknowledges, required a bit of a learning curve. So, she’d start by shadowing the caregiver she hired to ease her fears. Soon, she’d leave the house for 10 minutes and come back. Eventually, she was able to stay out of the house the entire workday.
Though she acknowledges some days are still tough, when you find the right in-home respite care, it’ll make *all* the difference. “Don’t throw yourself into the deep end with hiring a respite provider,” she explains. “Work up to it if you’re able to. Not everyone can do that, but if you can, it’s really helpful to build that confidence.”
Ultimately, respite care, as Schulman notes, will allow you to free up more time for the most important task of all: spending quality time with your loved one, and taking care of yourself. “Go see friends, go see a movie, go sleep, but go do it for you,” he says. “Once you do, you will see you will be ‘on’ when you need to be with your loved one. That is the benefit.”
