10 Tips for Hiring In-Home Help Through an Agency

Recently, Sandy’s 82-year-old mother has agreed to having a helper come into the home a few times per week to help with meal preparation, grocery shopping, and some light housekeeping. As age and arthritis affect her ability to comfortably complete these daily tasks, Sandy and her mom realize that hiring an in-home caregiver will allow Sandy to maintain her current work schedule while ensuring that there is someone available to assist her mother during weekdays. While both Sandy and her mother are excited about the prospect of some extra help, they’re unsure of how to go about hiring an in-home caregiver. Although there are many reputable home-care agencies, families are often caught off guard by news stories of in-home caregivers who are abusive, undertrained, or completely unsupervised. Thus, researching home care providers and taking the steps to hire an agency, and caregiver, that best meet your needs can help ensure that your loved ones are safe and well cared for in the hands of an in-home caregiver.

1. Assess your needs
The availability of in-home help ranges from companion care to keep a senior company and assist with light housekeeping or errands, all the way to skilled nursing for individuals with debilitating health conditions. If you’re unsure of the best fit for your loved one, your physician, or an initial assessment visit from a home care provider, can help determine what type of care is best suited to your particular situation.

2. Work with a reputable agency
Some family caregivers consider hiring an individual directly to provide the care, as opposed to hiring someone through a home-care agency. While working directly with a caregiver may provide some cost savings, it is important to remember that by choosing to do so, you’ll also be acting as an employer and be solely responsible for oversight, hiring, firing, background checking, confirming certifications, and more. By working with a reputable agency, you hand off a greater share of these duties, enabling you to focus on your role as a family caregiver seeking help, rather than a family caregiver and employer.

3. Ask about caregiver background checks
There’s nothing wrong with being picky about who you allow to provide care for an elderly loved one. Be sure to ask agencies if they background check their caregivers and if so, what methods they use. If you feel uncomfortable about a home care agency’s procedure for screening caregivers, it may be best to trust your gut and use a different provider.

4. Inquire about caregiver training
Ask what training and certification requirements caregivers are required to meet for employment, if any. Basic certifications like CPR and First Aid may provide peace of mind that basic aid is available in case of an accident while the caregiver is on duty, as well as give you an idea about the hiring standards of the company. Special language skills or cultural capacity such as training to work with Holocaust survivors or LGBTQ+ community members may be important for your needs.

5. Ask whether the agency meets local certification requirements
Requirements for home care agency certifications vary from state to state. However, inquiring about an agency’s State Certification status can help you gauge their legitimacy and ensure monitoring from regulatory agencies. For information on specific agency certification requirements in your agency, contact your local Area Agency on Aging (FCA’s Services by State can help with this), or your local department of senior services.

6. Evaluate the supervision process
With caregivers working in the home, a common concern of family caregivers is a lack of supervisory oversight. However, family caregivers have a right to ask about how the agency supervises the quality of care in the home. Ask about drop-in supervisor visits, and tools like home care software used to manage caregiver clock-ins and care plans during a shift.

7. Ask to meet potential caregivers You probably want to make sure the caregiver that you choose is not only well trained, but that they are also compatible with both you and your loved one. Ask the home care agency about their process for matching caregivers with clients and ensure that both you and your loved one can meet the caregiver prior to their first shift to be sure the match is a good fit.

8. Line out billing ahead of time
Depending on the types of services provided by the agency, as well as the specific condition of your loved one, some in-home care services may be covered by Medicare, Medicaid, or long-term care insurance. Don’t hesitate to talk to the home care agency’s intake coordinator about the rate for services, as well as billing practices, ahead of time to help avoid unexpected charges.

9. Ask for references
For assurance about the proficiency of a home care agency that you’re considering, you have the right to ask for references. Most reputable home care agencies will be able to provide you with referrals of current clients or referral partners that can attest to their experience with the agency.

10. Talk about a care plan
When you’re paying for someone to provide in-home care, you’ll likely want to be sure that they’re addressing the tasks they’ve been hired for. Discuss a plan of care with the home care agency intake personnel and caregivers prior to the first shift, and ask about how the agency tracks the progress and completion of care plans. With a good plan of care, you can be sure that your loved one is having their essential needs met, be it help with keeping up the house or assistance with bathing. A plan for care helps make sure that that nothing significant is overlooked. Accepting help from a home care agency can be a major change for both family caregivers and their loved ones. Choosing an agency to hire can be a time-consuming process, but when armed with the right questions, you can help put your nerves at ease when choosing who to trust with the care of your loved one. More in-depth coverage of this topic is available in our fact sheet, Hiring In-Home Help. Have you had experience in hiring an in-home care agency? If so, please leave a comment and let us know what you’ve learned about how best to choose an in-home care provider.