Roughly 70% of Americans who reach age 65 will need some sort of caregiver. While some people have family members who can fulfill a part- or full-time caregiving role, many will look to experienced professionals who can provide respite, help out some of the time or take over the duties entirely.
In particular, those who find themselves in the sandwich generation can be spread thin by taking care of both older and younger loved ones and trying to hold a job. Hiring a private-duty caregiver may be the best way they can make it work so that their loved one can stay at home.
When you’re looking for quality senior care, it helps to know what a typical caregiver does so you can find the right person to meet your needs. Here’s a look at what an at-home caregiver does, how to choose someone and how to manage your ongoing relationship.
What Do Private-Duty Caregivers Do?
Private-duty caregivers are trained professionals who come to your home and provide personalized care tailored to your senior loved one. They can be hired short- or long-term depending on how long you expect to need care — whether it’s for a couple of months following a surgery, a couple of years until you can retire from your job or indefinitely.
While they may specialize in certain services, such as memory care, you can hire a caregiver to provide everyday, non-medical care.
Here’s what you can expect from a private in-home caregiver:
- Assisting with daily living activities and personal care
- Reminding to take medications
- Planning and preparing meals and snacks
- Helping with mobility and ensuring safety
- Performing light housekeeping tasks
- Doing occasional shopping and errands
- Accompany them to appointments and social outings
- Arranging or providing necessary transportation
But this isn’t all they do. Caregivers engage with the people they’re caring for, taking note of their interests and needs so they can help them keep up a high quality of life.
Consider these key benefits of having an in-home caregiver:
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Companionship: Private-duty caregivers can help alleviate the loneliness and isolation seniors can feel when they have limited access to friends and family. They may plan crafts, play games, take them places, watch movies, read together — or just be someone to chat with.
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Familiar Environment: Caregivers provide a chance for seniors to age in place in the comfort of their own homes. Staying where they are is what many seniors want for as long as possible, and it can foster important feelings of independence, control, confidence and a sense of safety.
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Trust and Continuity of Care: In-home caregivers may spend significant time with your loved one and build a strong, trusting relationship. It can be crucial to have someone with training and experience in caring for seniors, who can monitor their personal and home safety as well as observe changes in their condition you need to know about.
By hiring a private-duty caregiver, you get the peace of mind of knowing your loved one is receiving compassionate, high-quality care from a professional.
If you’ve decided in-home senior care is the best route for you, your next step is finding the right person for the role.
How to Choose a Private-Duty Caregiver
You’ll want to do your homework to ensure you find an at-home caregiver who is qualified, compatible and trustworthy. Here are some tips to help you get started:
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Determine your hiring strategy: Decide whether to go through an agency or hire someone directly. There are pros and cons to each approach.
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If you go for an agency…
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Research them: Explore local home health care agencies and read reviews about them. It’s worth the effort because reputable home care agencies ensure their staff meet all necessary regulations and training requirements. Medicare has a tool to compare home health care providers in your state, and the National Association of Home Care and Hospice’s online database lists more than 33,000 agencies throughout the country.
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Interview them: Ask not just what services they provide but how they train and vet their caregivers. Get details about payment expectations, employment tax responsibility and insurance coverage. Go in with a list of home care agency questions so you compare what different agencies have to offer.
- If you go for a direct hire…
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Meet with several potential caregivers: Ask about their approach to caregiving, their availability and flexibility. Watch them interact with your loved one to determine if their personalities and communication styles align.
- Conduct a background check: This includes asking for professional references and speaking to previous clients or their families. (If you are using an agency, they will have already taken care of this.) If you’re hiring a CNA or LNA, it is important to check their state licensure to make sure they’re in good standing.
- Either way, discuss expectations: To avoid misunderstandings, be clear with the agency and the caregiver about responsibilities, schedules and any other concerns.
Legal Considerations When Hiring a Private Caregiver
Once you’ve chosen a caregiver that fits your needs, you should sign a formal agreement for services that outlines all the expectations, payments and other details.
If you’re using an agency or a caregiver who has their own contract, be sure to read it carefully and consider having an attorney review it for you before you sign. Alternatively, you may want to have your attorney be the one to draft the contract. It can be worth taking these measures to protect yourself and your loved one.
One thing that’s often overlooked in direct-hire situations is being clear about liability. It’s a good idea to have the private-duty caregiver to provide proof that they have their own liability insurance coverage. Otherwise, you or your loved one could be held responsible for injuries the caregiver sustains on your or your loved one’s property.
Potential Management Challenges With Caregivers — and Solutions
As you start to establish the caregiving relationship, perhaps the most important thing you can do is maintain open communication. Provide honest and constructive feedback, and encourage the caregiver (and their agency, if they’re with one) to be equally comfortable talking with you.
No matter how wonderful the caregiver or how professional the agency, challenges will arise. Here are some scenarios you may encounter and how to work through them:
- Workforce Shortages: The demand for private-duty caregivers is outpacing supply. That means it may take longer to find the ideal person for your loved one.
- Solution: It can be difficult at times, but try to stay flexible and adapt to the circumstances. This might involve seeking additional help from family and friends while you continue your search. If you’re working with an agency, it can help to explain your caregiving needs and talk through all the options they have.
- Scheduling Conflicts: At some point, your in-home caregiver may have an emergency or other conflict and won’t be able to show up as scheduled. This can be frustrating, especially if your plans can’t be changed.
- Solution: If you’re working with an agency, they may be able to send someone else. If you’ve hired someone directly, it’s a good idea to have a couple of backup caregivers you can call in a pinch. Short-notice cancellation shouldn’t be common, though; if it is, bring it up with the agency or the caregiver and consider asking or looking for a new person.
- Tasks Left Undone: If the caregiver isn’t performing the activities or tasks as agreed upon, it may be that there are too many, that they’re just forgetting to do them or that they didn’t know they were supposed to do them.
- Solution: Outline the expectations clearly and revisit them often. A written care plan can be useful for laying out what you expect the private-duty caregiver to do each day. Regularly review the plan of care with either the caregiver (or involved agency) and your loved one to ensure everyone is on the same page.
- Lack of Communication: At times, you may not feel the caregiver is keeping you apprised of what’s going on with your loved one, or the caregiver may feel they aren’t getting the feedback they need from you.
- Solution: Set aside a specific time for daily or weekly check-ins to happen and create a list of the top things you each want to know. Plan to have a longer talk every month or so to discuss how care is going overall. For these, you may even want to include other family members so they can have periodic updates and ask questions.
These are just a sample of the logistical challenges that can arise when you hire a private at-home caregiver, but these and most issues can be solved with patience, preparation and communication.
Financial Resources for Private In-Home Care
Many people think private-duty care is out of reach, but that may not be the case. Be sure to check all existing health care benefits and government assistance, whether it’s through Medicare or another care plan:
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Medicaid may provide financial assistance for various in-home care services.
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Medicare Advantage, unlike original Medicare, may cover private-duty caregivers. (This is referred to as in-home support services on plans.)
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Long-term care insurance policies may cover in-home caregiving.
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Veterans benefits may include home health care and financial support.
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Hospice benefits may include some at-home care for patients in home hospice.
Additional Resources:
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BenefitsCheckUp from the National Council on Aging, which helps you find area agencies and programs for health care and more
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United Way 211, which provides connections to social services and other resources, specifically for people caring for an older loved one
Being a caregiver for an elderly parent or loved one can be overwhelming. But private-duty caregivers can help you better manage the demands of your role, provide support for your loved one and make life easier for you both.