Choosing the Right Home Health Aide

Are there parts of caring for your parent that you absolutely hate doing?

Maybe it’s giving them a shower, making dinner, getting them ready for bed, doing laundry, or taking them grocery shopping. That’s okay. We all have things we don’t like to do.

Or maybe you’re simply tired of every visit with your parent becoming a list of chores. You want the chance to be their son or daughter again.

That may be a sign that it’s time to bring in some help.

But how do you find the right aide—and what should you look for?

Going Through an Agency

If your parent has Medicaid, start by contacting their Medicaid plan or a local licensed home-care agency to find out what services they may qualify for. Medicare coverage is different and generally does not pay for ongoing custodial care simply because someone needs help with everyday activities. Medicare home-health benefits have specific eligibility requirements.

If you are paying privately, an agency is another option. Agencies generally handle things such as hiring, payroll, insurance, scheduling, and screening their employees. Ask exactly what background checks, references, and training the agency requires—don’t assume every agency handles these the same way.

The downside is cost. Agency care can be expensive, and many agencies have minimum shift requirements. If all your parent needs is help with a shower, you may still be required to pay for several hours.

Also ask about transportation. Some agencies restrict aides from driving clients or using their own vehicles to take clients grocery shopping or to appointments.

Hiring an Aide Privately

Hiring privately can give you more flexibility and may cost less, but you become responsible for doing the vetting.

You might find someone through personal recommendations, local community groups, neighborhood Facebook groups, churches, senior organizations, or community bulletin boards.

When you advertise, be very specific about what you need:

• Medication reminders

• Grocery shopping

• Light cleaning

• Meal preparation

• Showering and personal care

• Laundry

• Companionship

• Walking or exercise

• Transportation, if needed

State the hours you need and the rate you are offering. In many areas, around $30 an hour may attract experienced private caregivers, but rates vary considerably by location and the level of care required.

And remember: everything takes longer when you’re helping someone with dementia.Don’t underestimate how much time an aide will need.

Medication safety is especially important. Unless the person is legally permitted and appropriately qualified to perform a medication-related task, don’t assume they can fill pill boxes, administer medications, or make medication decisions. Be very clear about what they may and may not do.

Before You Hire Them

Have the potential aide come to the house and meet your parent.

Then watch.

Does your parent seem relaxed or tense around this person? Does the aide speak directly to your parent—or talk about them as though they aren’t in the room? Do they listen? Are they patient?

And if you have a dog, watch the dog too! Sometimes animals notice things before we do.

If you use cameras in the home, tell the aide about them and make sure you’re following the laws in your state regarding recording and privacy.

If you decide to hire the person, put expectations in writing. Include specific duties, days and times, transportation expectations, emergency contacts, household rules, and boundaries around things such as personal cell-phone use and television.

Hiring an aide isn’t about handing your parent off to someone else.

It’s about choosing which jobs someone else can safely do so that you have more time and energy to simply be their son or daughter.

Next week, I’ll talk about the precautions you should take after hiring an aide—and the warning signs you should never ignore.