Hiring Help

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How To Find Home Help

Choosing the Agency Option

How do you find a good agency? Consult your relative's doctor, hospital discharge planners, the Better Business Bureau, and fellow caregivers about the agencies you are considering. Review the contents of any service contract carefully before you sign it. Among the questions you might want to ask are:

	How long has the agency provided home help services?
	Does the agency have a written statement of fees, eligibility, and payment procedures?
	Is the agency currently licensed and bonded?
	Can the agency provide you with references from people who have used its services?
	Does the agency provide a written plan of care that explains the service to be performed, days, hours, and fees? Is the plan reassessed periodically?
	Are there extra charges for travel, lunch, supervision, weekends, holidays, or an agency fee?
	Must we accept a minimum number of hours or days of service?
	Is help available evenings and weekends?
	Is there someone to contact after hours?
	How are emergencies handled?
	How does the agency recruit, screen, and train its workers?
	Will the agency send the same worker(s) regularly?
	How does the agency respond when a worker calls in sick?
	Who supervises the worker(s)? Will the supervisor ever observe the employee in my relative's home?
	If we are dissatisfied with the employee, will the agency send someone else and how soon?

This research may take time, but in the long run such efforts can pay off.

CHOOSING TO HIRE A WORKER DIRECTLY

Be selective. When interviewing a candidate, think about whether you and your relative will feel at ease working with that person. Ask questions about the individual's work history, what he or she wants out of a job, and his or her experience with older people. Find out if he or she has habits that might be disturbing in your relative's household (for instance, if the person smokes, or likes to watch soap operas while working). Consider how the person presented him- or herself over the telephone and in person. Was he or she polite, on time, and dressed appropriately for your meeting?

Tell the applicant about your relative's condition. A potential live-in companion must know about your family member's sleeping habits or if he or she is incontinent. How does the person respond to this information? How does he or she handle such situations? Do not hide problems. You will not get and retain the kind of person you need if you fail to be open.

Ask the candidate for at least three references, and check them. You want someone who is capable and trustworthy.

Draft a contract that states the conditions of employment, specific duties, and termination procedures. You and your employee should agree to it and sign it. These actions provide you legal protection.

Having confidence in the home care worker will start your working relationship off well. Discuss periodically how things are going, and make adjustments if necessary.

Finding home help takes time. But the practical support you and your relative derive from using home care services will be worth your efforts.

FINDING HOME CARE SERVICES

Ask friends, family, clergy, and other caregivers if they know of capable individuals or agencies. Turn to your area agency on aging (often listed in the blue pages of the telephone book under "aging" or in the yellow pages under "senior citizens"), senior centers, or family service agencies for referrals.

You may decide to use an agency that will send employees or volunteers into your relative's home or you may hire helpers directly. The chart below outlines the pros and cons of these options. Much will depend on you and your relative's needs and your community's resources.

USING AGENCIES

Pros

Cons

Agencies can save you time and energy by:

	screening and hiring qualified workers
	providing help quickly
	sending replacements when necessary
	taking care of training, supervising, and providing liability insurance for workers
	handling record keeping (Social Security deductions, workers' compensation)
	helping to resolve problems between you and the employee
	It can be less costly than going through an agency.
	You directly manage the person and exercise more control over the employee's hours and tasks

	The services may be too costly to use regularly.
	You may have to accept employees on a schedule that may not meet your family's needs.
	You may not be pleased with the quality or reliability of the worker.
	Different workers may be sent on different days, interrupting the continuity of care.
	You are responsible for all advertising, recruiting, and interviewing--a time-consuming process
	When an employee does not show up, you will need to arrange for substitutes yourself.
	You are responsible for all paperwork, such as Social Security records and payments, and insurance.
	You will need liability insurance to cover the worker in case of accidents.

Source: How to Find Home Help, The National Council on the Aging, lnc., � 1988� Copyrighted by and reprinted with permission of the National Council on the Aging. Inc., 409 Third Street, SW, Washington, DC 20024. A catalog of publications and resources---including "Caregiving Tips" and other inexpensive educational brochures is available upon request.

Choosing a Home Care Provider

INTERVIEWING A PROSPECTIVE HOMEMAKER OR AIDE

It's quite likely you've never interviewed candidates for a job as home care worker or homemaker aide. This list of interview questions has been compiled from the suggestions of people who have been through the process:

	Where have you worked before? Get names and telephone numbers of three previous employers and contact each of them.
	What were your duties? If possible, you should hire an aide who has had direct experience with the duties and conditions your situation entails. If you need someone to help you care for your husband who wanders because he has Alzheimer's disease, the fact that an aide has had experience only with patients with limited mobility should give you some concern.
	How long were you employed in previous jobs? How long might you be able to work on this job?
	Do you smoke? If you do not like the smell of smoke, obviously a nonsmoker is your best choice. But if your best applicant does smoke, consider how you can work this out. Don't compromise too easily, however. An aide might go outside to smoke in good weather, but how will you feel in cold weather when the aide smokes inside and you cannot easily air out your home?
	Now that we have discussed the duties involved in this job, is there anything you feel you cannot or would not want to do? Remember that a caring person might be willing to learn to do new tasks, whereas an inflexible attitude indicates possible problems ahead.
	Is there anything in your situation that would prevent you from arriving for work on time ? Find out what would happen if the aide cannot come because of illness or a family problem. Is there any backup plan available?

CHECKING REFERENCES

You might find it a little awkward to call people you don't know to question them about a former employee, but this is one of the most important things you can do to ensure satisfactory home care. Here are some of the questions to cover:

	What duties did this person perform for you?
	Was he or she dependable and honest?
	Why did he or she leave your employment?
	Would you rehire this person?
	Did he or she get along well with you and the other people in the household?

MAKING THE FINAL DECISION

If you have several qualified applicants from whom to choose, your final decision might be based largely on personality--how you will feel about having that person in your home several hours a day. You will, of course, be guided by your discussion with the applicant, by the reference check, and by the applicant's personal situation. But, in the end, you might choose one applicant--despite the fact that she cannot work on Wednesdays as you wanted--instead of another applicant, because something about her manner makes you feel she would fit in better in your home. Trust your instincts. After all, what can be more important than feeling comfortable with the person spending time with you in your home?

WRITING AN EMPLOYMENT AGREEMENT

When you have made an offer and the applicant has accepted it, you need to prepare an employment agreement. The agreement should include your name, address, and telephone number, and the same information for the employee. You also need the employee's Social Security number, as well as your Employer I.D. Number if you have one. List the hours to be worked and the types of care or services the employee will provide, along with the frequency of those services if that varies. Specify the rate of pay and exactly when it will be paid. List any benefits you will provide, such as meals, bus fare, sick leave, and annual leave.

You also might wish to indicate a probationary period of one week in the agreement, after which time either you or the employee must give two weeks' notice before terminating employment. Additionally, some employers list unacceptable behavior that will be grounds for dismissal without notice, such as drinking on the job or the use of foul language.

Source: Anne P. Werner and James P. Firman, Home Care for Older People: A Consumer's Guide, United Seniors Health Cooperative, Washington, D.C., � 1993.