Hiring a Home Care Aide

Your parent needs more help than you can provide alone. Maybe they need assistance with bathing, or someone to prepare meals and remind them about medications. Perhaps they need companionship and supervision while you're at work. Hiring a home care aide can be the solution—but finding the right person is crucial.

This guide walks you through the entire process: understanding your options, knowing what to ask, recognizing red flags, and setting up the arrangement for success.

Agency vs. Private Hire

The first major decision: hire through an agency or find someone on your own.

When to Use an Agency

• You need backup coverage when aides are sick or on vacation
• You don't want to handle employment taxes and liability
• You need skilled nursing care
• You're long-distance and can't supervise closely
• Your parent needs care quickly without time for a lengthy search

When Private Hire Makes Sense

• Budget is a primary concern
• You want to choose and build relationship with a specific person
• You have time to properly screen and manage
• You have backup options (family can cover gaps)
• Care needs are straightforward (companionship, light assistance)

Determining Your Needs

Before you start interviewing, clarify exactly what you need:

Type of Care

• Personal care: Bathing, dressing, toileting, grooming
• Mobility help: Transfers, walking, wheelchair assistance
• Medication: Reminders, organization (not administration)
• Housekeeping: Light cleaning, laundry, organizing
• Meals: Cooking, feeding assistance
• Companionship: Conversation, activities, preventing isolation
• Transportation: Doctor's appointments, errands, outings
• Supervision: For dementia or safety concerns

Schedule

• How many hours per day? Per week?
• What times? Morning care, evenings, overnight?
• Same time every day, or varying?
• Weekend care needed?
• Live-in or hourly?

Special Requirements

• Dementia experience
• Experience with specific conditions (Parkinson's, stroke, etc.)
• Physical ability to transfer or lift
• Driver's license and reliable vehicle
• Cooking abilities or dietary knowledge
• Language skills
• Personality match with your parent

Where to Find Caregivers

Agencies

• Search "home care agencies" in your area
• Ask your parent's doctor for recommendations
• Hospital discharge planners have referral lists
• Area Agency on Aging can provide options
• Check Medicare's Home Health Compare for quality ratings

Private Hire Sources

• Care.com: Large caregiver database with background checks available
• Carelinx: Matching service with vetting options
• Indeed/Craigslist: Post job listings (requires more screening)
• Word of mouth: Ask friends, neighbors, church community
• Nursing schools: Students often work as aides
• Other families: Ask caregivers of others in your parent's community

Screening and Interviewing

Initial Phone Screen

• Briefly describe the job and schedule
• Confirm they're available and interested
• Ask about relevant experience
• Discuss pay expectations
• If promising, schedule an in-person interview

In-Person Interview Questions

Experience and Skills:

• "Tell me about your experience caring for elderly people."
• "Have you cared for someone with [specific condition]?"
• "Describe a typical day in your last caregiving position."
• "What personal care tasks are you comfortable with?"
• "What would you do if my parent fell?"
• "How do you handle someone who is resistant to care?"

Reliability and Fit:

• "Why did you leave your last position?"
• "How do you handle being late or calling out?"
• "What's your backup plan if you're sick?"
• "Are there any tasks you're not willing to do?"
• "How do you handle stressful situations?"

Practical Matters:

• "Do you have reliable transportation?"
• "Are you comfortable with our schedule?"
• "What are your salary expectations?"
• "Are you comfortable with a background check?"

Background Checks

Essential for private hire. Check:

• Criminal background: Use services like Checkr, GoodHire, or state registry
• Abuse registry: Check state's adult abuse registry
• Driving record: If they'll be transporting your parent
• References: Call at least 2-3 former employers; ask specific questions
• Credentials: Verify certifications (CNA license, CPR)

Reference Check Questions

• "Would you hire this person again?"
• "How did they handle emergencies or difficult situations?"
• "Were they reliable? On time?"
• "How did they interact with your family member?"
• "What were their strengths and weaknesses?"
• "Why did they leave your employment?"

Red Flags

Walk away if you see these warning signs:

• Unwilling to provide references or submit to background check
• Gaps in employment history they can't explain
• Bad-mouthing former employers
• Vague answers about experience or qualifications
• Arriving late to the interview (if they can't be on time now...)
• Talking over your parent or ignoring them
• Seeming more interested in pay than the work
• Pressuring you for an immediate decision
• Expressing rigid ideas about how things "should" be done
• Your gut says something is off

Setting Up for Success

Written Agreement

Even for informal arrangements, document:

• Work schedule (days, hours)
• Pay rate and payment schedule
• Specific duties and responsibilities
• House rules (no smoking, no guests, etc.)
• Policies on calling out, lateness
• Termination terms (notice required, immediate termination causes)
• Confidentiality expectations

Training and Orientation

• Walk through your parent's routine
• Show where everything is kept
• Explain medications and schedules
• Discuss your parent's preferences and personality
• Provide emergency contact information
• Explain medical conditions and what to watch for
• Review any equipment (wheelchair, walker, medical devices)

Communication Systems

• Daily log or notebook for communication
• Regular check-in calls or texts
• How to reach you in an emergency
• App-based care tracking (CareZone, Lotsa Helping Hands)

Monitoring Care Quality

Signs of Good Care

• Your parent is clean, well-groomed, and comfortable
• Medications are given on schedule
• House is tidy and safe
• Caregiver follows the care plan
• Good communication—you're informed of changes
• Your parent seems content or even happy
• Caregiver is punctual and reliable

Warning Signs

• Your parent seems afraid or anxious around the caregiver
• Unexplained injuries or bruises
• Weight loss, dehydration, poor hygiene
• Medications not being given correctly
• Missing items or unexplained financial transactions
• Caregiver discourages visits or monitoring
• House is messy or unsafe
• Your parent expresses that they don't like the caregiver

What to Pay

Rates vary significantly by location and type of care:

Factors that increase cost: dementia care, overnight hours, weekends, holidays, skilled care needs, high cost-of-living areas.

Paying for Home Care

• Private pay: Most common; out-of-pocket
• Long-term care insurance: May cover home care after elimination period
• Medicare: Only covers skilled home health care after hospitalization; not custodial care
• Medicaid: Covers home care for those who qualify financially; varies by state
• VA benefits: Veterans may qualify for home care assistance
• Workers' comp: If injury caused need for care