Caring for a family member with a chronic illness can be exhausting, so at some point, you may want to hire additional help to provide the best care possible and prevent yourself from burning out. Hiring a paid caregiver or personal care assistant can offer significant relief and ensure your loved one receives the support they need.
I’ve hired several part-time caregivers for my husband who is disabled due to ME/CFS and also have helped my sister hire full-time caregivers for our elderly parents. In my husband’s case, we’ve decided to call our part-time hired help a “family assistant” instead of “caregiver.” It’s partly because I’m the “chief household officer” of our family, and the person is helping me get things done that I don’t have bandwidth to do because there is simply too much for one person to manage. It’s also partly so my husband feels less like a sick patient, since it feels more like the entire family is getting an assistant to help with things that both he and I have limited capacity to tackle.
Here's a step-by-step guide to help you through the process of hiring a paid caregiver or family assistant.
Step 1: Assess Your Needs
Before you begin your search, it’s important to determine what kind of help you need. Consider the following:
Medical Needs: Does your loved one require medication management or any type of medical care? Depending on the level of medical care, maybe you would want to hire a Certified Nursing Assistant (CNA), who has more healthcare training and works with more medically complex patients.
Personal Care: Do they need assistance with daily activities such as bathing, dressing, or eating? If so, maybe you'd want to hire a Personal Care Assistant (PCA), who supports an adult with disabilities or an elderly person by assisting them with non-medical daily living activities. While PCA certifications exist, they aren't required.
Household Tasks: Will the caregiver need to help with cooking, cleaning, or running errands?
Companionship: Does your family member need social interaction and emotional support?
Hours: Do you need someone for 8 full hours, fewer hours, or more hours? What time of day/night do you need them? Do you need help just Monday to Friday? Keep in mind many people are looking for full-time roles, though there are people who want part-time jobs.
Creating a detailed list of responsibilities will help you find a caregiver with the right skills and experience.
Step 2: Determine Your Budget
Caregivers' rates can vary widely based on their qualifications, the complexity of care required, and your location. Consider:
Private Hire vs. Agency: Hiring through an agency is typically more expensive, but it often includes background checks, training, and liability insurance.
Hourly vs. Live-In Care: Hourly care might be more suitable if you only need assistance for part of the day, while live-in care can provide round-the-clock support.
Insurance and Benefits: Check if your health insurance or government programs (like Medicaid or VA benefits) can cover part of the caregiving costs.
Research Your Location: Find out what the going rate is for paid caregivers in your local area. Consider how much you’re willing to pay within that range. If you need someone just part-time, you may need to pay a decent hourly rate to make it worth their while.
Step 3: Write a Job Description
Create a job description that outlines the responsibilities and requirements for the role. This will help you recruit candidates who are a good fit for your needs.
As an example, here's our job posting from earlier this year:
We're seeking a part-time family assistant to help my husband (who’s disabled due to a chronic illness) with meal prep, light housework, driving to doctor’s appointments, helping with home organization, administrative work, and running errands.
Must be compassionate, detail-oriented, responsible, pro-active, trustworthy, reliable, mature, non-smoker, and a good driver. You will be driving our vehicle most of the time. If you drive your vehicle to run errands, we will provide mileage reimbursement.
Hours will be 1-4 p.m., Monday to Friday, and sometimes more depending on your availability and our needs.
Step 4: Search for Caregivers
There are several avenues to explore when looking for a paid caregiver/family assistant:
Home Care Agencies: Agencies handle the recruitment, vetting, and sometimes training of caregivers. They can quickly provide a replacement if your regular caregiver is unavailable.
Online Job Boards: Websites like Care.com or Indeed can help you find independent caregivers. Make sure you conduct thorough interviews and background checks. Care.com offers different types of background checks that you can purchase.
Local Resources: Community centers, hospitals, and support groups might have recommendations or bulletin boards with caregiver postings. You can also try posting in your local community’s Facebook or NextDoor group. I've had luck posting on my local community's parenting group on Facebook.
Tip: Look for caregivers who live within a 10-mile radius of your home. This makes it easier for them to arrive on time instead of getting stuck in traffic. The caregiver may also appreciate a short commute, giving you an edge over other employers.
Step 5: Conduct Thorough Interviews
Plan to talk with the top 3-4 candidates by phone. Then invite your favorite candidate to your house where you and your loved one can talk with the candidate in person. You’ll get a sense if there’s good chemistry from a personality standpoint. Remember if you are in a hot job market, you may need to act in a timely manner. Ask the candidates if they are actively interviewing with other families.
Interviewing potential caregivers is a crucial step. Prepare a list of questions that cover the following:
Experience and Qualifications: Ask about their previous caregiving experience, training, and any certifications.
Specific Skills: Ensure they have the necessary skills for your loved one’s needs, such as lifting techniques, medication administration, or familiarity with specific medical conditions.
Availability: Confirm their availability aligns with your schedule and discuss how they handle emergencies or sudden changes.
Personality and Approach: Caregiving is a personal job. Make sure their personality and caregiving philosophy match your family’s values and expectations.
My first-round phone interview questions to screen candidates:
Please tell me about yourself & your experience with caregiving and helping families. Where have you worked before and what were your duties?
What is your experience with cooking, tidying up, helping organize spaces, and scheduling appointments? How about doing online research to find things like a handyman or plumber? Any other things you’ve done for clients?
We generally will need help 3 hours/day, from 1 to 4 p.m., Monday to Friday. Some days may be longer due to doctor appointments. Does this time work for you?
Can you tell me about a time when you had to problem-solve something for your client? What steps did you take in coming up with the solution?
What kind of precautions do you take to avoid getting COVID or a cold? My loved one is immuno-compromised.
Do you smoke, wear perfume, or have pets at home? My loved one is sensitive to strong smells. And unfortunately, our family has a lot of allergies, including cat hair and sometimes dust from dog hair.
My In-Person Interview Outline and Questions:
Thanks so much for coming to meet with us in person. I enjoyed talking with you over the phone.
Let me tell you about my loved one’s health conditions. (He has fatigue, brain fog, chronic pain, migraines, can't walk much, etc.)
Due to my loved one's immune system issues, we need to be careful about COVID, colds, and allergies (pollen and pets). He also has sensitivities to loud sounds and strong smells. What type of precautions do you already take and/or could take?
Let's discuss the job responsibilities in more detail. (Then go over all of them). Can you tell me about your experience with these areas?
Food prep: Explain meal needs/preferences. What type of meals are you familiar with making?
Tidy up the house as needed (e.g. put away laundry, make the bed, etc.)
Ability to make doctor’s appointments, phone pharmacy & health insurance, pick up medications at the pharmacy, place grocery orders online and pick up, do research (e.g. online research to find a handyman), etc.
Do you have any questions for us?
Can you give me contact info for 2-3 people you’ve worked for as references?
Ideally, you can find a caregiver/family assistant who can become like an extended member of the family or a family friend, someone who’s caring and trusted. We've had mixed results over the years, but several times we've found wonderful people who we still consider as friends. The one time we had a problematic hire was when I didn't do thorough reference checks. Which leads us to the next very important step.
Step 6: Check References and Run Background Checks
Always ask for and follow up with 2-3 references. Speak with previous employers to get an understanding of the caregiver’s reliability, trustworthiness, work ethic, and demeanor. Additionally, conduct a criminal background check to ensure there are no red flags. When you use Care.com, there are different types of background checks that you can purchase. You can also conduct background checks through other websites. Questions I ask previous employers:
Can you tell me about your experience with xxx? What did you have her/him do?
Would you recommend her/him? Is she/he trustworthy? Is she/he reliable?
Is she/he pro-active & can you give me some examples?
Is she/he good at problem-solving & can you give me some examples?
Step 7: Create a Care Plan and Contract
Once you’ve selected a caregiver, create a detailed care plan outlining:
Daily Tasks and Responsibilities: Be clear about what is expected each day. Tip: I make a list of daily tasks each week and print it out to share, so we're on the same page. Then each week I update the list with specific tasks that pop up for that week (e.g. Drive my husband to a doctor’s appointment at a certain time and include the address). If you expect them to administer medication, provide the medication schedule.
Emergency Protocols: Provide instructions for emergencies, including contacts and medical information.
Payment and Schedule: Agree on the payment terms, schedule, and any benefits like paid time off. If you are hiring an independent caregiver, you may want to use a payroll service company, which will help with weekly payroll and deal with tax filing. From each paycheck, employee taxes are withheld. It’s important to note, both employers and employees are required to pay taxes on the wages earned by an employee.
Draft a formal contract that both parties sign. This document should include all agreed-upon terms and serve as a reference in case of disputes.
Step 8: Monitor and Communicate
After hiring a caregiver, maintain open lines of communication. Regularly check in with your loved one and the assistant to ensure everything is going smoothly. Be open to feedback and ready to make adjustments as needed. As your loved one's health condition and needs change, you may need to update the assistant's responsibilities.
In addition to updating and sharing the weekly schedule of tasks and appointments for the paid caregiver, you may want to consider asking him/her to keep a daily log of activities of your loved one (e.g. note mealtimes, sleep times, and any issues that arise) so you can keep close tabs on their well-being.
Importance of Taking the Right Steps to Hire a Caregiver
Hiring a paid caregiver can significantly enhance the quality of life for your family member with a chronic illness while providing you with much-needed respite. By carefully assessing your needs, conducting thorough interviews, background checks, and reference checks, and maintaining clear communication, you can find an assistant who will offer compassionate and competent care. Remember, the goal is to create a supportive environment where your loved one feels safe, respected, and well-cared for and to provide you some breathing room.
