When we find that a parent, spouse, loved one, or ourselves need care beyond what we can provide, we know it’s time to explore hiring paid caregivers. It can be challenging to face the reality that direct care support is necessary. While this change takes some adjustment, it’s the best way to ensure you or your loved one remain safe and as 

independent as possible at home.

When it comes to hiring a caregiver, the first step is understanding your goals and needs. This resource provides you with a roadmap to get started on this journey, from planning and budgeting to building a care team and establishing respectful relationships with caregivers.

Key Takeaways

1. Develop a care task list and calculate the time and budget necessary for the role.
2. Determine whether to hire through public programs or privately.
3. Integrate three foundational elements of a respectful working relationship: a written work agreement, regular check-ins, and annual evaluations.

Note: There are a lot of different words people use to describe this support role, including home care worker, caregiver, personal care attendant (PCA), and many more. We use the term caregiver in this resource for simplicity.

Creating a Care Plan & Budget

For effective caregiving, it’s essential to assess the care needed. Consider daily care requirements, the duration of specific tasks, and the total hours of care needed. For example, different tasks like bathing, dressing, and companionship take different amounts of time, so you’ll need to estimate how many hours each task takes and then add them up. For detailed advice on creating care task lists check out Hand in Hand’s Guide to Developing Care Task Lists.

Exploring Financial Assistance & Public Programs

Long-term homecare can be expensive, but there are alternatives to institutionalized care. Public programs such as Medicaid and Medicare, as well as state-specific resources, can offer financial support. For disabled people of any age, Centers for Independent Living (CILs) provide assistance with navigating available care resources. The Independent Living Research Utilization’s Directory of Centers for Independent Living (CILs) and Associations can help you find a CIL near you. For older adults, the Eldercare Locator at the US Administration for Community Living (hotline: 1-800-677-1116) is a helpful tool for researching programs available in your area.  

The process of registration and approval can take months, so start as early as possible. Also note that caregivers hired through public programs are typically directly employed by the government, so you will not be able to directly influence their rate of pay or paid time off.

Hiring a Private Caregiver 

If public programs are not an option, consider hiring a private caregiver. Private homecare can be more cost-effective than institutional care like a nursing home. In-home care is important skilled work, and caregivers should be compensated with a fair, living wage to ensure they can provide for themselves and their families. 

It’s a good idea to familiarize yourself with employment laws in your state and city as they serve as a baseline for caregiver employment standards. This information can be found by searching, “[Name of State] Department of Labor employment laws.”

Regardless of local legal requirements, Hand in Hand recommends following these wage and paid time off guidelines:

• Wages: Use MIT’s Living Wage Calculator to find out the appropriate compensation rate in your area.
• Overtime: Any worker who works more than 40 hours a week or 8 hours a day should be paid time and a half for the hours above those hours. If this rate of pay is more than you can afford, you can hire an additional care worker to avoid overtime hours.
• Paid Sick Leave: 1 hour for every 30 hours worked
• Paid Time Off: 1 hour for every 20 hours worked

Building a Care Team

Based on the care needs you identified, you’ll be able to determine whether you need a part-time caregiver or a team of caregivers. Crafting an effective caregiver job ad will help lead to successful recruitment. Follow our Simple Guide for Creating and Using an Ad to Recruit a Personal Care Attendant/Home Caregiver.

After you have interested applicants, conduct pre-interviews by phone to assess candidates’ suitability, discuss care needs, and address practicalities. Use this opportunity to  determine whether they meet the requirements of the job.  

Some questions you may want to ask in this brief call are:

• Do you have availability during the times we need a worker?
• Would the commute to my home be manageable for you?
• Are you allergic to pets? (if applicable) 
• Are you able to operate a patient lift? (if applicable)
• Are you certified in first aid and CPR?
• Do you have a driver’s license and insurance? (if the caregiver will need to drive you or your loved one to doctor’s appointments and other outings)

If the pre-interview goes well, schedule face-to-face interviews to further assess compatibility. This is an opportunity to get to know each other. Introduce yourself and/or your loved one who will be receiving care and other key people whom the caregiver would interact with. 

Be sure to ask specific scenario-based questions, like: 

• “What would you do if my mother fell and hurt herself?” 
• “If there were a fire in my apartment, and I needed to evacuate, how could we work together to stay safe?”
• “What would you do if my father wasn’t eating?”
• “What is a difficult situation you faced in a past caregiving experience, and how did you work to solve it?”

For more ideas about interviewing, refer to Hand in Hand’s interview guide.

Building a Positive Relationship Through Clear & Respectful Communication

Once you hire a qualified caregiver, lay the groundwork for developing a professional, dignified relationship. The basic framework for success includes  a work agreement, regular check-ins, and an annual review.

Written Work Agreement

Building a respectful and effective relationship begins with shared expectations. A written work agreement outlines requirements of the job, compensation and benefits, and the conditions and process for terminating the employment relationship. Create the agreement with input from the caregiver you are hiring. The document will serve as the foundation of your relationship that you both can return to for clarity.  For example, if you want the caregiver to record when you or your loved one took their medication each day, include that expectation in the agreement.

Download one of our sample work agreements as a starting point. 

Regular Check-ins

Regular check-ins provide an opportunity to discuss any changes to care or schedules or to work together to solve challenges. Schedule these during paid hours at a regular time when both of you can focus exclusively on the conversation. Try once a week when you start out and less frequently as you get into more of a rhythm together.

Annual Reviews

Plan for annual reviews to give both you and your caregivers the opportunity to reflect on job duties, revisit the work agreement, and set future goals. If you’re privately paying a caregiver, the annual evaluation is an occasion to demonstrate your appreciation with a pay raise. If you do not pay directly, you can commit to advocating for wage increases for publicly funded caregivers who are usually underpaid.

For more information, consult our How-to Guide for Annual Evaluations for Employers of Caregivers/Attendants.

Next Steps

1. Get started with creating a care task list.
2. Continue learning about how to be a fair employer.
3. Become a member of Hand in Hand.

Conclusion:

You now have the knowledge and tools to hire and manage caregivers for yourself and loved ones effectively. From planning and budgeting to building a care team and fostering a respectful relationship, you can confidently navigate the journey of caregiving and provide the best possible support for yourself and family members.