When we find that a parent, spouse, other loved one — or even 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 also is 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.

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. 


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Creating a Care Plan and Budget

To ensure 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, if support is needed with bathing, dressing and companionship during the day, think about how many hours of care a day those tasks require.  For detailed advice on creating care task lists check out Hand in Hand’s Guide to Developing Care Task Lists.

Exploring Financial Assistance and 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 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 (Phone hotline: 1-800-667-1116) 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 for “[name of state] Department of Labor employment laws.”

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

  • Wages: Use the MIT’s Living Wage Calculator as a guide for appropriate compensation 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

Image of older black woman sitting next to older black man who is reading a prescription bottle

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 and use our downloadable caregiver ad template.

After you have interested applicants, conduct pre-interviews by phone to assess candidates’ suitability, discuss care needs, and address practical considerations. Use this opportunity to ask preliminary questions to determine if they could 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 you’ll want the caregiver to drive you or your loved one to doctors 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 in their lives who 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 complete guide for the interview process.

Woman in a wheelchair sitting a table holding taking notes on a pad of paper
Image courtesy of Disabled And Here

Building a Positive Relationship through Clear and Respectful Communication

Once you hire a qualified caregiver, lay the groundwork to build a professional, dignified relationship.  The framework for success are these three tools: 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. Think of the work agreement as the foundation of the working relationship. Create the agreement with input from the caregiver you are hiring.  The document will be something you both can return to for clarity.  For example if you want the caregiver to write down 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 a platform to discuss any changes to care, schedule or 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 at the beginning of the relationship 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. 

It’s also a great time to schedule changes that might be necessary. If you’re privately paying a caregiver, the annual evaluation is an opportunity 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 guidance about annual reviews, consult our guide.

Asian woman wearing a blue nursing shirt sitting next to an older asian woman in a wheelchair. The two are playing a game.

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.