Choosing a Live-in Caregiver: Who Will Care for Your Loved One When you Can't

By Darlene Oakley HERWriter

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Statistics show that approximately 80 percent of long-term care provided in the United States is carried out by 44 million American families. But at some point in a family’s life they may be faced with the decision of whether to hire someone as a live-in caregiver.

Perhaps the loved one’s needs are just too great for someone without proper medical or caregiving training. Perhaps the family living situation will not accommodate the extra special needs that caregiving for an adult might require.

One of the main reasons for a live-in caregiver or home care is to provide a loved one with the dignity and comfort of staying in their home as long as possible.

The Job Description of a Live-In Caregiver

It is important to be observant about the needs of our loved ones, to be able to recognize when they need help. Arthritis, Alzheimer's and Parkinson's are all obvious conditions where coordination and dexterity make bathing and dressing difficult.

Housekeeping, remembering to take medication, grocery shopping may also become challenging and are indicators that help may be needed. Family Care America has a Needs Assessment Worksheet that can help with this at www.familycareamerica.com/

Because each person’s abilities and needs are different, the individual circumstances need to be assessed in deciding whether a live-in caregiver or home care is necessary or beneficial, how much care is needed, and what skills your caregiver needs to have.

A caregiver is defined as “a person ... who helps an older person with activities of daily living, health care, financial matters, guidance, companionship and social interaction. A caregiver can provide more than one aspect of care.”

Depending on your loved one’s particular situation, your live-in caregiver will need to provide a range of services and take on several roles, such as helping with bathing, dressing, cooking, grooming, etc. (health care aide); medication management and other more specialized care such as tube feedings, dressing changes, and therapy prescribed by a physician (nurse); devising a diet to meet certain medical requirements, e.g., diabetes (nutritionist); help with basic housekeeping (homemaker).

Depending on the level of care required, you need to make sure that the live-in caregiver you hire can carry out these responsibilities, or coordinate with a team of professionals to provide the best care.

This is a big responsibility and obviously can’t be left to just anyone.

Considerations for a Live-In Caregiver

As you face this decision, there are several things that must be considered in the selecting of the right person to care for your loved one:

1) Cost – Do your research. Investigate hiring through a caregiver agency or looking for a provider on your own. Don’t always go with the cheapest price.

Investigate what insurance companies and Medicare/Medicaid cover. You also need to find out your responsibilities as an employer of a “household employee” both on a federal level and a state level.

2) Caregiver agency or finding your own – Self-hiring is often less expensive and more personal than going with an agency. The advantages of going to an agency are that caregivers are screened and can be hand-picked to deal with your particular situation, and you don’t have to worry about payroll and other employer responsibilities.

3) Skills – Make sure the person you choose has the appropriate knowledge and skills to be able to handle your loved one’s unique issues. Know what kind of training is required to provide certain care and make sure to be specific in your live-in caregiver job description.

4) At the Interview – Ask about where they’ve worked before and their experience in dealing with people with your loved one’s particular issues. You need to know how they handle things like transferring someone in and out of a vehicle or wheelchair, or mood changes. Always, always ask for references and follow-up on them.

5) Contract – Make sure you settle the working agreement, including wages, hours of work and duties expected.

Sources like your local Area Agency on Aging is a good place to start when looking for live-in or home care.

Sources:

Caregiver. Sloan Work and Family Research Network Boston College. Web. Jan 24, 2012.
http://wfnetwork.bc.edu/glossary_entry.php?term=Caregiver,%20Definition%28s%29%20of

Caregiving Info & Advice. Family Caregiver Alliance National Center on Caregiving. Web. Jan 24, 2012.
http://www.caregiver.org/jsp/content_node.jsp?nodeid=344

Hiring In-Home Help. Family Caregiver Alliance National Center on Caregiving. Web. Jan 24, 2012.
http://www.caregiver.org/jsp/content_node.jsp?nodeid=407

Hiring Paid Caregivers for In-Home Services. Michigan Office of Services to the Aging Community Services Division. Web. Jan 24, 2012. http://www.michigan.gov/documents/miseniors/CaregiverHiringGuide_176399_7.pdf

Caregiving Services. AssistGuide Information Services. Web. Jan 24, 2012. http://www.agis.com/eldercare-basics/Staying-at-Home/Caregiving-Services/default.aspx

Reviewed January 25, 2012
by Michele Blacksberg RN
Edited by Jody Smith

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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.