Millions of Americans have disabilities or chronic health conditions that limit their ability to take care of themselves without some support, and a significant percentage of that population is unable to live independently. More than likely, at some point in a lifetime—particularly in old age—you or someone you love will need personal assistance or long-term care handling day-to-day needs such as eating, bathing, dressing, shopping, transportation, and basic household chores. What if a family caregiver isn’t an option?
Throughout time, people have relied on family members to take on caregiving duties. But advances in medicine mean life expectancies are getting longer, even with chronic health conditions. The rise of two-income households means not as many women are available to take on extended caretaking roles. Delayed retirement means adult children are still working when their parents become elderly. More and more people are remaining childless, and adult children are often less willing to take on the responsibility of caring for elders compared to previous generations.
Choosing a caregiver can be challenging in the best of situations. But when there are no family members able or willing to help, or the individual needing care doesn’t want to be a burden to relatives, there is an added layer of complexity and cost.
As you search for and choose a caregiver, here are some things to consider to ensure as much comfort, safety, and peace of mind as possible.
Evaluate Home Care Needs
First, you’ll need to determine what level of care is needed for the individual. If medication management, physical therapy, or assistance with medical devices is required, you may need skilled nursing care. If the person needs help with light household chores, meal prep, bathing, dressing, and toileting, you may need a less skilled but patient and caring home care companion. If home maintenance, bill paying, or errand running is what you need, you may only need occasional assistance.
Keep in mind, these needs are likely to change over time, so it’s important to consider both short-term and long-term possibilities. Only with careful and ongoing assessment can the best solution be determined.
Do Your Research
Ensuring someone’s needs are met can feel like an overwhelming and sometimes lonely endeavor, but remember that people face this challenge every day, and resources are available. Start by asking around. Chances are, your friends, extended family members, and co-workers have faced similar challenges with their loved ones and could have some helpful suggestions you haven’t considered.
It’s not always easy to find the exact answers you need, but you will find a wide array of organizations and agencies dedicated to offering services, support, and information about caregiving, such as AARP, the Family Caregiver Alliance, and the National Institute on Aging to name a few. There may also be local agencies or organizations that can help you locate information and service providers.
It may take a considerable amount of time and effort, but with some digging, you’ll find that there are resources and aid available for elder legal, financial, housing, and caregiving support. Charitable and government programs exist for those with limited resources.
Recognize Caregiving as a Job
Family members often handle caregiving duties as unpaid labor, but it’s important to think of caregiving as a job. If someone in the extended family or community is tapped to help, remember that this person is giving up not only personal time but time that could be used to earn an income, even if they are a homemaker or retired. Compensation should always be a consideration.
No matter who will be fulfilling duties or how well you know them, there should be a formal job description with specific required skills, abilities, and expectations spelled out to avoid misunderstandings and problems developing in the future. You should also create a contract that includes the job description, wages, payment processes, unacceptable behaviors, and legalities. Put everything in writing to avoid any misunderstandings or unwanted issues.
Handle the Search Process
As with any job, finding the right person isn’t always easy. In cases where light support is needed, a friend, neighbor, or community member may be able to handle the tasks; but if daily, ongoing help or skilled support is needed, you’ll want to hire an experienced home care professional.
First, turn to your network for ideas about where to hire, where they found care for their loved ones, what agencies they would recommend and which to avoid, and for direct referrals. Career home health aids move from one client to the next as the client’s needs change or expire, so you might be surprised that a suitable referral is available at the right time.
After exhausting your personal network, search online for reputable adult daycare, home care, or home health care agencies near you. No matter the source, it’s important to look for a licensed and bonded professional when possible.
Conduct a Thorough Screening
After assessing the applicant pool and narrowing candidates, be prepared to conduct interviews, asking questions about their background. It’s best to ask for specific, relevant examples of how they handled situations in the past, looking for evidence of experience, problem-solving skills, and a compassionate approach to their job. Bring a friend or family member for a second opinion and allow for an opportunity to observe the candidate’s interaction with the person they will be caring for. If the person being cared for is able, be sure to include them in the interview process.
ALWAYS ask for references and take the time to check those references thoroughly. Never skip the criminal background check. Even if the candidate was already required by the state or agency to pass a background check, do your due diligence to ensure they haven’t been involved in questionable criminal activity that would not have disqualified them, such as driving without a license or drug use, which could present a safety risk. Keep in mind that people slip through the cracks all the time, so don’t hesitate to double-check the candidate’s background.
Manage the Caregiver Carefully
Hiring a caregiver will greatly reduce the responsibility you take on as a family member or concerned friend, but keep in mind that managing caregivers and monitoring the situation will be an ongoing task. Establish a relationship of mutual trust, treating the caregiver with respect. You’ll want to ensure that you or another trusted person checks in regularly.
Keep lines of communication open with both the caregiver and the elder or disabled person if they are able to speak on their own behalf. Periodic home visits should also take place, looking for signs of neglect, abuse, or exploitation.
Creating Peace of Mind
Whether you are currently considering caregiving options for yourself in the future or your concern is a loved one, there’s no question that the prospect is daunting. Nobody wants to be in a situation where they can’t take care of their own daily needs, but the reality is that it’s likely to happen. The better prepared you are now, the readier you will be when the time comes. Take comfort in knowing you are doing the best you can to address a difficult fact of life.
Brendan is the Managing Director for Waymark Wealth Management. He has extensive experience in comprehensive wealth management. His focus includes retirement planning, behavioral finance, investment portfolio construction, education funding, insurance & risk management, taxes, charitable giving, and estate planning. Brendan has an ability to take clients' complex visions and distill them down to simple action plans, helping them move from where they are today to where they want to be tomorrow.
The opinions voiced in this material are for general information only and are not intended to provide specific advice or recommendations for any individual.
This information is not intended to be a substitute for specific individualized employer/employee advice. We suggest that you discuss your specific scenario with a qualified legal advisor.
This material was prepared by Crystal Marketing Solutions, LLC, and does not necessarily represent the views of the presenting party, nor their affiliates. This information has been derived from sources believed to be accurate and is intended merely for educational purposes, not as advice.