When your elderly parent needs help.
How do you find a caregiver? Whether your elderly parent is in crisis and needs a caregiver with them full time or you just want someone to check on them every once in a while, or something in between, where do you start? A Google search to find some help can be overwhelming.
Stacy Scarborough of Visiting Angels Georgetown talks to Kim and Mike Barnes of Parenting Aging Parents and shares expert tips on hiring non-medical caregivers.
In this interview learn how to find caregivers, whom to talk to, what questions to ask, what to expect and how much you’ll likely pay. She also explains the differences and pros and cons between private caregivers and home care agencies and lays out the steps you need to take when you start looking.
Read the full transcript
Transcript of Interview: “How to Hire a Caregiver for Your Aging Parents”
Mike Barnes:
We have both been in the situation where we need a little bit of help for our parents. When my dad had COVID, my mom was by herself in independent living. That was not a good deal. I needed somebody, I needed somebody now.
Kim Barnes:
Absolutely. We wanted just a little bit of help to be brought in, but trying to figure out how do you find it and how do you do it. So today, we’re going to talk to Stacy Scarborough from Visiting Angels Georgetown, a home care agency. Thanks so much for being with us.
Stacy Scarborough:
Thanks for having me.
Kim Barnes:
Mike mentioned sometimes you’re in sort of a crisis where you need somebody now. In my case with my mom, it was just a gradual noticing that we needed to bring in and have a little bit more help. You want to bring in a non-medical caregiver. Where do you start?
Stacy Scarborough:
Yes, we actually come across this a lot. Typically, when you want to hire a caregiver, it’s quick, it’s fast, you’re in panic mode, you’re overwhelmed, you’re exhausted, and you’re not feeling good. So, we always recommend talking to your family and friends who have used something like that. Personal referrals and word of mouth go a long way. You’re really going to get that honest perspective of somebody who’s gone through it before you. Then, you’re going to take that list and maybe compare it to who your primary care physician might recommend. If you are currently in a health care system, maybe you’ve been in the hospital or you’re at a rehab hospital, they have social workers, case managers, or discharge planners who are typically very in touch with who’s serving that area, what types of payment methods they take, their limitations, and can give you a good list as well. The key takeaway is to start with a short list as you’re gathering that information and always call around to multiple options. That way, you can get the benefits of each and get a better idea of who and what is the best fit for you.
Kim Barnes:
I know that in our neighborhood, we have a very active Facebook group just for our neighborhood. A lot of times, people ask questions like that. Obviously, our Parenting Aging Parents community has a lot of people who have had experiences that you could ask for questions too.
Mike Barnes:
In my situation, my dad had to go to the hospital because he had COVID. This was about three years ago. My mom was by herself, dementia level five at that point. I didn’t go up there because I was three hours away, and it was COVID time, everything was locked up. I think my mom was actually positive too, even though she wasn’t showing any symptoms. I had no idea what to do. I needed to get help for my mom, so I Googled and tried to find somebody. I made some calls, but it didn’t help at all. What should I have done better?
Kim Barnes:
I think asking for those referrals, not just going straight to Google. Even once you get that short list, what kinds of questions should you ask? Because a lot of times, an agency might have some minimum required hours and things like that, right?
Stacy Scarborough:
That’s right. Your first step is when you do make those calls, who’s answering? What home care agencies are answering the first time you call? What does the voice sound like on the other end? Are they patient and answering your questions? Can you tell that there’s compassion on the other side of the phone? That’s step number one. You’re going to get a real feel for how this group does business. Then, you are going to want to ask questions. It’s very normal to have that person on the phone be able to answer all of your questions. You shouldn’t have to wait to schedule an in-person meeting, sign paperwork, or sign up upfront before knowing how it works. You should ask, what is the payment structure? What is the cost? Generally, it’s based on an hourly rate structure. You want to ask, do you take alternative payment methods? Do you take long-term care insurance? Do you take the VA for veteran benefits? You want to ask, how do you hire your caregivers? Where do your caregivers come from? What are your credentials and your requirements for your employees? You want to be able to ask, are they available to call 24/7? What if something happens and it is on a weekend or in the evening? Can I speak to someone in management? You also want to ask, what is their cancellation policy? Some agencies are going to be far more flexible than others. As we know with health care, we really can’t plan when we need to change our schedule or we need to cancel or change our plan. You really want someone that can be more flexible. So, the cancellation policy and, like you mentioned, a minimum. Do I have to sign up for a certain amount of hours on an ongoing basis? What if I only need it one day or a couple of weeks? Can you do a short-term case?
Kim Barnes:
Is that pretty common that most home care agencies will have some sort of minimum, whether it’s hours in a block of time where it needs to be four-hour shifts or something like that? Is that pretty common?
Stacy Scarborough:
It is very common. Some do still have like a one-hour minimum. At Visiting Angels, we don’t have one and have never had one, but it is becoming far more common to have like a four-hour minimum where the caregiver can only see you in four-hour blocks or it could be like a per-week minimum. You have to schedule 12 hours or 20 hours per week of care.
Kim Barnes:
Would it be appropriate to also ask how much turnover they have with their caregivers? In today’s world, in all kinds of service-based industries, like restaurants, I would imagine in senior care too, we’ve heard that it’s really hard to keep caregivers. Would it be helpful to know how often they are hiring new ones and would I see the same person likely or would it always be a different person? Are those kinds of questions too?
Stacy Scarborough:
I think even more helpful than the turnover question is what is your staffing like right now? How well-staffed are you? How quickly can you start a case if I call and need help? What does that turnaround look like? Once I do start care, how well-staffed are you to be able to send me the actual type of caregiver I need for the schedule that I need? When you’re more well-staffed as an agency, that’s what allows the flexibility. You can change caregivers if it’s not the right fit or you can change the schedule. You can change the hours a lot easier when you have a much larger pool of caregivers to try.
Mike Barnes:
We were talking earlier about being in panic mode, and so many of us are in panic mode when we need some help. But we could plan ahead. If you know that your mom or your dad is doing okay now but you think maybe in the near future they’re going to need some help, is it silly or do I sound dumb if I call you and say, “I think I may need some help in 2025, can you give me some information?” Is that something that’s okay to do?
Stacy Scarborough:
It is. We honestly really encourage it because it’s not like you’re necessarily signing up for an actual schedule at that point. You may be just preparing for the just-in-case or you just had a situation that caused you to be pretty close to knowing that you need assistance, so it’s got you thinking. Make that call, ask the questions, and at least have that short list of options. You can give this list to your family members if something happens again. These are the people I’m going to call to try first. A lot of agencies will allow you to pre-register. You just get in their system with basic information, there’s no contract, and now at least the paperwork part is done. If you do call for assistance, we just need to do the more specific care planning aspect of it and prepare for actual care to take place.
Kim Barnes:
One of the things that I ran into is that we only needed a little bit of help for my mom. Someone to fill her pill box once a week and then somebody really just to get eyes on her a couple of times a week. Hiring an agency really probably didn’t make as much sense because we just needed a little bit of
help. In my case, we were able to find a private caregiver who already worked in helping another woman in the independent living where she lived. That’s actually another place to ask for referrals. If they’re in independent living, there are oftentimes either agencies that might be coming in or private caregivers who already help a couple of people a little bit. That ended up being a really great fit for us. Sometimes people do like that very personal approach and want to be able to just hire one person to help them. When you’re going down that road, what suggestions might you have? When I contacted the woman who is the caregiver that helps my mom now, I was able to call another family and get a referral from them and check the reference, if you will. What are some other things if I think I really would rather just have a private caregiver, what do I need to take into consideration and how do I do that?
Stacy Scarborough:
I think the biggest thing there would be there can be some flexibility with having a private caregiver. So, you’re not answering to an agency. Just knowing if you’re going to hire privately, then who in the family or in the care circle is going to be kind of that manager and that coordinator? Is there somebody that can take on that responsibility to provide some type of oversight? Who’s going to do the interviewing? Who’s going to pay the caregiver? Accounting for taking out taxes, where the agency would do all of that for you. Who’s going to be the one in communication with the caregiver to coordinate schedules or providing a backup plan if that private caregiver becomes unavailable? Is there somebody else willing to be that backup or that sub? Absolutely, you want those personal recommendations. I recommend seeing them in action. Just sitting down for a formal interview with a private caregiver and asking questions will help you, but it’s only going to get you so far. You want to have that person actually in the home providing some care and see their demeanor and how they might approach things. Have somebody else there to help the client feel comfortable.
Mike Barnes:
We have so many people in our Facebook group who post every week about needing somebody to check on their mom just three or four times a week for a couple of hours or something like that. Not nine to five, but still a little bit more than Kim’s mom. They’re always asking what do I do? Who do I look for? Real quick, rehash what the first things they should do to find somebody.
Stacy Scarborough:
To find somebody, you want to ask your friends and family, ask the medical professionals that you trust and who know your situation. If you are in a senior community, typically the management there is going to have a good sense of who’s in their building, who does a good job, who has a good reputation, or who has availability. You want to go to those trusted sources and always compare and talk to multiple agencies. Create that list of what’s important to you so you can see those slight differences that may make a big difference in what causes you to go one way or the other.
Kim Barnes:
Is there a difference in cost a lot of times between a private caregiver versus an agency? Just to give people a ballpark of what you might expect to pay, and I know it varies depending on where you live.
Stacy Scarborough:
Typically, whether it’s private or a home care agency, you are paying an hourly rate. The difference with an agency is there will be a slightly higher cost because you’re paying for the agency to be bonded, insured, and licensed. You’re getting a caregiver that’s been vetted and insured. With private, you’re on the hook if something goes wrong. That is, of course, a benefit to private caregiving. You can generally save a couple of dollars. Overall in the market right now, you’re looking at paying on average anywhere from $25 to $40 an hour for caregiving.
Kim Barnes:
That could depend on what part of the country you’re in, like New York City versus a small town. If you’re looking for some additional help, maybe just a little bit of help, maybe it’s even asking around in your neighborhood. Is there a stay-at-home mom who would like to help check on your mom? For those families who have a loved one who still lives at home, that is probably harder because they don’t already have people in the building helping to provide some of that care. I think it’s asking around and sometimes being creative. Just like we did initially with our kids with our babysitters, we had to get super creative because of our really weird work schedule. We pieced together some really crazy stuff. I think it’s trying to get a little bit creative. Are there any pros and cons of agency versus private caregiver and private caregiver versus agency?
Stacy Scarborough:
Both have pros and cons. It’s really what’s important to you and what has to be a priority. We all have a budget, so there can be a cost difference. There can be an oversight difference. With home care, you’re paying for those caregivers to be vetted and to have oversight. You have that liaison in between you, serving as a buffer. If there are concerns or issues, you have someone to go to and answer to who can solve that problem for you. The number one perk of a home care agency is those caregivers are bonded and insured. Whether there’s theft, a lamp gets broken, or the caregiver gets injured on the job, they will have workers’ compensation insurance, so you’re protected that way. You also have a group to call upon for backups and subs. If your regular caregiver is unavailable, you can call that agency typically around the clock, 24/7, and they can supply you with a backup caregiver so that you’re not stuck.
Kim Barnes:
As you mentioned, some of it depends on what you really need help with. I knew that for my mom, filling her pillbox was going to be really important. Maybe we should touch on this briefly. Because of licensing, a home care agency or caregiver can’t fill a pillbox because then you need home health. I guess it’s also just knowing what kind of help they really need and remembering that all this home care help, whether it’s an agency or a private caregiver, is going to be private pay. A lot of people think Medicare pays for this, but this is additional non-medical care.
Stacy Scarborough:
That’s right. It’s private pay out of pocket. Long-term care insurance will typically cover home care agencies. That’s something else to consider with home care versus private: to find out if your long-term care insurance will even allow you to hire private. A lot of them will have a rule that it has to go through an agency because you’re more protected that way. The VA also requires that it be an agency contracted with the VA, not just anybody, so they would give you a list of who has that contract.
Kim Barnes:
Good to know. I think it’s just having to really sit down and hopefully this helps educate people in a way that they at least sort of know the questions to be asking themselves and to be asking an agency or a private caregiver so that they can make these decisions.
Stacy Scarborough:
That’s right. Knowledge is power.
Kim Barnes:
Exactly.
Mike Barnes:
Thank you so much, Stacy Scarborough with Visiting Angels Georgetown. Thank you so much. I think you’ve calmed the panic mode that a lot of people are in as they’re looking for help.
Stacy Scarborough:
Thanks so much.
Mike Barnes:
Yeah, I think it’s something that we all just need to know. Make a list of what you need and what you can get. It kind of sounds silly, but plan ahead when you can. Even though mom or dad are fine right now, maybe not in the future. It’s kind of like we talk about college. Let’s plan for college way ahead of time. Well, same thing here. Let’s plan ahead of time.
Kim Barnes:
Just knowing what the process is that you’ll go through makes it so much easier. Even just understanding what it actually is is the first step too.
Mike Barnes:
Hey, if you have any other topics you’d like us to discuss, please let us know. Parenting Aging Parents.
*This transcript is auto-generated. Please excuse any typos or mistakes.