How to Hire a Caregiver

In this article...
  • Do you know how to hire a caregiver? Find out how to find, hire and pay for a qualified in-home caregiver for yourself or for a loved one who needs help.
Caregiver makes coffee for her patient

Tens of millions of Americans live with some kind of disability. For many people, hiring a caregiver to help with activities of daily living is the only way they can remain independent in their own homes. Trained caregiver assistance helps people with age- or health-related disabilities stay out of long-term care facilities, and the assistance these professionals provide goes a long way toward restoring the dignity many adults with disabilities feel in danger of losing.

It isn’t always easy to find a good caregiver, however. The quality of care you or your loved one gets varies with the individual caregiver’s skill, training and dedication. Hiring a great caregiver takes time, but it’s one of the most important things you can do to help yourself or a loved one with a disability live well at home.

When Do You Need a Caregiver?

Caregivers do so much for the people they take care of that there’s good reason to hire one at all levels of ability. For some people, hiring a caregiver is the right choice as soon as age or health issues make routine chores, such as shopping or cleaning the house, difficult to do alone. People with more severe limitations may need a caregiver when they start having trouble with personal care tasks, such as bathing or dressing, and will hire a helper for more of their activities of daily living.

Some people hold off on hiring a caregiver until illness or injury has made even basic tasks too difficult to do on their own, and they need to find someone who can help out with some medical care tasks, such as managing a feeding tube or rolling the person in bed to prevent bedsores. There is no single right time to hire a caregiver, other than the point when you feel you need someone in the home to help out.

How to Find a Qualified Caregiver

Once you’ve decided to hire a caregiver, you might be at a loss for where to find someone you can trust. Classified ads are a generally an unreliable choice for hiring caregivers, since little or no screening is done by newspapers or job sites. Word of mouth is somewhat more reliable, but your circle might be limited, and you could miss out on a great caregiver simply because you don’t know the right people. Asking around your workplace, church or other community group can expand this word of mouth network, as can asking your doctor or other healthcare provider. You can also, in many cases, get help hiring a relative or personal friend to act as a caregiver.

Fortunately, several resources exist to connect you with qualified, pre-screened caregivers for yourself or a loved one. Area Agencies on Aging are private nonprofit organizations that work in concert with state governments to connect seniors with skilled caregivers. These agencies are organized by geographic area to serve seniors and adults with disabilities in each state or part of the state. Agencies can also be a great resource for connecting seniors with Meals-on-Wheels, low-cost and free transportation and several other services that help people with disabilities remain independent.

Hiring a Caregiver

Wherever you find a caregiver, it’s important to take the time to carefully vet the candidates before you make your final decision. Apart from having a clean background and giving a good impression during the interview process, the qualifications a caregiver should bring to the job depend on the type of care that’s needed.

Companion Caregiver Qualifications

Companion caregivers are the basic level of home caregivers. These are often friends, family members or part of a church or other nonprofit group who help out with regular activities of daily living but who do not provide medical care. While it is not strictly required for these people to have training before starting work, they often have some background in CPR, elder abuse identification and prevention, and mobility training that includes fall prevention.

Home Care Aid (HCA) Qualifications

HCAs generally have the same training as companion caregivers, but they often help out with more activities of daily living, such as shopping trips and transportation for medical appointments. In many states, HCAs must have extra training in infection control, pass a LiveScan background check and register with the state department of human or social services. These agencies can assist you with finding a registered HCA.

Certified Home Health Aide (HHA) Qualifications

HHA caregivers provide the same services as companions and HCAs, but they almost always have extra training to provide light medical services, such as wound care and bandage dressing. In most states, HCAs also have a limited ability to assist with medication. States generally require HCAs to register and complete periodic refresher training to stay current with their qualifications.

How Much Does a Caregiver Cost?

In-home caregivers average between $23 and $25 an hour in the United States, according to Genworth Financial’s 2020 Cost of Care Survey. This can fall outside of the range of many people to pay, though family members often pool their resources to hire a caregiver for their loved one. Because in-home caregivers do not provide licensed medical care, health insurance plans generally don’t cover the cost of hiring a caregiver.

Resources to Help Pay a Caregiver

Fortunately, many resources exist to help pay for high-quality in-home care. Most states’ Medicaid plans include some form of in-home care waiver for eligible beneficiaries. Waiver programs make state Medicaid funds available to enrollees whose age or physical condition would normally justify placement in a skilled nursing facility. In order to reduce the cost of residential care for these beneficiaries, Medicaid participants who waive placement in a care home can get help hiring a caregiver and paying for their services.

Each state that offers a waiver has its own rules about eligibility and application procedures, but as a rule, you can ask for a Medicaid waiver directly from a Medicaid worker in your area. Waivers can also be requested by discharge planners at nursing homes, family members and others involved in caring for seniors and adults with disabilities. Once a waiver is granted, the beneficiary can hire any caregiver they like, including a spouse, family member or friend. Prospective caregivers then attend an orientation, pass a background check and log the hours they spend providing direct care in the home. The waiver program then typically issues a check every two weeks, up to a maximum of allotted hours of caregiver time.