The first step to hiring a well-matched senior caregiver for a loved one is to recognize which type of care you’re looking for. If they don’t need nursing or medical assistance but aren’t able to maintain or complete all activities of daily living (ADLs), you’re likely seeking a non-medical in-home caregiver. This knowledge will help frame the type of qualifications you look for and the candidates you interview.
Non-medical assistance can include a range of things from companion care to assisting a person with ADLs including bathing, eating and dressing. The type of support also ranges from a few hours or a couple of times of week to full-time care, depending on the circumstances. Families may also be seeking a home caregiver for another valued aspect: companionship.
Once it’s clear that a personal or companion caregiver is what you’re looking for, start by screening applicants over the phone or video conference. If things feel like a good fit, introduce the potential provider to your senior loved one.
Here, all the bases you’ll want to cover when you meet.
Initial interview questions
During the process, don’t underestimate the importance of interviews being conducted face-to-face (even if that means over Zoom) and making the most out of your opportunity to ask questions. “There are many compassionate, trustworthy care providers, but not all will be a good fit for your loved one,” says Beatrice Tauber Prior, a clinical psychologist and author of ”Grandma and Me: A Kid’s Guide for Alzheimer’s & Dementia.” “Begin with a set of questions that you’ll ask all care providers.”
A few basics:
- Do you have a driver’s license and a clean driving record?
- Do you have reliable transportation and insurance? How far from here do you live?
- Are you willing to submit to a background check? Both state and federal? Nicole Broadhurst, a board certified patient advocate at Tennessee Health Advocates strongly recommends asking this of anyone you are seriously considering hiring. “The cost is worth the peace of mind,” Broadhurst says. She recommends employers get signed consent early on so it doesn’t hold up the hiring process.
- What are your expectations for vacation time, and are you willing to help find coverage for the days that you need to take off?
- Will you drive to appointments or errands when needed? Will you be comfortable driving my loved one’s car if need be, or using your own car to run chores if we request it? Do you expect mileage reimbursement if your car is used? (Check out senior transportation options near you.)
- Have you ever cared for someone with [conditions relatable to your loved one’s care: memory problems, elderly, wheelchair bound, etc.] before? If so, please elaborate.
- Are you able to work the hours needed? When are you available to start working? After a 30-day trial period, would you be willing to commit to a [fill in a time frame like 6-month or one year] term?
- Are you legally allowed to work in the U.S.?
- Are you looking for a short-term or long-term role?
- Are you comfortable with pets?
Get to know their senior caregiving background
Sam Abbas knows firsthand that the process is emotional on both sides. “On one hand, you’re looking for someone who is going to be with your family member, in their house, through some of their most vulnerable and challenging moments,” says Abbas. “And for the caregiver, the realities of the job can be at once rewarding and also emotionally taxing. That’s why the fit is so key.”
To ensure that compatibility, the most important thing Abbas’s family did was to dig deeper into the potential caregivers’ background by asking the following:
- Do I have permission to speak with your former employers? “Employers often ask for reference checks but then don’t bother calling,” says Abbas. “But here, more than perhaps any other kind of work, hearing from both a professional and a personal reference is critical.”
- Why are you looking for new work and how did your last role end? “If they are still working with that client, ask about the schedule and how they anticipate coordinating schedules,” says Broadhurst. “This will reveal upfront if it will limit their availability to meet your needs.”
- What can you tell me about your past families that you’ve worked with? Specifically, Broadhurst suggests asking what some of their favorite and least favorite memories or experiences are and why. “These stories will provide you with insight into how they feel about their role in their client’s lives as well as how they interact with clients and families,” she says.
- Can you give an example of a difficult situation with a past employer and how you responded? “Beyond getting a practical sense of how a caregiver works, it’s important to see that past work experiences are discussed diplomatically,” says Abbas.
- Do you have experience with memory or cognitive impairment?
- Have you accommodated special dietary needs in the past, and if so, how?
Clarify duties and expectations
As family members search for the right fit, Peggy Flannigan, who holds her doctorate in nursing and is the associate chair and associate professor in the online nursing program at Bradley University, urges them to keep both safety and their unique needs — which is different for every family — in the front of their mind during the interview process.
“For example, if the family member loves to cook but may not remember to turn the stove off, don’t hire someone to do the cooking, but instead, hire someone who is willing to assist with other needs and to be on-hand in the kitchen,” says Flannigan. “It is important to respect the independence of the aging family member while also doing everything possible to keep the person active and engaged with others and the environment.”
In order to get a sense of how a caregiver feels about a variety of duties and expectations, consider asking the following:
- What type of personal care are you willing to provide? Prior recommends being clear with what, if any, toileting assistance you’re looking for, as some in-home care providers are not comfortable with bathing, dressing or toileting.
- Here is a list of typical caregiving-related duties — is there anything on the list that poses a problem or concern?
- Are you willing to do household chores? If so, which are you comfortable with as far as dishes, food shopping, cooking, cleaning, organizing, laundry, helping with mail and how does this affect your rate?
- Are you open to providing emotional care? Do you have any suggestions for ways to improve quality of life? Bea recommends bringing this aspect up should your loved one be lonely and if they would benefit from engaged companionship.
- What are your expectations if hired, and what type of flexibility do you expect? Do you expect to receive a detailed daily/weekly/monthly task list? “Have them paint a picture of what it looks like to take this position,” Broadhurst says. “This allows you to better understand if they share your vision of what a successful relationship looks like regarding their position.”
- Is there anything you aren’t comfortable doing that hasn’t been mentioned?
Ask about safety
The following questions will offer you a sense of how prepared a caregiver might be in case of an emergency and where they stand on other safety- and health-related issues:
- Do you smoke? Or do you allow smoking in your home? Second-hand smoking is something you should take into consideration depending on your loved one’s health.
- What caregiving certification training do you have, if any? Do you have any CPR or first-aid training? If I pay for it, would you be willing to add to your skills?
- When was the last time you had to put CPR or first-aid training to use, and why? How do you tend to react in an emergency?
- How would you respond to care refusal? “This often happens with patients who have dementia that may need to be reorientated in time and place,” says caregiver Sayeed Sardar. “Care refusals from dementia patients can often include medication refusals as well.” He recommends having the interviewee draw upon past experiences and respond to the questions using the STAR method: situation, task, action, result.
- Do you keep your daily records, and how will you keep the family informed? Tena Scallan of TheUltimateCaregivingExpert.com notes, “Having precious documentation will keep everyone informed as well as save time.”
Red flags to note
The following questions could provide insight on how a caregiver might handle touchy issues that could come up down the road.
- Are you willing to sign a contract stating you will not accept money or gifts from my [parent/grandparent/spouse, etc.] without clearing it with me?
- Are you willing to sign that you will not have guests come into our home unless you’ve received prior approval?
- Are you comfortable with my [parent/spouse] having guests or other family members stopping by?
- Would you have a problem if I checked your driving record with the DMV?
- What services do you charge additional fees for?
- Can you share a bit about your own self-care routine? “Being a caregiver can be emotionally taxing, and it’s important that candidates can recognize the realities of the job, and articulate positive ways of handling the stress of their work when they go home,” says Abbas.
Sardar offers additional guidance that employers can bear in mind throughout the interview: If you believe one of the caregiver’s answers is incorrect or dissatisfying, see how they respond to being corrected, says Sardar, who elaborates, “Caregivers may need to be more agreeable as well as compassionate; this can be quite draining if this isn’t their natural state.”
Check on their flexibility
Ask the following to gauge a caregiver’s bandwidth:
- Will you be working other jobs that might be affected if I’m delayed getting home?
- Would you be available for respite care or to stay over for a long weekend?
- What are your responsibilities outside of work? Do you have to account for the schedules or needs of others in your workday, or are you flexible?
Offer potential scenarios
Ask the prospective caregiver how they would handle various care issues that might arise and are similar to your situation. A few examples:
- What would you do if my mother wakes up grumpy and doesn’t want to get dressed or eat her breakfast but she has a doctor’s appointment later that morning?
- If my father is running a fever and is acting lethargic, and you think there’s blood in her urine, what would you do? If I’m out of town and can’t be reached, what would you do then?
- My aunt falls, seems confused, doesn’t recognize you and won’t let you help her. She’s combative. What do you do?
Get a sense if they will be a good fit
If you’re satisfied with the above answers, explore some nontraditional interview questions to see how compatible they might be with your family.
Don’t underestimate the power of tuning into your instinct, says Prior. “If you think the fit may not be a good one, then move on to another candidate,” she emphasizes.
Consult your loved one
As you narrow down potential candidates, it’s important to involve your senior in the final decision. “Our parents spent most of their lives caring for us to give us the best life possible; now it is time to do the same for them,” adds Scallan. “Taking their feedback on who is caring for them will make the job much easier for all parties concerned.”