7 Tips for Hiring a Live-in Special Needs Nurse

May 31, 2017

Hiring a live-in caregiver or nurse can be essential when your family member has special needs. Learn how with this helpful advice.



Sometimes you need help caring for a child or adult with special needs. Hiring a live-in caregiver can be a huge help. But it's a big decision and comes with a lot of questions.

A live-in special needs caregiver provides more flexibility, more reliability and a consistency of care that isn't always available when you have different caregivers coming in every day, says Rachelle Czerwinski, a mom to a special needs son and a community relations manager at Care.com.

Hiring live-in care is cost effective when you consider the time spent hiring several caregivers and being able to cover when they call in sick, show up late or have to leave early, she says.

Check with your disability carrier to see if your family qualifies for any kind of services and waivers to keep costs down.

Follow these seven steps to make the process easier.

For more information, read these 12 Tips for Hiring a Live-In Nanny 

  1. Decide if You Need a Caregiver or a Nurse
    Live-in caregiver or live-in nurse? If your family member has special needs that are more cognitive or developmental, an experienced and trained caregiver may be all you need. But if your loved one has more pressing medical issues, like a feeding tube or multiple medications, a live-in nurse offers experienced medical skills. Another option is to hire a skilled worker who has been closely mentored and trained by a nurse in the procedures your family member requires.

  2. Figure Out What You Need
    "Put in a little time and think of the important requirements for your family," Czerwinski suggests. If your family is very religious, does your live-in caregiver need to share those values? If you're a vegetarian family, do you mind if the caregiver is a meat lover?

    "If someone is going to live in with the family, the family needs to mention what is important to them when listing job requirements and job duties," says Czerwinski.

  3. Know Where to Look
    Anyone who has a family member with special needs generally has an extensive network of people and resources to rely on, says Patricia Budo, vice president of the Association of Providers for Children with Complex Medical Needs, based in Toms River, N.J. Ask others for caregiver recommendations or to spread the word that you are looking for live-in care.

    Post your job on Care.com, and check in with local nursing schools for students or recent grads that might have experience and be interested in a live-in care situation.

  4. Interview Applicants
    After all the applications start rolling in, you have to find the one that is right for you, your loved one with special needs and the rest of your family. Interview your top five to ten candidates over the phone or in-person, then invite the best two or three to your home to meet your special needs family member.

    And remember: just because someone has experience with disabilities, doesn't mean they have experience with the disability in your family. Ask them how much they understand this specific disability and how comfortable they are caring for someone with these specific needs, says Leigh Ann Davis, project and information specialist with The Arc, a national advocacy and resource group for people with intellectual and developmental disabilities.

    Pose questions like:

    • What experience do you have with special needs?
    • What kinds of activities and care have you done with special needs individuals?
    • What is your educational background?
    • Have you graduated from nursing school or are you a student?
    • What extra training do you have in special needs background?
  5. Ask About Lifestyle
    When you hire live-in care, you want a good fit, says Czerwinski. You need to find someone with the right background, who will also be a good full-time addition to your home. Ask questions that address more than just experience.

    For example, ask the candidate things like:

    • Why are you interested in this position?
    • Why do you think a live-in position is best for you?
    • Describe how you are empathetic.

    Get more inspiration from our article on Interview Questions for a Live-In Nanny 

  6. Schedule a Trial Period
    A caregiver can have impeccable qualifications, but if she doesn't mesh with the care recipient and the rest of the family, it won't work out. Have a trial period and keep careful watch on how she:

    • handles expectations
    • manages duties involving things like hygiene, toileting, behavior issues, movement, transportation and feeding
    • maneuvers and maintains necessary equipment, like feeding tubes
    • deals with a sudden health emergency like a seizure
    • gets along emotionally with the members of the family
    • conducts herself in your home
  7. Have Patience
    When your caregiver moves in, says each side will have to make adjustments and compromises. "Having a live-in helper is a lot like a marriage," Czerwinski says. "On either side, don't make expectations too high. It is unreasonable to expect a person who is perfect right off, but they might develop into that after a month."

Not sure you need someone full-time? Explore Respite Care Options for Special Needs Families 

Julia Quinn-Szcesuil is an award-winning freelance writer and a mom to two girls. She lives in Massachusetts and has written for local and national publications

Tips and stories from parents and caregivers who’ve been there.

Please enter a valid email address

Thanks for signing up!

We’ll see you back in your inbox.

Leave a comment

Create a free account with Care.com and join our community today.

You may also like

How much should you pay for a babysitter?