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Need a home care provider for my dad in our home with our nine year old daughter. Without going thru an agency how can we vet a candidate's background properly?

I am a vetted ind caregiver (direct services, coordinating, manager / management services) through a retirement community. The facility requires us to do [some of] the following and residents select us for independent contractual working relationships:

1a. Get fingerprinted (criminal record check) - this is at my own expense. Is worth it to YOU and if someone wants a job, they will do it.
1b. At my own expense, I must get a TB test every year. Require this.
1c. If foreign born, ask to see ss card, work permit, etc.

2. Get copy of DL and proof of car insurance.

3. Ask for verifiable references, work experience, etc. Should be at least 2-3 or perhaps an entire work history. They should have a resume prepared although many don't.

4. Create a check off list: One for yourself with all these questions. If you potentially like the person, give them a copy.

5. For first interview, be it on phone or in person, see if they are on time (responsible to show up and/or call if they will be late). Surprisingly, many I talk to on the phone do not show up, are late and don't call.

6. ASK for proof of Covid testing and vaccinations, depending on your location and ability to acquire both. I must get Covid tested weekly.

7. If potential worker says (as one worker did to me) that they cannot disclose who their clients are due to HIPPA laws, this is not true. Anyone can give a reference if they desire. If a potential worker doesn't want to give references of the person they worked with (that is a red flag unless their client has dementia), ask for references from the client's family member, or anyone involved with and can speak of the potential worker's dependable, work experience.

8a. Give them a few scenarios of what could / may happen and see how they respond. This is important re judgment, honesty, 'thinking quickly on one's feet' in cases of emergency - and just having common sense. (One worker with a client of mine (I managed care for family living outside of area) had 24/7 caregivers. One of them allowed the client to DRIVE - and client has dementia. Sometimes you wonder (if) how these people THINK. Caregiver said she knows / knew client had dementia. Caregiver was through agency (I didn't arrange, family did) and I believe felt very intimidated by client.

8b. Due see if potential worker can handle aggressive, demanding, strong client personalities without caving. A care provider MUST be able to set boundaries and do what is in the best interest of the client. THEY must call you or a designated person immediately of any potential emergency or issue they do not know how to handle.

9a. If you feel it necessary, get a camera to double check. Unfortunately, theft is a reality in this kind of work, as abuse is (although the abuse aspect may be a low percentage, it does happen).

9b. As a test, I would leave $5 or $10 (or less) on a table or in a drawer they likely will need to open for medications or something and see if they take the bait. (Or leave it on the carpet, close to under the bed as if you dropped it).

10. Always offer a trial period vs an immediate ongoing working relationship. If you feel good about the person, say you'd like to try it out for a week or two weeks and see how things go.

11. Give them a clear list of duties, go over everything, see how that goes during the first two weeks. Gena.
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Reply to TouchMatters
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Christservant Feb 18, 2021
Wow, that is good.
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Hollyo, if you hire a caregiver privately, please check with your homeowner's insurance company about getting "workman comp" insurance, just in case the caregiver should get hurt on the job. Your caregiver would be your employee.

When hiring privately you need to find out if the employee is an "independent contractor" thus will be paying their own payroll taxes. Or if you need to do the payroll taxes. There are payroll companies that would do this work for you for a fee.

Also, ask the caregiver when he/she had their flu shot and their covid-19 shot, if they have proof of such shots even better.

For my own Dad, we used an Agency, the Rep came out to interview us, and we in turn interviewed the Agency. With an Agency, if a caregiver couldn't make her shift, the Agency found a replacement for that shift. Dad had the same two shift caregivers for over a year. One would help Dad with minor yard work, which gave Dad some outdoor time and exercise :)
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gdaughter Feb 18, 2021
Just a PS that one (supposedly well-regarded) agency sent out a MARKETING director to do the initial interview. She was inept and there was no followup indicating they did not want or need our business. I asked a particular question in re to background checking...like about driving record checks and apparently they didn't like that I knew too much:-) Furthermore, I took time from work to be present at this interview and THEY STILL had to send another person out to do the care plan that I thought was the purpose of this visit. Buh bye....no respect for caregivers trying to hold down a job....
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I've been in private in-home care for years. If you're looking for private help, use an online site. Or there are also care agencies that private caregivers get work from. How those work is the caregiver pays a finder's fee to the agency and they get them some work. The agency's involvement ends there. After that's done you pay the caregiver directly. You negotiate the pay with the caregiver and pay them directly.
Now, it never hurts to ask for potential caregivers to bring a back round check in writing from the police department of whatever town they've lived in for five years, or for how ever many years you think is appropriate. This isn't the most important thing to check up.
The most important thing is that a potential caregiver should furnish you with at least two references from families they've worked for long-term. If they were in elder caregiving, those references likely cannot come directly from the person they cared for because they're usually either dead or in a nursing home. Those references need to be from a client's family members or spouses. Not just a letter of recommendation. You need to actually be able to speak to the family members and ask them questions. This is how I get my work.
Next, insist on regular, periodical drug testing. Let the potential caregiver you're considering know that you will pay for this at your expense. This is important because many times when an in-home caregiver becomes necessary it is because the client has health conditions and there may be prescription medications in the home that are appealing to a drug user for two reasons. Either they will steal pain meds and other controlled substances for use themselves, or they take them to sell so they can gets drugs of their choice. In-home elder care is a line of work that often attracts the wrong sort of person for just this reason and also because they know that if a person is old and has dementia, stealing is easier to get away with. Always make sure every pill is counted and documented.
After you've found a caregiver you and the client seem to like, keep an eye on them. Pop in randomly. Set up nanny-cams to monitor how they're getting on with your loved one.
Of course you will already know to put all valuables like jewelry, cash, credit cards, checkbooks, etc... under lock and key. Never leave anything valuable accessible. Good luck in your search. You and your LO will be a lot better off with a private caregiver.
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Reply to BurntCaregiver
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If you are looking for as close to a guarantee, or protection, as possible, this is the really good reason why one would go through an agency.

Before you go down the private hire path you must know that hiring a caregiver makes you a de facto employer. As such, you will need to pay them in such a way as to track and report their wages, and comply with your state's withholding tax rules. This protects both your dad (should he ever need to apply for Medicaid) and the caregiver.

As en employer, I would start by being careful WHERE you post the job listing. If there is a jobs forum that requires job seekers to pay to view positions, this is a good filter.

Let applicants know that they will be required to submit their last 3 most recent clients or places of employment and that you will be contacting these references (although it's pretty easy to get a friend to give you a bogus review of the applicant if it's an individual). If it was an agency, you won't get an honest answer if they were terrible at their job. I've done hiring for 38 years...trust me, businesses and organizations won't tell you if they are losers. There are myriad reasons for this, no room to go into it here.

Then you should *definitely* pay for a thorough criminal background check. Let applicants know this also, to weed out unfit candidates.

Interview them in person, asking them questions about how they would approach this challenge or that, to get a read on what their actual experience level and if they have any common sense at all. Make sure they have a working understanding of your dad's illness and how to cope with his needs.

Finally, create a very thorough employment contract for them to sign.

Before letting strangers into your house, you need to have a thorough conversation with your daughter. You will also need to secure all sensitive financial or personal information, just for good measure.

I wish you success in finding the right fit for your family!
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Isthisrealyreal Feb 15, 2021
Geaton, I found that asking if the person was eligible for rehire was very telling.

If someone has just given a stellar review and then tells you that the person is NOT eligible for rehire you know that you just listened to a whole lot of CYA.

I found that I got better information if I asked on a scale of 1 to 10 how would you rate...(whatever you want to know) then nobody is saying anything that can cause blowback and I learned what I needed to know.

Many creative ways to get at the truth.

I think asking for personal and professional references helps stop the friends giving false job references.

And secure all valuables.
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The safest and easiest way is to go through an agency.
They will also take care of insurance for Worker's comp, taxes, withholding.
Another advantage is ..if you hire 1 person and they can not come in one day, or they take a vacation the agency will send a replacement so you are not without a caregiver.

I did find 2 awesome caregivers that I did hire myself. They were from the Local Community College. They had just completed their CNA course and were waiting for the Nursing School Program to begin. I hired them and told them I would work around their class schedules. BUT I was with a program through the VA that while I hired the caregivers the program was responsible for Background check, paying the employee and taking taxes and the program covered insurance as well. I was responsible for filing/reporting their time and keeping all the paperwork.
I would NOT have hired privately if it were not for this particular program there is so much involved with filing for taxes and making sure their insurance is covered.
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AuntSu Feb 18, 2021
Hi would you please let me know if the VA program you mentioned is Aid and Assistance? My father has that and I am also looking for an aid for hm when I need to go out.
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I wanted to add something that I was told by a friend in California who hired an independent caregiver. Not only did she have to pay/report payroll taxes and workers comp, in her state she was required to pay overtime because the person was on call 24/7. Either that or she actually needed to hire several shifts of caregivers so that no one worked over 8 hours and more than 40 hours/week. It may be state dependent but the old idea of hiring someone to live in with a parent (rent free plus salary) can't be done cost effectively in her state and probably in others as well.
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Isthisrealyreal Feb 18, 2021
Mary, many states allow the contract to specify total hours daily or weekly. You can do up to 45 hours as salary before overtime kicks in, you can do 8 hours a day or 40 hours weekly before you have to pay overtime. As long as the contract specifies exactly what the work week should be, ie ot begins after 40 hours and some days will be 10 hours while others can be as short as 2. Contracts are vital to ensure that everyone understands from the beginning what is expected and how they will be compensated.

If an independent contractor can not provide you with a current business license and insurance policy then they should be treated as an employee.

You can utilize payroll services or labor leasing type businesses to not have to do all the state and federal requirements as an employer.

And never pay cash!
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I wish to remind anyone who is thinking about or currently privately hiring that the IRS is the one who gets to decide if your caregiver is your employee or not!

Please see their website to find out or discuss with your accountant. Back taxes, back pay and penalty ramifications are financially punishing and can be avoided.

https://www.irs.gov/newsroom/understanding-employee-vs-contractor-designation
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Reply to Geaton777
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I had no luck over the past two years with our local home care agencies. Employees were inexperienced and unreliable. I had requested the same home health caregiver and each time they would send a different person that I knew nothing about, plus it confused my husband who had Alzheimers and had a difficult time with new people showing up. Some didn't meet my requirements and the agencies hadn't screened those caregivers and sent them here anyway. (like smokers and people with pets). My husband is now in a memory care facility which is costly, but unfortunately I had no choice since I could rely on our local agencies. When the time comes that I need a caregiver, I will personally advertise for one and screen them myself. Good luck with your choice.
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Reply to lovepat69
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Vsvechin Feb 18, 2021
I had absolutely the same experience with agencies.
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I have been an independant care giver for over 10 years. I joined 2 sites.
They run back ground checks (I pay) on everyone. I paid for the expanded check.
Meet them several times (not at your Dads home) before having them meet your Dad. Check their references. Check their facebook page if you can.
Agency help is irratic and because they are paid so little, the turnover is huge.
I love what I do and have been with most of my people for over 5 years.
Gold luck
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onions Feb 18, 2021
Can you tell me what a trained caregiver gets per hour? I Why is it that they get "paid so little"? I don't like the sounds of that! :( A company wants to hire and train me; and I wanted to know what the "going rate" is. Thank-you very much!! If they get paid "so little", that tells me that patients who are being "cared for", more than likely won't get the proper care that they need. Not good....!!!
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I actually got the name of a very sweet lady from one of the caregivers we hired through an agency. They had worked together for 15 years at a private care facility and the lady was happy to have some pt income. I am paying her $10/hr cash and she has been great (she had been making $8/hr at her previous job :( )

The agency was charging 26 dollars an hour and the caregivers only get $10 with NO benefits! By cutting the cg expense more than half, I can afford more hours and feel like I'm actually helping the cg. As duties increase, so will her pay, but for now it seems a win/win.

We tried posting on our community website and on FB, but didn't get any good responses. I strongly suggest going through friends and family or the local churches.

The only disadvantage I have found by hiring privately is that I don't have a backup (yet) in case of illness or inclement weather. Fortunately, I live close enough to take up the cg slack if needed.

Good luck in your search!
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gdaughter Feb 18, 2021
Oh yes, the back up is an issue, and Next Door type social pages may be a good way to get a lead. Also remember that you may need to keep records and file in regard to taxes. Hiring privately can get complex.
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