How to Select an In-Home Aide

Studies show that older Americans want to remain in their homes for as long as possible – even when they are struggling. For growing numbers of elders – and concerned family members – the solution to their struggle is a home aide.

If your family is considering hiring an aide, the first decision is what type of aide you need. There are two basic choices: a home health aide or a home care aide. Home health care aides provide personal care (bathing, grooming, etc.); assist with range-of-motion exercises and provide some medically-related care (empty colostomy bags, dress dry wounds, check blood pressure, etc.); and provide assistance with housekeeping and errands. They are often referred to as personal care assistants. Home care aides provide companionship and socialization and assist with meal preparation, housecleaning, laundry, shopping and errands. They are also called homemaker or chore aides.

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“The level of care the person requires determines who should be providing the home care and what it will cost,” says Mary Hujer, MSN, a gerontological clinical nurse specialist in Cleveland, Ohio.

Getting Started

Before beginning the search for an aide, download the National Caregiver Library’s Needs Assessment Checklist. Not only will it help you determine the level of care a loved one needs, it will also help you write the aide’s job description. In addition, it may inform the decision of whether to hire independently or through an agency.

With an agency, the aide has been screened and trained, and they will be supervised, explains Byron Cordes, LCSW, a certified care manager and the current president of the National Association of Professional Geriatric Care Managers. But, Cordes adds, there are other benefits of hiring through an agency: “Clients have access to all the resources the agency has. They have back-up if the scheduled caregiver can’t be there and the agency handles all the administrative responsibilities – reimbursement forms, payroll, taxes, workers’ compensation, insurance, and background checks and bonding of the employee.”

Hiring independently means you will be doing the screening and interviewing, supervision, coordination of care and all administrative paperwork. But, says Hujer, it also means you are able to hire someone – a friend or relative—who may already know the person, “so the trust factor is higher…and you will usually be paying less, too.” (For more on making this choice, click here.)

To locate potential candidates, “cast a wide net,” says Hujer. Get suggestions from the older person’s primary care physician or nurse; the local hospital’s social work department; local social service and/or disease-specific organizations; your community’s office on aging or senior center; the older person’s minister or rabbi; and/or friends and neighbors who have previously used a home aide.

Additional resources

Web sites

AARP: Needs Assessment Checklists

Administration on Aging: How Do I Hire a Home Care Employee?

American Geriatrics Society: Eldercare at Home

Family CaregiverAlliance: Hiring In-Home Help

National Institute on Aging: There’s No Place Like Home – For Growing Old

Mayo Clinic: Home Care Services: Questions to Ask

Veterans Administration: Aide and Attendant Benefit

ElderCare.gov: Where and How to Find Community Resources

Caring Connections: Caring for Someone

Books: