Many of us have, or will, be in the position of having to hire a home health aide for an ill or aging relative. There are so many things to consider, and often there isn’t a lot of time to stop and think everything through. Following are some thoughts and ideas if you find yourself in this position.
There are two basic ways to approach hiring home health aides: hiring a person directly based on a recommendation, or using an agency that specializes in home healthcare. Each has advantages and disadvantages. Hiring on your own based on a recommendation is usually less expensive as there are no agency fees involved. That being said, you must perform some of the tasks that the agency would cover, such as filling in for a sick aide, keeping track of time worked and issuing paychecks, and making sure that your insurance would cover the aide if they were injured on the job. If they leave suddenly, you may be left without coverage and have to scramble to replace them.
Agencies have varying methods of providing care. Some are merely employment agencies that procure an aide worker for you for a flat fee. Make sure that they will cover finding a replacement aide in case of illness (without extra cost) and ask how the payment of any personnel will be handled. The advantage here is that they usually will provide substitute workers and replacement workers if the initial aide takes sick or just doesn’t work out.
Other agencies operate like a temporary help agency, and charge by the hour or by the day for their workers. They charge you an hourly rate, and they train, insure and pay the aide from their office. These agencies can be quite expensive, but they have a large pool of workers to draw from and may send out supervisory personnel if the assigned aide has a problem with the patient. They also usually send an R.N out to open your case, and provide a detailed care plan for their workers to follow.
The first thing to do if you need a home health aide is to ask friends and neighbors who have hired one. They are often a wealth of information regarding local agencies. With any type of agency, make your preferences known. If you desire an English speaking aide, say so. You may even want to specify if you want a “legal” worker. The industry is rife with undocumented workers and some agencies will use them. Ask if the agency performs background checks, and what they consist of (fingerprinting is preferred). Let them know if you have a pet—a large dog can be a deal breaker for a lot of workers. Also investigate what happens if your relative just doesn’t feel comfortable with the worker sent. Don’t always feel that you must live with the first person sent if there is a problem. Agencies do want to make a good placement—that’s how they make money and get positive referrals.
Another thing to consider is what supplies you must provide. If you hire someone on your own, you will probably need to supply everything that they will need to perform their job. Full service agencies may provide their workers with protective gloves and antibacterial gels and soaps. This seems like a small thing but aides may go through six or eight gloves a day, and they aren’t cheap. A month’s supply can easily cost over $50, and may entail last minute trips to the drugstore.
The first aide placed in your home may not always work out. There is a demand for home health care personnel, and if your patient is difficult an aide may tell her agency that he/she doesn’t like the placement and wants another. When you find a worker who “clicks,” do what you can to keep them. Buy the supplies that they prefer to work with, food and snacks that they like, and try to be flexible if they need time off. And whatever your personal responsibilities are, be prepared to step in at a moment’s notice and fill in for your health aide in an emergency.
