How to Hire Home Elder Care Aides

Updated on July 27, 2018
Glenn Stok profile image

Glenn Stok experienced caring for his elderly aunt and handling her affairs. He shares what he learned about the legal and social issues.

A few years before my dear aunt passed away at 98 she said she wanted to be able to live out her remaining years in her own apartment, so I hired aides to help her.

This article is a detailed explanation of how I managed her finances, hired caregiver aides, wrote a healthcare agreement, and dealt with elder care agencies.

I’ll explain how to handle each of the following items:

  1. Managing Finances of an Elderly Person
  2. Maintaining the Well-Being of an Aging Relative
  3. Plan Your Eldercare Needs Before Choosing an Aide
  4. How to Write an Eldercare Agreement Contract
  5. How to Interview Potential Aides
  6. How to Work with Eldercare Agencies
  7. Eldercare Agencies Are Not Loyal to Their Customers
  8. Dealing with an Abusive Health Care Aide
  9. Why an Elderly Relative Should Sign a Power of Attorney (POA)

Managing Finances of an Elderly Person

Maintaining her finances is important to be sure money is spent appropriately.

If you're not good at that then it's best to hire a qualified person, such as a CPA, who can take charge of the important items. If you already handle your own financial affairs then you should be able to do this for your elderly family member too, as I had done for my aunt.

You need to keep track of items such as:

  • Paying bills.
  • Depositing checks.
  • Managing health insurance.
  • Filing important papers as needed.
  • Arranging a budget to cover expenses.

I knew that last item was crucial to be sure her social security and pension payments would suffice so she’d be able to continue in her own home as long as she lived.

Maintaining the Well-Being of an Aging Relative

I couldn’t do it alone to maintain her quality of life. I needed to hire aides to take care of her around the clock.

The elder care aides helped her get around. They took her to the grocery store, to the beauty parlor, museums in the city, to the park on nice days, and to the doctor when she had appointments.

Aides are expensive. You’re lucky if you can work out deals for around $12 an hour. This is not live-in. They work their shift and go home.

Live-in aides are cheaper because you’re giving them room and board. You’re sharing your home with them. That's something you need to consider.

My aunt only had a one-bedroom apartment, so that was out of the question anyway.

Plan Your Eldercare Needs Before Choosing an Aide

Before choosing an aide, it's important to know what your elderly family member wishes to have and what needs should be met.

  • Discuss what they feel they need.
  • Suggest additional concerns that may be overlooked.
  • Make a list of these needs and go over it to confirm if it's complete.
  • Discuss what type of person they would be comfortable with having.

After it's clear what type of aide to needed, an agreement should be written that could be used as a contract with anyone who's hired. This will clarify what work is to be performed.

Eldercare Agreement Contract

Independent Contractor Elder Care Agreement
Independent Contractor Elder Care Agreement | Source

How to Write an Eldercare Agreement Contract

A written agreement will make it clear what is expected of the aides. The contract also has to make it clear that the aide is an Independent Contractor. It also needs to specify the work to be performed.

This is what I wrote for that clause:

The Patient and the Independent Contractor agree that the Independent Contractor will perform the work as Home Health Aide with the following Elder Care Responsibilities:

  1. Provide patient with help moving in and out of beds, baths, wheelchairs, or automobiles, such as for transportation to doctor appointments.
  2. Personal Care such as dressing, grooming, and maintenance of hygiene.
  3. Administer medications as instructed per “Technical Direction” below.
  4. Preparing healthy meals, Local Errands & Shopping.

How to Interview Potential Aides

When interviewing an aide, get to know them and think about the issues that may cause difficulty if its not a good match.

  1. Ask for references.
  2. Call the references to check their background.
  3. Do they understand the needs of the elderly?
  4. Are there cultural differences that need to be considered?
  5. Discuss food differences and habits that may not be compatible.

Source

How to Work with Eldercare Agencies

Some agencies don't vet their aides well enough. They are just happy to take the money and place anyone. So you need to be aware of that and don't just trust whomever an agency sends to you.

I did my due diligence by asking for references and doing Google searches to see if anything negative could be found.

On the Internet you can also search for court judgments on companies and on individuals. These are important steps to take.

I hired two aids so each could cover 12 hours since she needed someone with her round the clock.

I thought I was all set, but I was wrong.

Eldercare Agencies Are Not Loyal to Their Customers

Don't let agencies boss you around. Let me tell you a daunting experience that I had. Early one day before dawn one of the aides called me and asked why she was being fired.

I was shocked to hear that and I told her if anyone were doing any firing, it would be me. I told her to come in as usual. Then I called the agency.

It turned out the agency told her not to come back. They decided to send another aide that morning. I was furious, and I made my feelings known.

How can they switch people like that and expect an elderly woman to be comfortable with a total stranger once again. I told them “To do that without warning is totally unacceptable! My aunt could have died from a heart attack!”

I found out later that the agency tried to fire the aide because they make more money placing her with another elderly person. That's because the first week with a new client is paid double—one payment to the aide and one payment to the agency.

By moving them around they get more of these extra payments. Not all agencies get paid extra for the first week, but it is something to consider.

Dealing with an Abusive Health Care Aide

Sometimes things go wrong. Not all aides are trustworthy. You need to keep a constant eye on where the money is going and keep good records of questionable events.

Here's an example of an experience I had with abusive aides:

When my aunt's aides needed cash for groceries they would take her to the bank to withdraw money. I noticed over time that the requests for cash were steadily increasing.

They took advantage of her by telling her it’s because of inflation. The elderly tend to be gullible and believe anything.

My aunt couldn’t have been eating so much and using so many of the staple items being purchased. The aides must have been taking things home for themselves, so I decided to ask them to keep a record of the items they purchased.

Other types of abuse can occur as well. My aunt started complaining that one of the girls was yelling at her and losing her temper.

Keeping records and examining them is one thing, but any kind of abuse should be handled quickly.

I had to fire two aides that were less than pleasing for my aunt. In one case the aide sued for being fired. I had to go to court to defend this case. I won, but it took time. All the more reason to keep good records.

Why an Elderly Relative Should Sign a Power of Attorney (POA)

There were a number of times that I hit brick walls when trying to help my aunt. One time I had to call customer service of her credit card to discuss a problem. They didn’t want to talk to me because they didn’t have my Power Of Attorney (POA) on file.

Another time I had to handle litigation after firing one of the aides that abused her. You need to consult a business attorney if you get into this predicament. Healthcare aids are independent contractors and cannot be fired unless they fail to meet the terms of the contract. I won that case, but that’s another subject.

Having a "General" POA is useless because banks don’t accept it. I discovered that banks usually want one to file a POA using the banks own forms.

In addition, it's important to have an additional POA made from a standard form that can be used when needed. You can find many sites with a Google search where you can purchase legal forms and download a standard power of attorney form.

Durable General Power Of Attorney
Durable General Power Of Attorney | Source

Include Litigation Rights on the POA:

The standard POA form has options to check-off that show which permissions you have. Make sure you include litigation rights. You never know when you might need that. It was required when I needed to defend my aunt in court for that lawsuit I mentioned earlier, brought on when I fired an aide.

Once you complete the form, you need to get it notarized. I had to bring my elderly aunt to the bank in a wheelchair to get it notarized. If that’s what it takes, you just need to get it done.

Power of Attorney Expires Upon Death:

The Power of Attorney is only valid while the person is alive. It becomes null and void upon death. If you were expected to handle the estate, then you would have had to be assigned as executor in the will. This is definitely something that needs to be handled well in advance.

With all the legal issues that can arise with any of this, it’s crucial that you speak with a family attorney.

Final Thoughts

These can be the most struggling times for both the elderly and the family members who look after them.

When all the issues are handled properly, and with foresight, one can keep things going smoothly and assure that the elderly relative is comfortable and happy. With less stress on you too.

My Dear Aunt at 96
My Dear Aunt at 96 | Source

Questions & Answers

    © 2010 Glenn Stok

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      • Glenn Stok profile imageAUTHOR

        Glenn Stok 

        5 years ago from Long Island, NY

        Grace,

        I'm glad things are coming along and that you have it all worked out with the aides. Giving them time off with pay once in a while will also assure that they don't get burnt out. It's good that you and your sister know how to handle things when the two of you visit because elder care requires some special knowledge and is not easy for everyone.

        I am sure your mother appreciates both of you and enjoys your visits.

        Thanks for checking back in with your update.

      • gracenotes profile image

        gracenotes 

        5 years ago from North Texas

        Glenn, I thought I'd return and make another comment. I see it's been 14 months since I remarked about my mother's stroke. After a few months of ladies coming about 5 hours per day, we determined that mom really did need 24-hour care at home. Also, since December 2011, mom's cognitive functions have been declining a little.

        Had two or three live-ins who didn't work out (to be expected), but the situation has been stable since April. That is, we have two live-ins who come on alternate weeks. One week on, one week off. One of the ladies is a former ambulance driver who has also worked in nursing homes in the past. I'd say this has worked out well. It has a few negatives, but nothing terribly difficult. For instance, what do we do when I or my sister wants to come and visit for a few days? Simple, we give the caregivers time off with pay while we are at mom's house. This is very much appreciated by them!

        I'd say it took my mother about six months, after the stroke, to accept that she could no longer live on her own, and needed someone to care for her all of the time. She didn't want to leave her home, so this was the best option we could have taken. With stability and always having the same two caregivers, they don't make mistakes with medication, etc. And the supervisors (my brother and his wife) are less than a mile away. Sometimes the caregivers need someone to talk to, and to share concerns this way is very convenient and easy for them.

      • Glenn Stok profile imageAUTHOR

        Glenn Stok 

        5 years ago from Long Island, NY

        Nina,

        It's clear that you were a very loving wife and I'm sorry about the passing of your husband. You do not have to feel guilty for putting him in a nursing home, because it's understandable that this was the best thing for him after your own resources ran out. That's the point that makes it clear how much you loved him. You were willing to do, and did, everything you could for him while you were able to.

        It's understandable how depressing a situation can be and how it affects one's ability to continue to offer help. There comes a time when one can get so run down, that it is not in the best interest of the other person to continue to try to help. So, I repeat, you did the right thing.

        Thanks for voting up.

      • nina64 profile image

        Nina L James 

        5 years ago from chicago, Illinois

        This is a wonderful hub. It takes a lot of love, patience and courage when caring for an elderly parent, spouse or other relatives. I went through this same situation when my first husband was ill, unfortunately he passed in October 2006. In those years prior to his passing, I have never endured such heartbreak, frustration and so many other issues when it came to caring for my husband at that time. He had severe rheumatoid arthritis, high blood pressure, heart problems, obesity issues. During those years, I still had 2 school age children, I worked full time, handled the family finances, cooked and cleaned, and cared for my husband while he was ill. I sought the help of outside elder care services as well as other social service agencies. He had one niece who came out to help me from time to time. When it was all said and done, I ended up putting my husband in a nursing home because I felt that I could not give him the help that help he so desperately needed. To this day, I still feel somewhat guilty, but I had no other choice given the circumstances of our situation at that time. I actually thought that I was going to have a nervous breakdown because I was handling so much; but thanks to lots of prayer and faith I was able to overcome my depression. I commend you for helping your loved one when they needed it the most. I think to myself that one day, I will need that same help from my loved ones. I wish you all the best. Again, great hub!!! Voted up.

      • Glenn Stok profile imageAUTHOR

        Glenn Stok 

        7 years ago from Long Island, NY

        Grace, I'm sorry to hear that you recently lost your Dad. I hope your Mom recovers as much as possible from her stroke.

        There is a great book written by a brain scientist who had a stroke. She wrote it after she recovered. It's very educational since she experienced her own stroke and had the education to understand what was happening, and then was able to write about it. The name of the book is "My Stroke Of Insight." It might help you understand what your Mom is going through right now.

        You may need another aide or two, to take care of alternate shifts. Make sure you check their background before hiring them. Get references, but I'm sure you know that.

        You are a wonderful daughter to be so concerned about her welfare. I wish you and your Mom all the best.

      • gracenotes profile image

        gracenotes 

        7 years ago from North Texas

        Well, my mom just had a stroke 3 weeks ago, and she is coming out of rehab very soon, so we need to get her house prepared. It's 325 miles from here, but I will be traveling down there to stay a while.

        She lives in a small rural area, and there aren't any agencies where you could find an aide for hire. They need to be located using word of mouth. My brother is working on this. In fact, one of mom's daytime caregivers will be the woman who was taking care of my Dad during his last few months of life. So everyone already knows her really well, and she has a special appreciation for our family. We still don't know who'll take on night and weekend duties.

        On a negative note, one does have to be careful and monitor the situation. My brother can do this, and being that he lives 1/2 mile away, and is home all the time, it's pretty easy to do. No one likes to think that the elderly would be taken advantage of, and you are right in bringing this to our attention in your excellent hub. Years ago, my parents had a dishonest employee who embezzled thousands over a period of time, so we know what can happen.

        I'll take a look at some of the contract forms on the Internet. Thanks for writing this, Glenn.

      • Glenn Stok profile imageAUTHOR

        Glenn Stok 

        7 years ago from Long Island, NY

        Tina, Hopefully your mother-in-law will remain healthy for a long time to come. But while there is still the chance it is a good idea for your brother-in-law to talk with her about her desires and make sure she has a good will.

        Sometimes even a will is not good enough as I discovered when my Aunt passed away six months ago. The courts still have not approved probate because her lawyer didn't consider one important issue. Leave nothing to chance and double check even the professionals. I can say that from my own experience.

        Thanks for your comments and your vote up.

      • TINA V profile image

        TINA V 

        7 years ago

        Elderly care aides or caregivers are supposed to be there to extend help to old people or even the handicap. But I guess time change; families and relatives should really monitor them. You are blessed to have a loving aunt like her. She is also lucky to have you as her nephew who cared for her a lot. She has a beautiful smile in the photo.

        My mother-in-law is now 82 years old. She is healthy at her age. She is now staying with my brother-in-law without any caregiver’s help. But I think that someday they might also consider getting one for her. This hub is very useful. I’ll bookmark this and share it with them. Voted up!

      • Glenn Stok profile imageAUTHOR

        Glenn Stok 

        7 years ago from Long Island, NY

        Joyce, please do not think you are a bad daughter for deciding to put your father in a nursing home. I agree that there are times when this is the best thing you can do for your parent.

        In your case since he has dementia a nursing home is the right place for him. My case was different because my Aunt still had a clear mind and still knew where she was.

        The decision to do the best for a parent is not an easy one and I give you credit for researching and making the right decisions.

      • Joyce F profile image

        Joyce F 

        7 years ago from USA

        I'm going through this right now with both my parents. However, sometimes you have no choice but to put a parent in a nursing home. My father has severe dementia and needs 24/7 care. His body is fairly healthy and strong, but his mind isn't.

        I agree though, having the proper paperwork is imperative. Nice Hub.

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