Hiring a Home Health Aide

Hiring a home health aide on your own, without going through an agency, can be a difficult, and sometimes lengthy, process.  Depending on the age and competence of your parent, you can either do the interviewing and hiring, or be just their adviser. 

When interviewing potential aides, be sure to ask for references, and then follow through and CHECK those references.  Check certificates for any licensing (see the side bar link to check on licensing in your state).  Personality matches are also important.  Most people have likes and dislikes, personality issues, and innate instincts for whether or not they can get along with someone.  People may even change doctors, lawyers, even bankers for some un-explainable reason for why they feel uncomfortable with a certain person.  This intensifies in many people as they get older and needs to be taken into account when hiring someone.

Other considerations are more concrete.  For example, your parent may be uncomfortable with someone of the opposite sex if the home health aide will need to help them get in and out of bed or to help them bathe and dress.  A patient, like my own mother, may be hard of hearing.  If someone has English as a second language, she often has trouble understanding them, or they might not understand her. 

This happened in a rehab center she went to for a week and we had to request an English speaking aide because two aides who with only minimum English.  When she explained what she needed for her medical problem, they didn't understand it but instead of trying to help, just nodded and left.  Her care was compromised by the communication difficulty.   You can also request people who speak your language, English, Spanish, etc. for other things like when setting up phone repair and other maintenance companies.  Just explain that the patient has hearing problems and there can be communication issues.  A neighbor of ours had a phone repair man who spoke little English and ended up working on the wrong phone lines because he didn't understand her.  She called the company and they sent someone else to fix the problem, fortunately at no cost.

When interviewing a potential aide, You also need to ask to see their credentials, if any, for training for being a home health aide, CPR certification, driver's license, etc. 

Also be sure you have a second reliable person lined up that you can call in an emergency, such as when your aide is too ill to work or if they need a day off for personal business or a vacation.

Once you find a person you would like to hire, you will need to do a background check.  If you will need the aide to take your parent to doctor's appointments and shopping, you may want to check with your local police department on how to do a driving record search in your state. 

Do an Internet search for ("background check", how to) and you will get a list of sites that do background checks.  Some are free, others charge for more in-depth checks.  I've listed two examples here.

http://www.backgroundcheckgateway.com/

http://www.usa-people-search.com/Background-Check.aspx

Taxes and Insurance

Remember, if you hire someone yourself, you will be responsible for paying the aide's hourly rate and possibly some taxes.  As an employer of household help, you may have tax responsibilities.  For details of what kind of household help qualifies under the IRS, see information on "Hiring Household Employees" at    http://www.irs.gov/businesses/small/article/0,,id=97877,00.html.

You may also be responsible for medical treatment if the aide is injured on the job.  To protect yourself from lawsuits, be sure your homeowner's insurance covers household employees and you know who to call in an emergency. 

Depending on your situation, you might even want to check with a lawyer about your rights and responsibilities before hiring a household worker on your own.