Whether you choose to hire independently or go through an agency, doing some homework on your candidates will help ensure that you hire a reputable worker.
An excellent way to find a high-quality agency is Medicare's new Home Healthcare Compare tool, which allows you to search for agencies in your area that have met with Medicare's approval. The site gives a summary of statistics on the quality of each agency, such as "percentage of patients who get better at walking around," that you can use to guide your decision.
Also look for an agency that's licensed (if state law requires it) and that has liability insurance. Check to make sure the agency's caregivers are bonded and insured and that they're screened for communicable diseases, like tuberculosis, since the elderly are especially vulnerable to these.
If you hire someone yourself, it's a good idea to find an individual who has (or who once had) a home health aide license, so you know a registered nurse has trained the person in the basics of care. Also get a criminal record check from a service such as Intelius or SentryLink and always call references. There are always a few bad apples who'll take advantage of vulnerable clients -- make sure you don't unwittingly hire one. "If the person doesn't want to submit to a reference check, that's not the person you want -- it's a big red flag," says Dollar.
It's important to find an at-home caregiver your family will be comfortable with. When you're interviewing caregivers, include your parents (or whomever will need the care) and make sure they interact well with the aide. Do they communicate well with each other? Are there language barriers? Do your parents enjoy the person's company? "Having shared interests can make a big difference," says Dollar. "One of my clients loved NASCAR and found a home health aide who did, too. They immediately hit it off."


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