Firing an In-Home Caregiver

How to Break Up With Your In-Home Caregiver, and Find a New One
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When you hire a caregiver, either for yourself or to help with a loved one, the relationship quickly becomes very personal. After all, a caregiver comes into your home and takes care of your needs on a day-to-day basis. Because of this intimacy, it can be very difficult to decide that a caregiver isn't cutting it, or isn't the right fit. Even thinking about ending a caregiver relationship can make you lose sleep at night. And how to talk about it, once you have made the decision? Here are some things to think about, and steps to take, when it's time to "break up" with your in-home caregiver.

Step 1: Observe and document.
Sometimes dissatisfaction with a caregiver starts with a feeling, such as worry that things aren't right, or frustration when instructions are disregarded. Other times it starts with a specific incident, but you don't know whether it's an isolated episode or part of a pattern. What to do next?

Start paying attention. It sounds simple enough, but it actually requires a comprehensive, detailed approach. Each time you interact with the caregiver, jot down a few notes as to whether the day went well, or whether there were problems or issues to be addressed. Record the caregiver's attitude as well as attention to duties. Keep these records for several weeks, reviewing them every few days. (Unless the problems are drastic, of course, in which case you'll act faster.)

Step 2: Talk to your loved one.
If it's a family member who's being cared for, rather than yourself, involve him or her in the process as much as possible. Check in regularly, asking about the activities of the day, checking off whether the caregiver took care of everything that needed to be done. When you're with your loved one, observe whether he or she is clean and well cared for and seems to have a positive attitude about the day's activities. Also ask your loved one directly about the caregiver's attitude, their interactions, and how he or she feels about the caregiver.

Step 3: Check in with the agency (if you used one).
If you hired your caregiver through an agency or referral service, now is the time to let them know you're not satisfied and are considering making a change. Describe the problems you're having, and ask if similar problems have come up in the caregiver's prior placements.

Step 4: Try the checklist strategy.
If the problems with your caregiver revolve around duties and tasks not performed up to snuff but you like the caregiver personally, it's possible the issues are organizational. In this case, it may be worth experimenting with a checklist. Write down everything you want the caregiver to do, from larger tasks, like cooking meals, down to smaller tasks, like wiping down the bathtub or turning on music. It can help to divide tasks into two groups: required and optional. At the end of the week, go over the checklist with the caregiver, asking for explanations if something didn't get done. If you still aren't satisfied, the checklist can help you with the next step.

Step 5: Give a warning.
It's hard enough to fire someone under any circumstances, but it's even harder when it comes as a surprise. You can avoid this problem by issuing a warning. Use the notes and checklists you've been compiling to explain to your caregiver the problems you've been observing. Let her know you are considering letting her go and give her a set period of time to address the issues. Be clear that at the end of that period, if there haven't been substantive changes, you plan to let her go. If your caregiver was placed with you by an agency, let them know you've issued a warning and consider the caregiver to be in a probationary period.

Step 6: Be clear, concrete, and responsible.
When it's time to let your caregiver go, do so with the same consideration you would give any other relationship, whether business or personal. Think of it as a "no-fault divorce" -- keep criticism and blame to a minimum, and accept shared responsibility for the fact that things didn't work out. Stick to neutral language ("It wasn't a good fit") and keep feelings out of it. If the caregiver protests, argues, or gets upset, give a few concrete examples of problems (preferably the ones already documented) and leave it at that. If you like the caregiver's work and personality and feel the problem was situational, you can offer to provide a recommendation for future positions.

Step 7: Vet your next caregiver carefully.
Now that you know how tricky it is to end a caregiver relationship, let this knowledge guide your selection of a replacement. Use your notes and checklists to create a clear list of the skills and qualities you want in the next caregiver, and take the time to ask about all of them. Use your list when you check references and online reviews about the caregiver's agency, too, so you get the specifics you need. And stand firm until you find the right person -- don't be tempted when you interview a candidate whom you like but who lacks some of the requirements on your list.

Step 8: Give your new caregiver a trial run.
Once you've chosen a candidate, be clear that you're hiring her on a trial basis. It can help to present it as a mutual trial run -- after all, she too may find the situation isn't a good match. (If you're working with an agency or a referral service, also let them know that you're hiring the caregiver on a trial basis.) Set a specific period of time, such as two weeks, and agree to decide then whether to make the position permanent. By following this careful process, you're much more likely to end up with a caregiver you can rely on for the foreseeable future.

Melanie Haiken

Melanie Haiken discovered how important it is to provide accurate, targeted, usable health information to people facing difficult decisions when she was health editor of Parenting magazine. See full bio