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Hiring Elder Companions / Caregivers

Why Should I Hire an Elder Companion/Caregiver?

There are many reasons why elder companions / elder caregivers are hired to support an elderly person and his/her family.  A brief list of the main reasons follows.

*  The elderly person does not have any family member nearby.

*  The elderly person has a family member nearby, but that family member does not have the time to commit to caregiving.

*  The elderly person has a family member nearby, but that family member doesn't have the necessary skills, training, or emotional capability.

*  The elderly person may have family nearby that meets many of his/her needs, but the elderly person prefers to also have an elder companion for an additional interpersonal connection.  (This is particularly true for home-bound elders who may feel like they don't see many people anymore.)

*  The elderly person may ask a companion to be a set of eyes for them,because they need a "friend" outside of relatives.

*  The primary elder caregiver may need respite (a temporary break to regroup from the stressful work of caregiving for the elders that you love.)


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How Much Does an Elder Companion / Caregiver Charge?

The per hour charge for elder companions and elder caregivers depends on a variety of factors.  A brief list of those factors follows.

* the level of skill that you want the companion or caregiver to possess (i.e., CNA, LPN, RN, or other credentials)

*  the amount of work you will be expecting the companion or caregiver to perform (i.e., companionship only, companionship plus household chores, companionship plus administering IV meds, etc.)

*  the degree to which there may be difficulties in the working environment (i.e., is the elder particularly fussy?)

*  the geographical location in which the care will be rendered

*  the source from which the companion / caregiver was hired (from within the family unit, from a full-service placement firm, etc.)

Given all these variables, the average hourly cost of a home care aide worker (according to a MetLife survey) was $19 per hour (in some states).  The surveyed rate was as high as $30 per hour in some  states  and as low as $9 per hour in some states.

The cost of elder companions / elder caregivers can be defrayed in whole or in part by health or other insurance, the Department of Health and Human Services, and various state and non-profit organizations that are designed to help senior citizens live life as fully as they can.

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What Qualities and Qualifications Do I Look for in an Elder Companion / Caregiver?

There are a variety of traits and skills that you may seek in an elder companion / caregiver.  A brief list follows.

*  patience

*  tact 

*  kindness

*  empathy

*  emotional stability

*  discretion

*  honesty

*  trustworthiness

*  dependability

*  good communication skills

*  ability to follow directions

*  ability to respond well to constructive criticism

*  ability to handle stressful situations well

*  ability to work independently

*  ability to multitask

*  ability to problem solve

*  ability to provide transportation for self and elder

*  ability to monitor and record physical and mental functioning of elder

*  ability to administer medications and perform medical-related services for elder

*  interest in the elder, his/her life and stories, what he/she thinks, and how he/she feels

*  liability insurance to cover professional errors, etc.

*  certification by the National Association for Home Care and Hospice

You may not need your elder companion / caregiver to possess all these qualifications (i.e., the ability to administer medications).  There may be other qualifications that you seek in an elder companion / caregiver instead.  However, the list above is a general list that most families use in the "typical' situation in which an elder companion / caregiver is hired.

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What Questions Should I Ask an Elder Companion / Caregiver?

  1. Why do you want this job?  (or)  What draws you to caregive for the elderly? 
  2. Having read the job description, do you have any questions about it (the job description)?  Do you possess the knowledge, skills, and abilities to perform all the functions listed on the job description?
  3. What do you know about the illness or condition involved?
  4. Are you comfortable with helping the elder with bathroom issues or other bodily needs? 
  5. Can you lift the elder, if needed, without risk of harming yourself?
  6. What job-relevant training do you have?
  7. Do you have a CNA, LPN, or RN license?
  8. Are you certified by the National Association for Home Care and Hospice?
  9. Please tell me about a time when you received constructive criticism at work and how you responded to that.
  10. Please tell me about a time when you dealt with a stressful situation at work and how you handled it.
  11. How would you handle it if the elder that you are caring for fell off the toilet right as the telephone began ringing and the pot on the stove began boiling over?  What would you do? 
  12. What is the best life story that you have heard from one of the elders in your care?
  13. May I have your list of references, please?  

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Job Expectations for an Elder Companion / Caregiver

Before you begin to recruit for an elder companion / caregiver, you should prepare a job description which lists each function that you want the companion / caregiver to perform and the skills, knowledge, abilities, and experience that you are seeking in the companion / caregiver.  A brief list of some reasonable job expectations for elder companions / caregivers follows.

Expect the companion / caregiver to commit to caring for your elderly loved one for a defined weekly schedule.  Do not expect the companion / caregiver to work seven days per week or be on-call 24/7.  

Expect the companion / caregiver to act in your stead, to spend time with, listen to, support, and assist your elderly family member.

Expect the companion / caregiver to follow your instructions and constructive criticism.

Expect the companion / caregiver to need a little of your time, especially at the beginning of his/her employment relationship, so that you can show him/her what to do, how to do it, etc. in the manner that you and/or the elder like things to be done.

Expect the caregiver / companion to make choices that are consistent with the list of special diets, likes, dislikes, mobility problems, heath issues, danger signs to monitor, possilbe behavior problems, medication schedules, thereapeutic exercises, eye glasses /dentures/prosthetics care regimens, etc. that are provided.

Expect the companion / caregiver to be willing and able to transport the elder to doctor's appointments, etc.

Expect the companion / caregiver to be physically able to provide and emotionally comfortable providing bodily care for the elder (i.e., lifting the elder out of bed, helping the elder in the bathroom, etc.).

Expect the companion / caregiver to handle calmly and responsibly many difficult situations (health crises, multitasking, etc.).

Expect the companion / caregiver to respond empatheticallly to any death and dying conversations that the elder may want to have with him/her.

Expect the companion / caregiver to maintain confidentiality on private matters about the elder.

Expect the companion / caregiver to genuinely like the elder and time spent with the elder.

Expect the companion / caregiver to want and need a regular paycheck, with a consistent hourly pay rate, and benefits (if any) that are understood by him/her.

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Responsibilities of an Elder Companion / Caregiver

Elder companions / caregivers perform a variety of functions.  Some functions are targeted to meet the social or interpersonal needs of the elder.  Some functions are targeted to facilitate the daily operation of the elder's household.  Some functions are targeted to meeting the bodily and/or medical needs of the elder.  A brief list of job tasks under each of these headings is as follows. 

Social / interpersonal tasks include spending time with the elder, chatting, listening, watching television, and (where possilble) taking the elder on outings (i.e., to a museum or other location of interest to the elder). 

Daily household operation tasks include planning meals, cooking, cleaning, doing laundry, changing bed linens, shopping, and running errands.

Bodily / medical needs tasks include helping with using the toilet, helping with bathing and dressing, lifting the elder out of bed or out of a wheelchair, assisting with administering medications, attending to a wound or bandage, and taking the elder to doctor's appointments or to the hospital.

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What to Include in Your Elder Companion / Care Contract

An employment contract for elder companions / caregivers is highly recommended to ensure a shared understanding of the terms and conditions of employment.  This is true even when you know the person well that you are hiring.  

A contract should provide specifics on:

*  compensation (what pay rate per hour, what payroll cycle, and what pay dates)

*  benefits (if any)

*  performance evaluation dates and any opportunities for pay increases

*  hours of work

*  job duties  (you may include the job description in the employment contract)

*  duration of the employment contract and the terms under which employment may be terminated


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Tips for Hiring an Elder Companion / Caregiver

1.  Write a job description which lists all of the functions that you will want the companion / caregiver to fulfill.  The job description should also list the skills, knowledge, experience, and abilities that are necessary for the successful performance of the job.

2.  Recruit and interview candidates based on the qualifications specified in the job description.

3.   Once you have narrowed your candidate pool down to one or two candidates, perform background checks on those remaining candidates.  Ensure that you have their signed authorization permitting you to do so.

4.  When you have chosen your one final candidate, and he/she has passed the backgound checks, you should offer him/her the job in writing via an employment contract.  He/she may wish to negotiate the terms in the contract, so don't assume that if you offer him/her the contract that his/her sole options will be to sign it or to walk away.  If he/she does wish to negotiate with you about the terms and conditions of employment in his/her contract, listen with an open mind and seek compromise where possible.

5.  When the contract is signed and the employment formally begins, train the companion / caregiver thoroughly.  Spend a few days with the companion / caregiver to orient him/her to the tasks of the job and how you or the elder wish for those tasks to be handled.  After training is completed, provide prompt feedback when actual work performance deviates from expected work performance.  Praise work performance that meets expectations.  Show up unannounced periodically, just to make sure that things are going well even when you are not expected to be there.  If possible, ask questions of the elder, when the companion / caregiver is absent, to determine if the elder is satisfied with the care provided by the companion / caregiver.  Meet with the companion / caregiver at regular intervals, determined jointly by you and the companion / caregiver, to discuss the job and how it's going.

6.  After a brief introductory period (usually 30 days), provide the companion / caregiver with a brief performance evaluation.  Ensure that work is being done as expected by you and/or the elder.  Where there are differences between the work being performed and the expectations of the work performance, determine what differences are can-do issues and what differences are will-do issues.  Can-do issues are differences that are caused by the companion / caregiver's inability to perform as expected (i.e., an inability to lift the elder out of bed).  Will-do issues are differences that are caused by the companion / caregiver's unwillingness to perform as expected.  (At this juncture, training on routine tasks should not be warranted as the companion / caregiver has been performing these tasks for 30 days and any performance problems have been redirected throughout the 30 days.)  Based on the can-do and will-do assessment, which may need to be determined through discussion with the companion / caregiver, you will need to determine whether to continue to employ the companion / caregiver.

7.  If the decision is made to retain the companion / caregiver, the introductory period will end, and regular employment will begin.  Congratulations, you have now successfully hired a well performing companion / caregiver!

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