Most people, given the choice, would prefer to be cared for in their homes rather than in a nursing home or long-term care facility. Sometimes, of course, that’s not possible, but in other cases, it can work with the help of a paid caregiver in the home.
If you have a loved one who wants to stay in his or her home, and you need to find a caregiver or caregivers to make it possible, where do you start? We’ve all heard horror stories of caregivers who were unqualified, dishonest, or worst of all, abusive. Here are some questions to ask in order to make sure your elderly loved one gets care you’re both comfortable with.
Questions to Ask Yourself
In order to get what you need, you first have to understand what you need. So, before you call an agency or caregiver to begin the interview process, think about these things:
- What are the older adult’s medical conditions and physical limitations?
- Does the older adult have Alzheimer’s or dementia?
- How many hours a day will care be needed?
- Will the caregiver need to transport the older person to appointments?
- What specific services will be required?
- What resources are available to pay for care?
- What are your house rules (no smoking, no guests, etc.)
- What are your own worst fears with regard to hiring a caregiver?
The answers to these questions will inform the questions you choose to ask a caregiver candidate. Some older adults may only need a few hours of assistance at a time. Others, for example those with dementia or serious medical and mobility issues, may need round-the-clock care from a more highly-trained caregiver.
Questions to Ask a Caregiver Candidate
Whether you are hiring through an agency or dealing directly with potential caregivers, you will want the chance to meet and interview candidates before they begin caring for your loved one. Make the most of your interview opportunity by asking these questions:
- Tell me about your experience as a caregiver. How long have you been doing this type of work? Describe some of your previous work situations.
- Are you willing to provide me with the information (name, birthdate, SSN, address) necessary for me to have a background check performed on you? Is there anything you’d like me to know before I do?
- What do you like about working in the home care field? What do you dislike?
- Why did you leave your last position? Have you ever been fired from a job? (If so, what was the reason? Having been fired is not necessarily a deal-breaker, but pay attention to how the caregiver talks about what happened. Is she defensive? Bad-mouthing the previous employer? These may be red flags.)
- Do you have any particular certifications for care (like CPR or dementia care)? Can you (or agency, if applicable) provide documentation?
- Can you (or agency, if applicable) provide me with current documentation of your health status and recent immunizations, insurance, and bonding?
- What are your expectations if you’re hired for this position?
- What hours and days are you available to work? What happens if you’re unable to make a scheduled shift?
- Are you comfortable transporting the client to appointments?
- Are you comfortable with the house rules (e.g. no smoking, no guests) I’ve described?
- How do you handle difficult situations (e.g. an older person who refuses to comply with care or who becomes combative)?
- How do you prefer to communicate with me about what happened during your shift (e.g. medications given, meals served, how much client ate, any descriptions of illness or unusual events)? How do you prefer to receive feedback or instructions?
- What is your hourly rate? ($17/hour – $20/hour in the Metro Detroit area)
- How do you expect to be paid?
- Is there a written and signed contract?
That last question is more important than you may think because payments to caregivers can cause Medicaid ineligibility. This is a relatively recent development in the law, and applies even if caregivers are not related by blood, marriage or adoption to the person receiving care. In order to avoid disqualification for Medicaid, there must be a written contract for care in place before the care services are provided and there should also be a statement available from a physician certifying that the services were necessary to prevent the older person from needing to be in a nursing home.
Without a proper contract and physician’s certification, payments made to caregivers will be considered gifts under the law, which create periods of disqualification – called divestment penalty periods, if made within five years of applying for Medicaid. Even if a person would otherwise be eligible for Medicaid, these “gifts” will bar them from receiving such benefits for certain period of time.
Therefore, even if you plan to have your loved one cared for in his or her home, you should consider the possibility that a nursing home and Medicaid will be needed down the road, and consult an experienced Michigan elder law attorney about Medicaid planning. The cost to protect your older loved one’s assets is much less than what they risk losing if you don’t.