Care at Home

Care Planning, Search and Selection: How to Begin

Follow these steps:

  • Begin with a doctor’s assessment for in-home care. To help you understand what kind of caregiver to hire (such as someone with a nursing background versus a home care aide or homemaker-companion), have the person in your care checked by his or her doctor. A doctor can also help determine whether in-home care is the best route, or whether the patient requires temporary or long-term care at a skilled nursing facility.
  • Determine your in-home care budget. You’ll need to know how much money is available to spend for a professional caregiver. This will help you make important decisions about the number of hours you can afford. Talk first with family members to nail down roughly how much money you can pool to pay for in-home care. Then you can begin looking at other options for ongoing care. If long-term care is necessary, you may consider cashing in a life insurance policy or annuity, selling a home, or getting a reverse mortgage. However, none of these moves will get you cash in a hurry.
  • Plan an in-home care schedule. Once you know how much money is available for in-home care, and you have a sense of your or a loved one’s needs, you can draft a caregiver’s schedule. This is basically an outline of how many hours per day you want (or can afford) to hire someone, and what days and times work best for everyone involved. Then it’s a matter of finding a caregiver to fit this schedule.
  • Start your in-home care search. Once you confirm your budget and the hours you hope to fill, you can start looking for a caregiver. The main ways to find in-home caregivers include word-of-mouth (asking for referrals from people you know, including medical staff, senior organizations, and religious communities) and using an employment agency that specializes in home care agencies. The main difference between hiring independently or using an agency is that agencies can handle most of the paperwork, such as tax and social security forms. Agencies also screen employees. A good way to find in home care is to go to the Eldercare Locator; a government run service that links people to local senior agencies to provide a range of assistance, including finding home care. For Massachusetts residents, use You can also find agencies through the Internet (use search terms home health care or in-home senior care in your town).
  • Identify the right in-home caregiver. When you’re working fast, a few things can help you make a good caregiver match. First, weed out caregivers or agencies over the phone if they don’t meet your scheduling or financial needs. Trust your instincts, ruling out anyone or any place you don’t feel good about. Narrow down an “interview” list and meet these people in person, with the person in your care if this is appropriate. Then, ask these questions of the home care agencies you interview.


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