A Step-by-Step Guide to Hiring an In-Home Dementia Caregiver

What Is In-Home Care for Dementia?

In-home care, or home care, provides nonmedical services for individuals in the comfort and privacy of their own homes. An in-home caregiver can make it easier for older adults to remain at home when they aren't ready or willing to move to a long-term care facility. This type of care is ideal for seniors who are mostly independent and don't require skilled nursing care. 

Research from Johns Hopkins reports the majority of those living with dementia remain in their homes and can maintain a high quality of life with the right support. Depending on the severity of your loved one's memory loss, an in-home caregiver can visit a few times per week or be available 24/7. In-home care services are personalized and can include:

• Assistance with personal care tasks, such as dressing, bathing and grooming
• Mobility assistance
• Housekeeping and laundry services
• Companionship and social engagement
• Medication management
• Transportation to appointments or social events
• Grocery shopping and meal preparation
• Respite for family caregivers

What Are The Benefits of In-Home Care for Seniors With Memory Loss?

If you're considering hiring a caregiver for a loved one with dementia, in-home care provides many benefits that can help them age in place safely during the early stages. These benefits include:

• Personalized Care: Instead of your loved one adjusting to the schedule and routine of a facility, an in-home care plan is customized to fit their needs and can include daily activities designed to improve cognitive functions.
• Cost-Effectiveness: Although prices will vary depending on where you live, in-home care is typically more affordable than residential care. Most caregivers are paid hourly, meaning you only have to pay while the caregiver is with your loved one.
• One-on-One Attention: In-home caregivers can only visit one home at a time. This means your loved one receives undivided attention when the caregiver is with them and their needs are met much faster.
• Family Involvement: Family members can maintain communication with their loved one's caregivers and receive progress updates, depending on how the agency operates. It can also be easier to check in on your loved one at home rather than at a facility to ensure their needs are being met.
• Independence: Loss of independence is a top concern for many seniors when considering care options. With in-home care, they can stick to their own schedule and receive assistance with certain tasks, such as mobility and driving, to help them maintain independence, even with memory loss.
• Peace of mind: You may rest easier knowing your loved one has someone routinely checking on them, especially if they're affected by dementia. An in-home caregiver can ensure they don't get hurt or wander out of the house without a way to find their way back. Staying home may also be more comfortable and less disorienting for your relative.

Home Care vs. Home Health Care for Seniors with Dementia

Home health care is an alternative home care option that provides skilled nursing services administered by certified home health aides or nursing assistants. There are a few differences between home care and home health care. 

How to Hire an In-Home Dementia Caregiver: Step-by-Step Instructions

If you believe in-home care is a good fit for your loved one but aren't sure where to start, there are a few steps you can take to make the process easier. Take a look at these step-by-step instructions to find and hire a caregiver to attend to your loved one's needs and keep them safe. 

Step 1: Assess Your Loved One's Care Needs

Before you research caregivers, it's important to determine how severe your loved one's memory loss is and the level of assistance they need. Home care offers several opportunities for customization, whether it's for part-time companionship to help your loved one stay social and active or 24/7 assistance with personal care needs. Here are a few questions to ask yourself when considering in-home care:

• Does your loved one need help with daily living activities?
• Are they having a hard time driving or moving around?
• Does your relative have a pet that they need help caring for?
• Do they need help maintaining their home and conducting basic cleaning tasks?
• Is your loved one lonely or isolated?

If the answer is yes to any of these questions, an in-home caregiver can help, but some may be better at certain tasks than others.

Step 2: Search for Multiple Candidates

The goal is to find a trustworthy, compassionate caregiver who will treat your loved one like family. To do this, search for candidates skilled in dementia care or the exact services your relative needs and read online reviews. If their reviews are mostly positive and they provide the services you need, add them to your list of potential candidates. You can also seek referrals from trusted friends or family members.  

You'll also want to decide whether you wish to work with an independent caregiver or an agency. Although this is mostly a personal preference, there are pros and cons to each option. For instance, working with an agency may cost more and offer less flexibility, but they usually screen their caregivers and can provide backup if your original caregiver is sick or unavailable. Independent caregivers can offer more flexibility and affordability, but you may have to conduct your own background screening, find emergency coverage and take on payroll responsibilities. 

Step 3: Pay Fairly and Legally

Most in-home care agencies have nonnegotiable rates. When hiring an independent caregiver, you may have to determine what's considered fair pay based on the services you're seeking. Standard in-home care rates will also fluctuate based on where you live, so it's important to research rates in your area.

Offering a flexible rate based on experience may attract a wider range of candidates, including those with a lengthy caregiving background. If a caregiver has been doing their job for a long time, offers extensive dementia care services and has good reviews, the higher rate may be worth paying. 

Keep in mind that if you pay an independent caregiver more than $2,100 per year, they're considered a household employee, not an independent contractor. The IRS provides rules and resources for determining your caregiver's employment status and how to ensure they're paid legally. 

Step 4: Conduct Multiple Interviews and a Trial Period

Interviewing a potential candidate just once may not give you a complete picture of their personality and caregiving abilities. A three-step interview process can present a well-rounded view of a potential candidate. Here's an example:

• Conduct a phone or Zoom interview to ask about relevant experience in dementia care and determine whether the candidate meets the basic requirements of the job. 
• Those who pass the phone screening can be invited for an in-person interview to further discuss job details, such as the schedule, required services and pay information.
• The final interview can involve introducing the candidate to your loved one to see how compatible they are and if your loved one feels comfortable around them. 

Before permanently hiring a caregiver, holding a trial period can give you a chance to see how well they interact with your loved one, navigate the home and handle caregiving duties. 

Step 5: Check the Caregiver's References

After the interviewing process is over and you have your top candidates, it's crucial to conduct background checks and ask for references to contact. Even if a candidate seems like the perfect match for your loved one, it's better to be safe and follow up with past employers and check criminal records. 

This is especially important because about 1 in 10 seniors experience some form of abuse. Checking a candidate's criminal record in all states they've lived or been employed in will reveal any past charges or convictions. When contacting a candidate's references, there are a few questions you may want to ask them, including:

• How well that person performed the job
• Whether they would hire that person again
• If they'd recommend that person for your specific job

Step 6: Develop an Employment Contract

Once you have your new in-home caregiver, developing an employment contract clearly outlining the job expectations is beneficial to you, your loved one and the caregiver. It can prevent any confusion surrounding your caregiver's job duties and the needs of your loved one. There are several important details you may want to include in the document, such as:

• Detailed job description
• Pay rate and frequency
• Schedule, including expected hours per week
• Any other terms agreed upon during the interview

After reviewing the employment contract together, both you and the caregiver should sign it to show you agree to the established terms.

Hiring an in-home caregiver for a loved one with dementia offers personalized care, cost-efficiency and peace of mind. By following these steps, you can find a trustworthy caregiver who ensures the safety and well-being of your loved one, allowing them to age comfortably at home and maintain some independence.