In-home caregivers can help your loved ones with instrumental activities of daily living (iADLs) and activities of daily living (ADLs).  You may need an in-home caregiver because you have a family member who is unable to stay home without assistance and perform basic self-care tasks. This could be due to injury, illness, or disability.  Choosing an in-home caregiver can seem like quite a daunting task! However, there are some things that you should keep in mind before hiring one. In this blog post, we will discuss 5 tips for choosing an in-home caregiver so that the experience goes as smoothly as possible.

TIP #1. Consider what instrumental activities of daily living (iADLs) need to be done

TIP #2. Ensure the person you hire has experience with people who have similar limitations as your loved one

TIP #3.  Ask potential home health aides how they will communicate with you on a regular basis

TIP #4. Decide on a budget for hiring an in-home care provider

TIP #5. Look at different options for finding an in-home caregiver – ask family members, friends, neighbors, etc., as well as looking online

First, let’s start with a definition of a term that may be new to you: Instrumental Activities of Daily Living (iADLs).  You may have heard this term from other medical professionals or read about it in pamphlets.

What are Instrumental Activities of Daily Living?

Instrumental activities of daily living (iADLs) are instrumental life skills that are necessary for self-care. These activities are instrumental because they enable people to manage their personal care needs, carry out daily routines, and maintain independence within the community.  iADLs include meal preparation, housework, laundry, taking medications as prescribed, doing grocery shopping, handling finances (paying bills), and managing correspondence.  Click for a full list of IADLs.

In other words, if your loved one has reached a stage where they can no longer perform these instrumental activities of daily living, it may be time to consider an in-home caregiver to help maintain their quality of life.

TIP 1: Consider what instrumental activities of daily living (iADLs) need to be done

Sadly, most elderly individuals rarely recognize that they need daily living help until it’s too late.  It’s really up to us, their family, to notice little things like they are not managing their money well, or caring for a pet the way they used to.  These are signs that your loved one may need some assistance.

Assessing their needs and prioritizing them is key to choosing the right in-home caregiver.  The balance that needs to be struck is between maintaining the quality of life for older adults and ensuring basic self-care needs are met.  These may seem like they should be the same thing but to an older person one may add more quality of life than another.  For example, to your aging parents. managing finances may be less important than pet care.  From the outside, it may seem that in order for them to live independently they would need to manage their finances but for their mental health, their pet may be more important.

It’s not just about managing money either. You will have to prioritize their ability to do basic activities like managing medications, preparing meals, and much more.

Once you have prioritized your list you can begin searching for an in-home caregiver who can meet your loved one’s needs.

TIP 2 – Ensure the person you hire has experience with people who have similar limitations as your loved one

You don’t want to hire someone who has not worked with people in a similar situation as your loved one.  If they have experience, chances are that you will be able to trust them more and feel comfortable having an extra set of eyes on your aging parents.

In order to find a caregiver who has worked with people similar to your loved one you want to ask questions like:

• What was your last client like?
• Can you list the instrumental activities of daily living (IADLs) that they were limited in?
• What was their mental state like and how did it affect your job as a caregiver?
• How did they communicate with their family/loved ones?
• Was there a need for medication management? 
• Do you provide transportation to doctor visits or community outings?

If the person has the experience, they will be able to answer these questions with ease.  If not, there may be an indication that they don’t have enough experience and you may want to look into hiring someone else.

Additionally, reputable in-home health aides would complete a functional assessment of your loved one and include a plan with suggested care.  You can use their assessment to ask further questions about their experience and training.

TIP 3 – Ask potential caregivers how they will communicate with you on a regular basis 

We mentioned communication earlier but it bears repeating. When it comes to in-home caregivers, communication is key.  You want someone who will keep you up to date on your loved one’s progress or lack thereof.  Someone who will provide you with the truth no matter what.  Especially if your loved one is dealing with cognitive decline, it’s doubly important to communicate with their home care specialist. If they are unable to provide this information regularly, chances are that their care will not be sufficient for your aging parent’s needs. 

TIP 4: Decide on a budget for hiring an in-home caregiver 

As with anything else you will have to consider your budget.  Though costs can vary wildly depending on the area and level of care needed, in-home caregivers generally range from $20-$40 an hour for part-time services and $30-$60+ per hour if they work full time.  Many companies also offer a flat-rate fee for services.  This is usually the most expensive option but it is simple, straightforward, and they will provide all of their own equipment. The other options will either be a per diem rate or you can pay hourly.

TIP 5: Start looking early if possible, the process tends to take longer than expected.

The time to start looking for assistance is pretty clear. The moment you see your loved one needs help or is losing the ability to continue living independently, it’s time to start looking for a caregiver. Some of the areas where they may start to show signs of struggle are the ability to pay bills, driving, cooking, shopping, disengaging from community events, or managing finances, to name a few. If an older person struggles with any of these areas or has been diagnosed with dementia, then it’s time to get help from professionals.

The truth is it can take months to find the right home health provider for seniors. Not only will you want to ensure they can perform iADL tasks that are needed, but you must determine that their companion care will meet your standards. The little things matter; if your loved one needs to take a trip to their physical therapist but can no longer drive, you wouldn’t feel confident with them on public transportation, either. In this scenario, a family caregiver would immediately help and provide a ride to the doctor or physical therapist’s office. Would the in-home care provider you’re considering do the same?

Are nursing homes or Family Caregivers an option?

• By this time you may be wondering, “If my loved one can’t do self-maintaining tasks, then maybe we should consider a nursing home.” While a nursing home provides excellent support, it is important to note that they often strip older adults of their independence.

Family can often step in for awhile, but the constant care of older people can take a toll on family members. Additionally, families can provide great support but they often lack the training to provide all of the services that are needed.

Choosing the right professional to help the senior in your life is a very delicate balance between their needs, your budget, and how much help is needed. There is no easy formula when hiring outside assistance, and there is no crystal ball to say how much help would be of benefit, especially if your loved one is suffering from dementia. However, your loved one still deserves the best assistance, support, health care, and treatment your family can afford.