Family & Friends
Utilizing Paid In-Home Caregivers
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Before engaging any caregiver or agency, a family needs to know what level of care their loved one requires. The case manager, hospital, or rehabilitation center should be able to instruct the family as to what qualifications a suitable caregiver would need. Confirm that the person you are hiring has the appropriate credentials and training or if using an agency, ask if they employ credentialed caregivers that provide the required level of care.
Aside from the caregiver certification, there is a range of training that the family can provide to caregivers that will greatly impact their ability to care for the one needing assistance including:
- Videotaping of training to develop a training library
- Taping training sessions with physical, occupational and speech therapists to outline the in-home daily therapy program to be provided by the caregivers
- Books and articles on coping strategies for activities of daily living, cognitive and behavioral issues for interacting with the person with the brain injury.
- A notebook and charts for medication, strategies for speech, occupational and physical therapies, etc.
- A spiral-bound communication notebook to be utilized by all caregivers, family and treating therapists to communication information regarding the client’s response to care or problems in delivering the outlined plan of care.
This spiral notebook provides an informal method for team members 24 hours/day, seven days/week to communicate with each other regarding the client and the plan of care. It would be the responsibility of each caregiver to read the most current notes in the communication notebook prior to providing treatment.
Tips for hiring an individual to provide in-home care:
If you are hiring someone privately, you may want to ask:
- What experience do you have as a caregiver?
- Have you worked with persons with behavioral, cognitive and physical problems?
- Are you willing to participate in training?
- Why are you interested in working with this person with a brain injury?
Other factors that are important in determining whether or not a particular person may be an appropriate caregiver are the person’s ability to communicate to the person he/she will be caring for and the family.
- Is there a language barrier?
- Any literacy problems?
- Does the person have the language skills, mental alertness and temperament to be able to problem solve? To call for help? To receive direction? To follow through on instructions?
Personnel Procedures for hiring a paid caregiver:
Explain the terms of employment in writing including:
- Salary or hourly wage
- Hours and days of work
- How to arrange in advance for time off
- Employment status – is the person your employee or an independent contractor? Who will take responsibility for paying state and federal taxes? Is the employee willing to sign a release if they work as an independent contractor to be responsible for their own tax obligation?
- Benefits, including vacation, sick leave, etc.?
- Payment schedule (procedure for payment – where and when)
- Schedule of evaluations – it is recommended an individual be evaluated at one, three, six and twelve months and subsequently annually. (If your state is not a Right-to-Work state, it may be wise to sign a one or three-month mutual release form.)
Application process:
- Have the applicant complete the following forms:
- Job application
- Release for criminal/background check
- Mutual 3-month release form (if applicable)
- Call references submitted on application for additional personal and professional background
- Run background checks
- Review any applicable house rules concerning:
- Bringing personal friends/family for daily activities or into the home
- Television policies (restrictions on when and what may be watched)
- Drinking, smoking and drugs
- Appropriate language and attitude
- Caregiver’s personal cooking activities and personal space
- Individual preferences of client – employee dress code, smoking, etc.
- Use of telephone for personal business
- Rooms off limits to caregiver
- Responsibility of caregiver for household chores and laundry
- Use of transportation vehicles (you may wish to keep a mileage log in the vehicle for use by the caregiver)
- Management of keys for vehicle and home (avoid giving caregiver keys when possible)
Ms. Buchanan serves as the Director of Clinical Services & Safety for Southern Home Care Services. Through its state-licensed and CHAP*-accredited offices, Southern Home Care Services provides personal support, respite, homemaker, skilled nursing services, and a variety of specialty services to clients of all ages. In her corporate capacity, Ms. Buchanan oversees clinical operations for all of the Southern Home Care Services’ offices. A Registered Professional Nurse, Ms. Buchanan achieved specialty certification in Critical Care Nursing as well as in Nursing Administration and worked for many years in acute care hospital settings.
Southern Home Care Services is a wholly-owned subsidiary of ResCare, Inc., a leading provider of residential, therapeutic, job training, educational, and in-home support services to populations with special needs, including persons with developmental and other disabilities, including those caused by acquired/traumatic brain injury and spinal cord injury.
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