DPHHS Home       About Us       Contact Us       News & Events       Programs & Services       Health Data & Statistics

A - Z Index

Hiring In-Home Help

A Practical Guide for Consumers

Compiled by Cecilia Cowie
Montana Department of Public Health and Human Services
Senior and Long Term Care Division

August 2001


Hiring In-Home Help

There comes the point when we may need help to remain in our homes as a result of an accident, prolonged illness, disability or the frailty that comes with age. When this happens, individuals may turn to family or friends. More often, they seek no help and live with reduced abilities due to the fear of having to leave the home. People need not live in fear.

Fortunately, there are options for individuals faced with this situation – hire someone to help. The helper can be hired from a home health agency or private duty firm. In this instance the home health agency or private firm do the hiring for you. Many find it more affordable to hire an in-home caregiver privately. Under this option, you are responsible for finding, hiring, training, directing and firing your helper. With careful planning and consideration, it is possible to find the right person for the job yourself.

While there are many places to turn for assistance, there is no real "consumer-buying guide" for this type of care. We have put together this pamphlet to provide you with basic information to purchase in-home help. These "tips" are designed to walk you through the many facets of hiring in-home help. This guide is by no means an all-inclusive tool.

What kind of help do you need?

In order to hire quality in-home help, you need to know what type of duties the person will be performing. To get to this the individual who needs assistance must be evaluated in terms of the help that they require. This will also protect you from over or under purchasing services.

A simple evaluation can be completed utilizing layman terms. This can be completed by the individual needing services or by family members. The evaluation will also be the foundation for the job description or work contract, recruiting and even training the help you hire.

For your convenience, a sample evaluation format is included on the following page. A number of tasks are listed for consideration. Each task has space to rate the ability of the individual and indicate who is going to provide the care. The person providing care could be hired, or a friend or relative. The "sandwich" generation often uses a combination of family members and hired help in order to meet the changing needs of an extended family.

If an individual is already receiving some assistance, indicate that in the comment section. This will assist in keeping track of what is already covered and where the unmet needs lie.

A few blanks have been left under the task column, in case there are special needs to consider. Perhaps assistance is needed with a therapy or exercise program. The list is by no means inclusive. Tailor it to meet your situation.

A Basic In-Home Help Evaluation

Task

Score

Help

Comment

Bathing

Dressing

Grooming

Transfers (in/out bed/chair)

Mobility (walking or w/chair assist)

Medication Assist

Eating

Shopping

Housework

Laundry

Money Mgmt

Transportation/Escort

Socialization

Supervision

Scoring: How does the individual currently complete each task?

0: Independent – Requires no help
1: With Difficulty – Can be managed
2: With Help – Cannot complete task without assistance, supervision or prompting.
3: Unable –Task will not be completed without assistance

Help: Who is going to assist?

H: Hire someone to help
F: Family or Friend, Record the Name of the Individual
S: Self; the person manages this on their own.

Remember this is to serve as a guide. There may be additional duties that need to be completed. Don’t forget to think about chores such as lawn mowing, chopping wood or shoveling snow.

Review the completed form. Do you need to hire outside help or can you and your family and friends meet the needs? Is there enough back up help if something goes wrong or if someone is unable to meet his or her commitment? Consider those issues.

Defining the Job

This is your first step. You have decided to hire a helper. Decide whether to use an agency (such as home health firms) or find a helper on your own. This guide can help you hire on your own.

You have filled out the in-home evaluation. The evaluation can now be translated into a job description. Exactly what do you want the helper to do? The answer to this question can serve as the foundation for a contract between the individual/family and the hired helper (often called a caregiver or attendant). When defining the job, make sure you include at least the following:

  • A detailed list of duties to be carried out.
  • Statement of wages and benefits
    • Consider hourly wage, mileage reimbursement, and meals.
    • Paid time off; if any
  • Whether the caregiver can bring children to the job site
  • Hours of work and schedule
  • Unacceptable behaviors – with the consequences
    • Smoking, abusive language, etc.
    • Abuse, exploitation, harm
  • Termination process for both parties.
  • Signatures of employer and employee (you and the helper)
  • All pertinent employee data.

Having this developed prior to looking for help, will assist in your selection process. You will also be prepared to hire that "right" person when you find them.

Looking for Help

Now you are ready to find the right person to fill the job description. Getting the word out in many ways can assist you in finding that right person. Here are some options:

  • Word of Mouth – Recommendations from a trusted friend or relative
  • Job Centers at Colleges and Universities
  • Churches
  • Senior Centers
  • Newspaper Advertising
  • Community Centers

Any time an ad is taken out or a flyer is made, consider these tips first:

  • Make your job sound appealing
  • Describe the interests of the individual
  • Include any perks
  • Consider an answering service/ PO Box
  • Do NOT list your address
  • Do NOT list your full name
  • Be clear on when to call
  • Get advice from the newspaper staff

Screening

If you are going to place ads or post flyers, be prepared to screen the individuals first by sending them an application. This can help you select individuals for formal interviews. Once the individual calls you in response to your ad, describe the job in detail and state specific expectations of the work contract. If the individual is still interested, tell them you’ll send them a formal application to find out more about them.

Before sending the application, you can ask some basic questions to exclude unqualified candidates. Consider these questions:

  • Do you have experience as a caregiver?
  • Do you have a driver’s license?
  • Are you currently working?
  • Why are you attracted to this job?

Asking some basic questions over the telephone provides you with a first impression of the applicant. Making the applicant fill out an application and mailing it to you gives you further opportunity to screen the individual. Having them mail the application gives you time to review qualifications, references, and work history in the privacy of your home without pressure. If you like what you see, schedule the interview. Remember to ask the applicant to bring identification.

Interviewing

Scheduling the interview is only part of the process. Preparation for the interview must also occur. First and foremost, find a neutral location to conduct the interview. Community centers, libraries or even restaurants are good places to meet someone. Bring the application, notepaper, and additional questions for the interview and the work contract. Sometimes it is helpful to bring another person along to observe and provide a second opinion.

Go over the application with the individual, asking for more information when the information seems to be vague or unusual. Then proceed with any other questions. Keep focused and have the interviewee do most of the talking. Take notes to assist in recording answers or facts.

For additional questions, consider these:

  • Why are you looking for work?
  • How do you feel about caring for another individual?
  • Do you have experience cooking for others?
  • What time commitments are you willing to make to stay on the job?
  • Do you have any training in this area?
  • Is there anything in the job description that you are anxious about?
  • Do you have transportation?
  • Have you been bonded?
  • Are you willing to submit to background checks?
  • Can you safely lift or transfer an individual?

(For further questions, check your local library for books pertaining to interviewing and selections of employees.)

After each interview is completed, review and finalize notes. Whether you are conducting one interview or five, this is your record of what occurred.

Ready to Hire? Not Yet!

Once you have found a candidate (or two or three) for the job, complete reference and background checks. Why? Knowing that the individual has provided correct information, has been successful in this type of work and does not possess a criminal record will add confidence to your decision. It will also protect you from undue harm.

The candidates have provided references for you to check. You can check references through telephone calls or written requests. If the reference is a previous employer, minimal information may be provided due to perceived liabilities by the firm. Be prepared to ask about work history, ethics and commitment. Don’t be surprised if you receive only notification of dates of employment and a statement on eligibility of re-hire from some employers.

Don’t hesitate to call personal references. While it may appear to be time consuming, you may find out more about the individual and assist in making the right decision.

Once you have completed reference checks. It is time to consider background checks. The following resources are available to individuals hiring into their homes:

The Nurse Aide Registry

The Certification Bureau of the Department of Public Health and Human Services maintains a registry of certified nurse aides (CNAs). This registry contains approximately 8000 names. To be listed on the registry an individual must have completed CNA training, passed the state mandated test, and completed the CNA application form. The individual is then certified for two years. To remain registered the individual must complete annual inservice requirements.

An individual can become decertified by: not meeting annual in-service requirements, being convicted of abuse occurring in a nursing facility, a bona fide serious allegation, (results in being listed as a perpetrator) or not working the minimum eight hours as a CNA.

This registry also tracks home health aides in the same manner. A home health aide has an additional 16 hours of training designed to cover providing assistance in a home rather than an institution.

This information is available to employers in the long-term care industry, including consumers. (That’s You!) Contact the Certification Bureau at (406) 444-2099.

The Montana Department of Justice – Criminal Records

Montana Criminal Records Bureau is the central depository for all criminal history in Montana. Their main purpose is to maintain and disseminate criminal records as per Montana Law. As long as you have the consent of the applicant, you can request criminal records as a condition of employment.

A criminal history record will provide information in accordance with Montana’s dissemination criteria. The bureau disseminates information regarding misdemeanors and felonies committed/prosecuted within the State of Montana.

The identification bureau can disseminate criminal records by obtaining basic information such as names (including aliases or previous surnames), date of birth, social security number and gender. Since this check is information based, an individual may contest the record by demonstrating it is not them. The cost is $5 and due to the high volume takes about three weeks.

If the request is accompanied by a good set of classifiable fingerprints, a finger print-based check can be done. Your local law enforcement agency can assist in obtaining these prints. This is more accurate and eliminates the potential of contested records. The cost for this background check is $8. It takes approximately two weeks.

To obtain a criminal history gather the following:

  • Names(s)
  • Date of Birth
  • Social Security Number
  • Gender
  • Signed Release
  • Appropriate fee
  • $5.00 without fingerprints
  • $8.00 with fingerprints

Send this to:

Montana Criminal Records
Post Office Box 201403
Helena MT 59620-1403
For further information call; 406-444-3625.

After your request is processed, you will receive one of two things. If the individual does not have a criminal record, your request will be returned with "No Arrest Record Meeting Montana Dissemenation Criteria" stamped in red with the operators intial. This means the individual has not been convicted of a misdemeanor or felony within the past five years.

If there is a criminal history, a short description of the conviction(s) will be provided. This includes the contributor (i.e. entity who handled the arrest), the name on the record, and the date of the arrest, the charge and the disposition of the charge. The report will indicate if the charge is a felony or a misdemeanor. Oftentimes, just mentioning that you will do a criminal background check will deter questionable individuals from applying.

County Sheriff Offices

As of July 1, 1997, Montana has a Sex & Violent Offender Registry. Local officials manage this registry. Requests for information need to be made to your local county sheriff’s office. This information is also available on the Internet. You can check the Montana Sexual and Violent Offender Registry at https://doj.mt.gov/svor/; "sexual and violent offender registry".

Receiving this type of information may help you make an informed decision. Individuals with a prior history of assault, theft, domestic abuse, exploitation and the like, may prey on seniors or individuals with disabilities. While some individuals reform and become contributing members of society, it is in your best interest to consider previous charges seriously.

Offer the Job

After the interview, reference and background checks, you may have found the right person to fill the job. Let the person know as soon as you decide. Set up a time to meet with them in your home. This is the time for you to review the work contract in detail, establish a schedule, review the layout of the home, discuss rules and finalize wages. Time spent here will help avoid future problems.

Employer Issues

Hiring of in-home help qualifies you as an employer of a "household employee". There are many issues regarding taxes, liabilities and employment eligibility. It is time to consult with your insurance agent and your tax professional to make sure you follow proper procedures.

Household employers should verify that their household insurance (renter’s or homeowner’s) covers household employees in case of an accident. If you are going to have the helper drive one of your vehicles, verify that your automobile coverage is adequate for this to occur.

As the household employer, it is imperative that you be fully informed of the legal responsibility for paying taxes for household employees. Either consulting with a tax professional can do this or by reviewing IRS publication #926, Household Employer’s Tax Guide. This publication will help you decide whether you have a household employee and, if you do, whether you need to pay federal employment taxes. It explains how to figure, pay and report social security taxes, Medicare tax, federal unemployment tax, and federal income tax withholding for your household employee. It also explains what records you need to keep.

The IRS summarizes household employer responsibility as follows:

Household Employer’s Checklist – What you may need to do

When you hire a household employee:

Find out if the person can legally work in the US.

Find out if you need to pay state taxes.

When you pay your household employee:

Withhold social security and Medicare taxes.

Withhold federal income tax.

Make advance payments of earned income credit.

Decide how you will make tax payments.

By February 1

Get an employer identification number.

Give your employee Copies B, C, and 2 of Form W-2, Wage and Tax Statement

By March 1

Send Copy A of Form W-2 to the Social Security Administration

By April 15

File Schedule H, Household Employment Taxes with your federal tax return.

Again Publication 926 explains these issues in detail. You can reach the IRS via their web site at www.irs.ustreas.gov or by calling 1-800-TAX-FORM (1-800-829-3676).

It is also imperative that you are aware of state tax issues. For state unemployment taxes: contact:

The Department of Labor and Industry
PO Box 1728
Helena MT 59620 406-444-2747

For state income tax withholding contact:

The Department of Revenue Income and Miscellaneous Tax Division
PO Box 202701
Helena MT 59624 406-444-0269

While it may seem overwhelming, a little bit of organization will enable you to collect, pay and report taxes and wages in an efficient manner.

Retaining your In-home Helper

Now that you have found the right person, wouldn’t it be great to keep them? That is what retaining employees is all about. All employees regardless of their line of work want to feel "in on things" and be appreciated. Consider these things:

  • Offer a pleasant working environment that someone can enjoy.
  • Be clear when giving directions.
  • Understand their need for time off due to illness, injury or a vacation.
  • Listen to their suggestions.
  • Negotiate schedule changes in order to meet the needs of all parties.

When Problems Arise

Unfortunately there are times when problems do arise. There may even be a time in which an in-home helper needs to be fired. This can be a difficult position for the employer. Use the work contract to stress job duties and consequences of unacceptable behaviors.

Many employers use progressive discipline to correct the action of employees. Given the severity of your situation, it may or may not be an option. Progressive discipline includes a verbal warning, a written warning and finally, job termination.

Terminating an individual from employment is not a pleasant process. It is wise to have another person present if it comes to last resort. (Or consider dismissal over the telephone.) Consider the following when you must tell your employee you no longer desire their services:

"I’m sorry, but I don’t think that things are working out. I need someone who (is stronger, can drive, can work more flexible hours, lives closer, has more experience, etc.). Thank you for your time and your help."

"You’re falling down on the job. You arrive between a half hour and an hour late and you have missed several workdays without notice; I need someone more dependable. I am sorry, but I have to give you notice of termination."

If you have to terminate an employee, keep accurate documentation of the event and reasons for termination. This will protect you in case of a later dispute. It is also a good idea to keep their employment record for a while. In addition, do not forget to collect keys or other items that belong to you.

Abuse, Neglect or Exploitation

A caregiver, paid or non-paid, should NEVER be allowed to inflict physical, verbal or mental harm, or exploit you or your assets. When this occurs, call the police. Do not wait to discuss this with your hired help. Termination of that individual can occur after you have filed a police report.

In closing…

Our home is where we are the most comfortable and where we can be our true selves. When prolonged illness or frailty occurs, it is possible to remain at home with quality in-home help. The key is to evaluate, organize and plan.

Acknowledgements

The following resources were utilized to develop this guide:

  • Duffield, Diane; MT Department of Justice, Identification Bureau
  • Family Caregiver Alliance Web Site; www.caregiver.org
  • Internal Revenue Service Web Site; www.irs.gov
  • Paraplegia News, Volume 49, No. 1; pp. 16-17.
  • Suisk, D. Helen, Hiring Home Caregivers, Impact Publishers, 1995.