Recommended process to select caregivers?

I agree with in general going with agencies, but I think that agencies will have a tough time hiring people on the books till the federal unemployment of 600 is over.  People are making more money on unemployment than they can working.   If you can wait till August, I think the agencies will have more people.  If you need someone before then, you may have to hire someone off the books, agree with checking with church.

We have a camera system in the house.  It cost about 100 for 4 cameras that can be monitored on any smart phone.  IMHO, just letting someone know they are being watched can help.   Ours you can also listen in on.  We have two bathrooms, one has no camera and is for aid.

Try to figure out what you need/what you don't.  We don't require aid drive or have car.

I need to respond. I just don't know where to start.

Very concerned about selecting a trustworthy caregiver to spend a few hours a day with my mother...

That brief sentence contains so many pre-existing beliefs.

Very concerned. Trustworthy.

It is extremely difficult for anyone to show him or herself worthy of trust that does not exist in the first place. The reason you are very concerned about it is that, for perfectly understandable reasons, you don't trust these people as far as you can throw them. You want someone in the house to support your mother and ensure her safety, perhaps to offer some companionship and be an extra pair of hands/eyes/ears for her, but you don't actually want to invite them over the threshold.

To spend a few hours a day... Simple, right? Unskilled, undemanding work, right? For heaven's sake, all they have to do is show up, keep their eyes open and not rob her - how hard can it be?

Well. For ten months now I have been doing this unskilled, minimum wage job. Here is a selection of the requirements included in my round yesterday:

full clean driving licence + own car
navigation
time management
online communication
verbal communication
recording fluid and nutritional intake
documenting ADLs
documenting client's mood, appearance, physical-mental-emotional wellbeing
establishing immediate rapport with clients whose health issues included macular degeneration, paraplegia, self-neglect, dementia and skin infections, epilepsy, bi-polar disorder, diabetes
fixing the tv
finding teeth (never throw away an empty potato chips packet without looking, is my top tip for the day)
talking to stressed family members
not talking to friendly but unauthorised neighbours
managing intimate personal care for a lady who has an overactive bladder but NO flannels, clean towels, skin wipes, cleansing cream or foam, or pull-ups. Oh, and she can't lie flat because her back hurts. She's very proud that her children have told her they will never put her in a home - what a shame they haven't got round to buying her anything she needs, just air fresheners in every room.
catheter care
medications management
dog management (two dogs, actually, adorable but disastrous for PPE)
at all times and in all places, correct use of PPE and infection control measures
client advocacy (arguing with my senior about a client's call time, which is currently useless to her)
short order cookery
*highlight of the day* - showing a gentleman how he could put on his own underpants by pulling them on over the injured leg first, then over the good leg. He did it! Reablement rocks!
I memorised four new keysafe codes.
I used four microwave ovens, models that I have never encountered before, all subtly different.
I found clean underpants, clean crockery and glassware, food items, equipment and medications in houses that I had never visited before, without worrying my clients that I was rifling through their cupboards and drawers to steal from them (add tact to the list).
I discussed hip prostheses, sweet pea varieties, vascular surgery, medical imaging, Isaac Asimov, the importance of falls alarms (unsuccessfully), pool (as in pool table), weight loss (intentional and other), dogs, military camaraderie, and how to explain to kind friends that undercooked vegetables hurt your teeth without hurting their feelings.

This was not an especially demanding or busy round. Only six calls, and I checked in as "safe home" with my shift leader at one minute past ten last night.

There were approximately thirty of us all doing this job in one small county yesterday.

We are that unskilled, untrusted labour.

So. What I'd recommend is that you sit down and really think, and list, what you're expecting this person to do during those few hours; and what the job demands of him/her. Start there.

My advice? Pay the extra money if you can and hire someone from an agency, and don’t be shy about watching them like a hawk, installing nanny cams, and requesting another person the MINUTE someone screws up. If the contract says they’re supposed to do light housekeeping & they won’t, get rid of them. Playing on their phone all day? Can them. Constantly leaving your loved one alone in dangerous situations like the shower? Bye bye.

Don’t hire a person that’s not with an agency, even though they tend to be cheaper. I Just got rid of my husband’s private pay care aide (she only wanted cash, $20+/hour, got mad when I told her about the state’s requirement that she be considered a household employee as far as the IRS is concerned). She didn’t want to clean, was mad in the end that I wasn’t “rich like her other clients who let her eat whatever she wanted out of their fridge” (she had never mentioned this being a problem, just wanted something else to be mad about). Didn’t notice until after she left that my husband’s wedding band was missing. Checked security cameras & it had been missing for several days. His fingers are too thick for it to have “fallen off”, and he hadn’t left the house in months!

Imho, I interviewed one friend of my mother's (really more of an acquaintance) to provide care for my mother. The woman was a person who had provided long term home health care for one of my mother's friends. My mother knew 2 such women, once of whom worked pro bono for us until I could drive 10 hours to move in and provide care for my mother. In the end, the caregiver was myself and I do NOT recommend it. I was already approaching elder status myself when I had to perform this task, making it even harder.

Work with and through a highly reputable agency. Interview the caretakers and go by your gut instinct. You get references and do a background check on your own. If you hire someone, discuss and put in writing (sign it by all) as to what she is expected to do. Try to have a backup in case the first one does not work out. Don't rush - take your time. You will know the right one.

Only hire from a reputable Home Health Agency, get online and check out reviews on the agency. Visiting Angels might be a good place to start. Nanny camera would give you peace of mind. Show up when hired help does not expect you. My mothers doctor recommended the agency we use and it is wonderful, like the staff very much, responsible and caring. We had another agency in the past and it was not a good one , that is when I decided to get another. My mother only has a visit once a week from an RN. There is some really good home health aides, try one and not the right fit for your mother, request another aide.

Hiring on your own in addition to the legal issues mentioned above can be a major challenge, but it can be done and in the end may be more rewarding...but there may not be back up in the event of illness. EVEN agencies or those that LOOK like an agency can be problematic. Just to forewarn you: I consider myself pretty savvy being in the field for many years and yet I assumed every agency would do background checks on their employees. That was my first lesson learned the hard way: In our state anyhow, ONLY agencies being reimbursed by Medicare/Medicaid are REQUIRED to do a background check. And even when they do, they may still hire someone you would prefer not. I was conned by a bright, energetic, slick agency owner who only did a background check when I asked. She flashed the training certificate at me on an iphone screen. The background check she revealed had a court appearance for apartment damage. She claimed the aide took the rap for her sister that was responsible....that was along with an inept search of my own that found a multitude of driving violations (yes, I'm sure it was the same person based on uncommon name and date of birth). Other agencies pulled other things: no show/no call just for an initial interview with the intake person and then having the nerve to yell at ME for being angry about my sacrifice of work time and energy; another couldn't understand the breach of confidentiality by having the aide get a ride to our home which then revealed to a 3rd uninvolved party where our home was located and knowledge of a frail elder inside...The one I would have gone with demanded a 6 hour minimum per week, which was more than we could afford or need. The one we finally tried was ineffective with the personal care we hoped for which I understood...but balked when asked to do light housekeeping which was part of the plan, and for which we were paying. When she did exert herself and was oh so proud of her efforts she managed to scratch the front of our fridge using an abrasive paper towel with glass cleaner on a plastic film, do a half job adding fingerprints to a glass tabletop, and put the crumb tray she had managed to empty from the toaster oven back. Upside down. Also beware the slick advertising of a national company that allows people to list themselves and you pay for "premium" access to connect with those you think "look good" to you. The good ones are more than likely taken/not available. At least that was our experience. I would additionally be very concerned right now hiring anyone...because if the person chosen also has another job or life for that matter, they would be bringing in all the people they had contact with who might have been exposed to COVID, particularly if their other job is in nursing home setting. The pay is substandard and often I think these agency jobs are a way to make some extra $$ without much effort. I have concluded that I should think of them as nothing more than expensive and hopefully reliable sitters and decided I really need a housecleaner. Wishing you luck...

Only consider using a home care agency. Get referrals if you can from friends or neighbors who have used agencies. I am not with a home care company, but you need to make sure the person is bonded and paying them cash is going to cause a big problem if you mom needs to go on to Medicaid.

You need to start somewhere. I have used private sitters from church that were well known from friends and also Concierage Home Care. After an initial assessment with the agency and a sitter is selected do drop ins to observe and make sure the fit is good.

The first best, easiest way to find a caregiver is to go through an agency.
They are background checked. Taxes are taken out so you do not have to deal with extra paperwork. A "supervisor or manager" should interview you and assess your mom as to her needs. This is done to select the right person for the level of care needed.
If the caregiver will be expected to help toilet mom that level of care may be higher (aka more expensive) than "just" a companion sitter. A companion sitter would do no "hands on" care. Typically they would be there for a shorter duration, no more than 3 to 4 hours.

(by the way if mom is a Veteran the VA does have programs that can provide limited help with getting caregivers as well as other programs that provide much more help)

The other route is to hire privately but that gets into a lot of paperwork. Taxes, workman's comp, background checks, checking references. Personally the ease of going through an agency is much better. Not to mention with an agency if your caregiver is ill they will send another, if you hire on your own unless you hire 2 people if your caregiver is ill you have no one that day.

It's very difficult to find a caregiver who is trustworthy, capable, caring and also is someone your mother likes. Some good suggestions from the other respondents, but remember that whoever you get, whether from an agency or you hire them directly, will need oversight. You don't want to micromanage, but you can't let people be completely on their own. You should also think about locking up her valuable jewelry and cash, and personal papers, checkbooks, etc. It's best not to leave personal papers such as bank statements lying around where others can see them. Definitely check references.

Working through an agency is the best first option in my view. My wife, 10 years into Alzheimer's, and I are very happy with Home Instead--the significance of the name is "home instead of a care home." It's a national organization, begun and strongest in the USA, with local franchises. Check and see if there is one near you. Also, ask other local people if they know of agencies that they like, as well as specific caregivers within those agencies.

Prayers and hope for a challenging, but purpose-full future.

i have been at this on and off for years...go through an agency...if you don’t like the caregiver they have sent then the agency will find you another one. It worth every extra dollar for all of the reasons already listed.
-the only other suggestion is going through your church. There may be a mom whose children are now in school that might want a few hours of responsibility plus the extra $$ but obviously this is dependent on if your LO needs a companion or some medical experience. This is how we found my moms very first “helper.”

I'm with Midkid. Although you will find many on this forum who have successfully found wonderful private CGs, it has (in my opinion and experience) a very risky downside.

Private Hire Pros:
- less expense
- more control

Private Hire Cons:
- may make you an employer (depending on your LO's state laws). This means paying taxes and acting like an employer (contract, etc).
- you do the background check
- you need to come up with a sub for when CG is sick or goes on vacation or quits abruptly
- no recourse for a bad experience (abuse, theft, etc)

Agency Hire Pros:
- agency does all the legwork re: background checks, affirms actual abilities of the CG, handles payroll, taxes, etc.
- provides all levels of certified help (companion to RN)
- provides subs
- has final legal responsibility in the event there's a bad hire or incident

Agency Hire Cons:
- more expensive
- minimum hours required
- not guaranteed to get assigned a perfect fit

My family's personal experience with a private hire was that a seemingly very lovely CG that they found on a job board at Publix wound up swindling their LO (a stroke victim) out of everything and then disappearing. To be fair, the family member who hired her only checked 1 reference and did not do a background check. She was a total predator as it was obvious she knew exactly what she was doing and how to do it based on how fast it all happened. She did NOT "seem like the type".

My ongoing experience in south FL is with Visiting Angels (6 yrs so far) and they've been awesome. I wish you much luck with whatever path you take!

If you do not know someone you feel you could hire privately, there are several agencies out there who have CG they match up with clients.

Honestly, it's a crapshoot as far as making sure your LO has an appropriate CG match. Sometimes you have to go through several before a comfortable medium is found.

CG is VERY poorly paid work. It can be exhausting and emotionally brutal on the CG, yet they still make about minimum wage.

When you sign up with an agency, they do the initial intake info and try to match a good CG with your LO. Be patient, and for the love of heaven, don't meddle as they grow used to your mom and your mom to them.

You should be concerned, but try to keep an open mind through this. No one is going to put your mother first, that's your job, esp if your CG has multiple clients.

Most agencies will charge you for 4 hrs minimum, whether the CG stays that long or not. So bear in mind, if you only want someone for 2 hrs, you may wind up paying for 2.

Probably start by asking around to see if anyone you know has a CG they use, then go to the actual agencies and apply.

Good Luck!