MANAGING CARE HELPERS Being a family caregiver is not about doing it all yourself. It is about making sure your relative's needs are met. In this role, there may come a time when you and your relative decide to start using help beyond what family and friends can provide. This decision must be made with your relative when possible, based on informed choices among available home care options, good judgement and fitting a service to your family care situation. The next step, after hiring a paid caregiver or arranging for volunteer help, is to prepare yourself and your relative to share their home and supervise the daily care being provided.

WHAT TO EXPECT You should start with having realistic expectations of what the service can and cannot offer. Homemakers don't give baths and usually home health aides don't clean. You may have to train the care helpers to perform tasks the way you or your relative likes to have them done. Be aware that the same helper may not be available all the time depending on schedules, time-off and illness. Benefits to your relative may include companionship; different approaches to care leading to favorable results in health, functioning and behavior; and overall improved happiness and well-being. Benefits to you as the caregiver may include: respite/personal time; reduced stress; transportation for your relative to medical appointments and recreational activities; learning new caregiving skills; peace of mind; and a better relationship with your loved one.

GATHERING INFORMATION Begin by creating a Personal Profile of your relative. Write down information in the following areas:

• Names - the name your relative prefers to be called, names of family members, where they live and how they contribute to your relative’s care.
• Health - medical conditions, treatments, medications, allergies, status of vision/hearing/ speech and aids used, and the location of advance directives, if applicable.
• Eating/Drinking Preferences - dietary restrictions, if any.
• Daily Routines - waking, sleeping, meal/snack times, exercise times and type of activities, best time of day, most difficult time of day.
• Getting Around - right/left handed, assistive devices used (canes, walkers, wheelchair), assistance needed both inside and outside of home, transportation used to medical/professional appointments.
• Assistance/Supervision Needed with Daily Activities - eating, dressing, grooming, bathing, etc.
• Activities/Hobbies – description of activity as well as time of day performed.
• Emergency Contacts - names and telephone numbers of: family members and friends, treating physicians, pharmacy(s) used, health insurance information, emergency medical department preference and poison control.

Make a copy of this information for all helpers involved in your relative's care. Care helpers must know what to expect.

PROFILING HOME CARE HELPERS What you are looking for in a home care helper is trustworthiness, reliability, dependability, skills, good-natured care and patience. You and your relative will need to observe and evaluate the helper(s). Consider asking yourself the following questions:

• Is the care helper compassionate, professional, calm and proud of their work?
• Is the care helper trained in first aid and other appropriate care techniques?
• If your relative has a Prehospital Medical Care Directive (orange card and page), does the care helper understand the terms of the directive and is willing to abide by them?
• Is the person willing to abide by household rules? (Smoking restrictions, TV or telephone use)
• What will happen if the helper has an emergency, is sick and/or unable to arrive at their scheduled time? Are there prearranged times when the care helper will not be available? Have they planned for problems with transportation, childcare, etc?
• What arrangements need to be made about vacation and holiday coverage and wages? How far in advance should they inform you about taking time off? How much time off and how often?
• Is the helper willing to be flexible and do extra tasks if the need arises?
• Are there cultural sensitivities or language abilities that should be addressed?

BUSINESS ARRANGEMENTS Make a list and discuss with the care helper what you expect them to do, how often and how you want tasks/activities to be performed. Once you have agreed upon the specifics of the care to be provided, use this list to write a contract, so that both you and the care helper have a copy of what was agreed upon. Make sure you include what the helper should expect to happen if the terms of the contract are not met.

Many families choose to hire a care helper privately rather than through an agency. Be aware that as an employer you are required to complete certain payroll and tax documents including tax withholdings, FICA and other related taxes such as unemployment compensation. The care helper will also need to complete an I-9 form for immigration purposes. For a fee, independent accountants or local accounting firms will assist you and make sure you have completed all the required documents to protect you as the employer and the care helper as the employee.