The Trust Factor: What to Look for (and Do) When Hiring a Caregiver

As you may be watching a steady physical decline in your elderly loved one, and you know you’ve got to get the right care, the question always seems to come down to, Where do I begin and whom can I trust?  While the Nathaniel Witherell offers superb long-term skilled nursing care and memory care, your loved one may not be ready for us quite yet.

As you embark on your journey, chances are you will wonder if you should hire an agency or do the search yourself? There are pros and cons for both.

It generally costs less to hire someone yourself, but realize that you’ll have certain employer responsibilities such as payroll taxes (You’ll need to get an EIN – an Employer Identification Number – from the IRS, and register with your state revenue department), Workers Compensation insurance, granting paid vacation or personal time off, and do other administrative paperwork. You’ll also want to do a background check, make sure the potential caregiver is licensed to drive, if the job requires it, and you’ll want to carefully scrutinize their work history. It’s best to ask for 3-4 references, then be sure to have conversations with those people.

Working with an agency is generally more expensive than hiring a caregiver yourself. However, there are certain benefits that come with agencies. You can usually obtain backup care if the person you hire is unable to get to work; agencies typically pre-screen caregivers; and they handle payroll and taxes. Some even do training. That said, check an agency’s track record carefully. For example, before signing on, ask what services they provide? How long have they been in business? Are ranked by the Better Business Bureau or other consumer groups? (Licensed agencies generally are subject to federal consumer regulations.) Can they give you 4-5 references?

No matter which course you choose – whether doing an independent search or hiring an agency – the trust factor will still play a critical role. Will the caregiver you’ve found or who’s been referred to you be reliable, professional, experienced, and easy to communicate with? Will the caregiver be both responsible and responsive to your loved one’s physical and emotional needs? Can I trust the caregiver?


These are important questions. We have some suggestions for you as you do your research:

  1. First, realize you are not alone. According to the Wall Street Journal, about 31% of the nation’s 53 million family caregivers have paid help. . As a first step, reach out to local agencies to see if you can get financial support through Medicare/Medicaid or other sources and what programs are available in your community to provide the kinds of services you need.
  2. Check to see if there are county, state, or local agencies on the aging that can provide guidelines or refer you to local organizations that provide support and low-cost services such as meal delivery, transportation to medical appointments, housekeeping, or companionship.
  3. Ask for recommendations and advice from friends and family who have been through the process.
  4.  Write up a job description, and when you ask for someone’s resume (experience, training, certifications), ask them to also include something about their hobbies and what they like about caring for the elderly. You’ll begin to get a fuller picture that way.

  1. Consider hiring a family member. Besides providing valuable assistance, they can offer emotional support and help with grocery shopping, food prep, and household chores; coordinate medication, and monitor your loved one’s health. If you follow this path, you may want to consider drafting a written “family care agreement” to protect you both. It’s also a good idea to write down your loved one’s limitations, likes and dislikes, and needs as a guide. Note: there are Medicaid, Medicare, and VA funded programs for family caregivers (check with the CDC for eligibility requirements and details.)


  1. Once you hire the caregiver, begin slowly, if possible, and focus on companionship to see if it’s a good fit. After a short while, you’ll be able to see how your loved one reacts to the caregiver and how they interact with each other.





“The main thing to remember is that the level of care your loved one needs will help determine who should provide the care, and whether or not your best bet is to consider a care center like the Witherell,” advises John Mastronardi, Executive Director, The Nathaniel Witherell. “It’s important to do your homework. That will increase the level of trust your have and your peace of mind.”


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