OTHER ISSUES OF CONCERN

The care recipient may be in need of home health or companion services. That leads to the question of whether to hire someone privately or go through an agency to secure the services. Purchasing services through an agency saves paperwork, supervision, and time. But the cost may be significantly lower if you hire directly.

If you feel that your relative's needs will be best met by foregoing an agency, you will need to determine specifically what help is required and develop a job description. The job description can be turned into a contract that clarifies the duties and responsibilities of both the employer and the worker. This formalized agreement is essential if there is a dispute about hours of work, salary, or tasks to be performed. The contract and job description can be updated or revised as the need arises, and should be as specific as possible, to lessen the chances of confusion or disagreement. In addition to a description of the duties to be per-formed and the salary, you may want to include in the contract the terms of payment, fringe benefits (i.e., transportation fees, or meals provided), unacceptable behavior, and termination procedures.

The best way to hire a responsible person to provide in-home services to your loved one is through a recommendation from a friend, neighbor, or other person whom you trust. In Florida, the local Elder Helplines maintain a sitters list" that identifies nursing assistants and homemakers who have gone through Department of Law Enforcement and abuse registry background checks. The care recipient's church or synagogue or a community organization that currently provides services also may be important resources.

If none of these methods work, then you may want to try advertising in the "Help Wanted" classified section of the community newspaper or in newsletters distributed by churches or social service organizations. The ad should include the number of hours needed, a very brief description of duties, a telephone number, and a time to call. Preferences such as non-smoker and the wage you are offering also should be mentioned.

You will not need to do a personal interview with everyone who responds to your ad. When respondents call, you should describe the job in greater detail as well as the expectations and wage range you are offering. It is important to know why they are interested in the job, and if they have previous experience.

If you identify individuals that appear to be qualified, schedule a specific time for a personal interview. Prior to the interview, you and, if possible, the care recipient should prepare a list of questions including:



· How do you feel about caring for an elderly or disabled person?

· Why have you chosen this kind of work?

· Do you have any physical or emotional problems, which might affect your ability to work?

· How do you feel about cooking and eating what someone else wants?

· How would you handle a person who is angry?

· What makes you uncomfortable or angry?

· Do you have any religious convictions that might interfere with providing services?

· What is your attitude towards smoking, drinking, and/or using drugs?

· What commitment are you willing to make to staying on this job? Would you consider an initial "trial" period?

· Can you provide two work-related and one personal reference?



During the interview, have the job description and contract ready for the applicant to review and ask if there is anything in the job description that he or she would not do. Make note of whether the person arrived on time for the interview, whether his or her appearance and grooming was acceptable and his or her and your own comfort level.

If the applicant is clearly unsuited for the position,. you can be noncommittal about future contact. Before ending the interview, remind any suitable applicant that you will be checking references before making any decision. Never hire someone without first checking references!

Among other things, you should ask previous employers about the duration and context of employment, the job applicant's reliability and trustworthiness and the quality of the relationship between the care recipient and the applicant. Most important, ask why employment was terminated and whether the employer would hire the applicant again if help of that nature were required. Always conduct an abuse registry and criminal background check. Additional information is available in Chapter 14.

A signed copy of the contract should be given to the person who accepts the job prior to their starting. If you pay $50 or more per quarter of the year to employee-and chances are that you will-you must withhold for Social Security benefits and make quarterly payments to the Internal Revenue Service. If you fail to do so, you may face prosecution by the federal government. Only if the person you hire meets the strict government definition of "self-employed" may you forego withholding.

Because weekly or bi-weekly paychecks may vary from one pay period to the next depending on hours worked, bookkeeping may become troublesome. It is essential that accurate records be maintained.

You should check with the care recipient's homeowners' insurance agent about the extent of his or her liability coverage as it applies to an employee. For tax purposes, you should determine whether payments made to the employee will qualify as a medical deduction. Because of possible legal and financial problems associated with paying in cash instead of by check, you should be prepared to use receipt forms or other proof of payment to the worker.

Once strangers begin coming into your relative's home to provide care, you may want to remove anything of significant financial or sentimental value and store it in a safe place. It is very important to develop an inventory of belongings, especially if your loved one has impaired communication skills and is unable to advocate on his or her own behalf. It also is wise to make a list of all credit cards the care recipient may have, including the account numbers. This will enable you to cancel them in the event that they are lost or stolen or in the event that bills begin to appear that list charges you know your relative did not incur.

Bringing your loved one into your home

You may be in a situation where you must, for the sake of your own sanity, bring your family member to your home to live or to a residential facility in your community. You may do so because you are confident in your own ability to provide care, you are more familiar with services available in your own community, or because you wouldn't have peace of mind with your existing long-distance caregiving relationship.

Before making a move-and assuming that your loved one concurs with the decision or is unable to make the decision for himself-you should seek support and assistance from other family members, friends, your religious community, local support groups, and/or professional counselors. If you make the decision to become full-time caregiver, don't isolate yourself from the outside world. Help is available, although it will not always be easy to find. Above all else, remember to take care of the care giver