I began my search for a caregiver for Robert in earnest after the harrowing day described in my story I Need Help Now! Looking at myself from the perspective of an outside observer, the way I was living – trying to juggle work, household upkeep, and caregiving for Robert – suddenly seemed ridiculous, precarious even. Why would anyone put themselves through all that if they had a choice?
What about a companion?
My initial thought was that Robert would really benefit from a companion hired for a few hours a day. If I could find some help with getting Robert dressed and out the door in the morning and have him occupied and engaged through the early afternoon, he could return home tired and ready for a nap. That would take us into the evening.
I didn’t know how to find a part-time caregiver. After a few missteps where I ended up on ad-fueled referral sites, I landed at the Redwood Caregiver Resource Center. RCRC is a local, nonprofit resource center in my area that was really useful in helping me better assess my needs.
What do you need…really?
To start your search, you must first clearly articulate the type of caregiving you need. Are you looking strictly for respite care for you? (Or in my case, “respite-so-I-can-work care.”) A respite caregiver is more like a companion for your loved one. They may do light housekeeping too, if that’s what you need.
Home health care aides are a step up on the continuum of care. Home health aides can provide the companionship your loved one needs, and they can help with like bathing and dressing if that’s appropriate in your situation.
If you need more extensive medical supervision from an aide, you may have to hire a medical caregiver. Medical caregivers might be certified medical assistants or certified nursing assistants. But if you need an aide to assist with medication administration, you may need to hire an RN.
After considering various options, my initial decision was confirmed. I needed a respite caregiver for myself, someone to be Robert’s companion for a few hours every workday. Next, how to find one.
For-profit (and some nonprofit) caregiving referral sites are websites that earn income when you click through to one of their advertising partners. Those partners are usually staffing agencies that can help you find a caregiver.
Benefits of using an agency
There are benefits to going through an agency. You know that caregivers have been vetted, that they have passed any certification requirements of the agency (or your area), and that they’ve completed a background check. In most cases, the staffing agencies may (depending on their size), send a substitute caregiver when your preferred aide is not available because they are on vacation or ill.
An agency will also handle all insurance, payroll, and taxes for your caregiver. I was willing to handle payroll and taxes on my own. As long as your caregiver works for other people over the course of the year (meaning they are not solely employed by you), they can be hired as a contractor, paid via personal check, and issued a 1099 at the end of the year.*
Scare tactics
I found that most agencies will try to scare you into thinking you can’t hire a caregiver on your own without going through either a referral or staffing agency. Agents will suggest that you will “never know who you are getting” unless you go through their agency. I disagree. The vast majority of people are honest and can be adequately screened with diligent reference checks. In fact, that’s how agencies screen potential hires!
Agencies essentially act as a wholesaler when you hire a caregiver. I dislike paying a middleman. I’d rather have all of my hourly payouts go to the person providing the care than to the agency.
The live-in care option
We have an on our property. My first idea was to rent our ADU to a caregiver. I reasoned that this would reduce my monthly out of pocket and allow me to expand the hours of caregiving when Robert needed more attention. My monthly payment to the caregiver would be reduced in exchange for housing in the ADU.
I was even referred to Sue, a nurse who was looking for this type of arrangement exactly. The idea seemed to take hold and we had some preliminary discussion that I thought went well. Then I mentioned that we had two dogs on the property. This was a non-starter for Sue.
Having the plan with Sue collapse, put me off renting the ADU to a caregiver. I got nervous about what would happen if the caregiver didn’t work out. How easy would it be to let them go when their home was tied up in their employment? (I’ve come to believe this is still a good option after arrangements have been established with a particular caregiver over some number of months or years, but I wouldn’t suggest this agreement out of the gate.)
Let the people speak
Feeling increasingly desperate, I started talking about my plans with my friends and neighbors….anyone who would listen. Surely someone would have an idea. And Mary-Jane did.
Mary-Jane is a friend up the street whose daughter went to school with Jackson. We have a lot in common and frequently stop on the sidewalk to catch each other up on our lives and travails. Mary-Jane mentioned that our neighbor, Violet, had contracted with a part-time caregiver.
Though I’d see Violet out walking with her grandson and dogs, I didn’t know her by name at that time. She is a diminutive person, maybe 5’2” tall, a few years older than me. Her grandson, Noah, is about the same age as mine. Her elderly dogs include a very protective white chihuahua and a 14-year-old deaf and blind toy poodle. Their walks are slow going, but that seems to suit the four of them just fine. Noah is often busy collecting sticks or seed pods to drop into his faded, toddler-sized shopping cart for the ramble home.
A silver lining
I learned that Violet’s 95-year-old mother lived with her and that Violet had hired a Fijian woman to care for her for several hours each day. The caregiver provided respite for Violet and company for her mother while Violet ran errands and cared for Noah.
Violet’s mother passed away a few months after I learned about her care arrangement. Violet was very forthcoming about her experience with her mother’s caregiver, Angeline. It was overwhelmingly positive. I asked for a referral. I was skeptical about hiring a woman in her 50s to care for my 180 lb husband, but phoned Angeline anyway to begin the discussion.
It turns out that Angeline was also hesitant to take on a 180 lb man! She referred me to Jace, another caregiver in the Fijian community. (I came to learn that across the country, some immigrant groups develop tight networks of caregiving professionals. In our area, the predominant at-home caregiving group is from Fiji. Some individuals are new to the area, some have been providing care services for years.)
A perfect match
Jace had just completed a seven-year stint with a family whose patriarch had battled dementia for years and had just recently passed away. Jace is a large, fit, strong man. A perfect match for Robert! After an initial meeting with Jace and two careful reference checks, I decided to hire Jace for $30/hour for a few hours each week. The total expense came to $2,400/month.
We live in an expensive part of the country. $30/hour seems like a lot of money, but a full-time job at $30/hour is just 60% of the area’s medium income; low enough to qualify for affordable (below market rate) housing. $30/hour is about what starting teachers in our area earn. (I have met more than one teacher who has retired early to care for their spouse with dementia! Hiring a caregiver on a teacher’s salary is not an option. We have a shortage of teachers. This is another example of the incredible cost to society for dementia care.)
It is possible to find a caregiver on your own. Be clear about what your needs are and how much responsibility you are willing to assume (think taxes). Reach out to area resource centers and your network to begin the search. I firmly believe that word-of-mouth rules.
Jace was a wonderful companion for Robert. I’ll tell you all about their relationship in my next story.
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*Consult your own tax advisor before you jump into a direct pay situation. Don’t take my word for it. I’m not a professional or legal resource.
Thank you for sharing 🩷 my mother and father are in Napa. My mother has FTD/PPA. My father is the sole caregiver. We are headed down the same path, starting to look for help and Really appreciate the information you have shared. Thank you!
Thank you, Kelly. My heart goes out to you. Please don’t hesitate to reach out if you have any other questions.