One of your fist steps into the world of the Sandwich Generation may be having to hire in-home assistance or care for your aging parent or relative when activities of daily living become a struggle.

In addition to navigating the world of payors, you may find yourself having to hire someone to come into your parent’s home in order to provide care whether it be long term or temporary.

Often, home care falls into three categories: Nursing/nursing assistants, home care aides, and, “personal attendants,” sometime referred to as custodial or companion care.

It can get complicated, but, whether or not insurance pays for this help mainly depends upon the patient having a “skilled care need,” i.e. something that only a licensed person (nurse or certified nursing assistant) can perform, or, their needs fall into “activities of daily living” such as eating or bathing that a certified home health aide can perform.

Companion care, tips for hiring in-home care:

1. Have a job description – a list of specific duties that are expected in the position lets the candidate make an informed decision and cuts down on misunderstandings later in the process. Be sure to include a schedule and hours needed.

2. Prepare a list of interview questions – If you are hiring independently, or if the agency lets you interview the prospective caregiver before committing, then you must be prepared with interview questions. Consider screening applicants over the phone and take notes.

Ask such questions as: Where have you worked before? What were your duties? Why did you choose this type of work? What attracted you to this job?

Ask for two work references and a personal reference. Always check them and find out information such as dates of employment, quality of work performed, reasons for leaving, attitude, absences, lateness, honesty and drug or alcohol use. Are they eligible for rehire?

Be sure to notice the reference’s attitude. Are they enthusiastic? Guarded?

3. Consider legal and financial issues – If you are hiring independently, then you must research legal issues such as withholding taxes and insurance coverage. If you’re using an agency, be sure to find out if insurance covers any of the services and the method of payment to the agency.

4. Prepare a written agreement – When you are ready to hire, draw up and sign an agreement with the chosen candidate.

To find independent workers, ask local senior centers, churches or senior organizations for referrals. Also check the classified ads in a newspaper.

You can locate home care companies in the phone book, get referrals from your doctor, hospital or social worker or consult online resources to find workers through an agency.