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Retirement Weekly: Your ailing parent needs in-home care. Here’s how to hire an aide who’s a godsend, not a horror show.

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When hiring an employee, you want to take your time and pick the best candidate. But when you’re desperate, all bets are off.

In seeking in-home aides to provide hands-on care to your elderly parent, you can hit a wall. There’s a limited supply of workers and a surging demand for them.

In the rush to line up staffing, you might hire almost anyone who passes a background check and seems competent and reliable. That’s especially true if your parent is declining rapidly and needs 24/7 care. Amid a nationwide shortage of aides and many shifts to fill, you can’t always be choosy.

A home health aide provides an intimate service. It can include helping your loved one with eating, bathing and toileting. It’s risky to bring in the first person available who seems willing to do the work.

You might enlist the help of a home health agency to vet candidates and serve as a kind of job placement service. While homecare agencies have varying business models, they usually try to match families with in-home, nonmedical aides.

Regardless of how you find aides, whether through an agency, word-of-mouth or other avenues, don’t skimp on the interview process. When you’re under pressure to hire quickly, it’s tempting to forgo the kind of due diligence that prevents larger problems down the road.

At the very least, contact a candidate’s past or current employers. Checking references is critical, says Rani Snyder, a vice president at the John A. Hartford Foundation, a New York City-based private philanthropy.

“Find out if they show up on time and their clinical understanding,” she said. “A lot of home health aides don’t have technical training, but they have experience with taking blood pressure, body motion exercises and how to lift a person” properly.

Early in the interview, describe your parent’s health status and ask, “What skills of yours apply to our situation?” and “What training or experience have you had that relates to our situation?”

“When asking these questions, consider how your parent’s health may decline or worsen over time,” Snyder said. If an aide has helped someone with late-stage dementia, for instance, that might be a plus if your loved one currently has early cognitive impairment. It signals the aide’s awareness of disease progression and how it affects seniors.

Assuming you’ve found a strong candidate, explore their needs and objectives. While you don’t want to pry into their personal life, Snyder suggests asking, “How many hours do you want to work?” and “What are your expectations for this job?”

Establishing an alignment between the person’s goals and your needs can pave the way for a more productive working relationship. Of course, there’s a possibility that their situation can change—and the nature of the caregiving can change—and that can cause disruptions later.

Another smart question is to ask candidates to describe their previous employer and how that engagement ended.

“Find out if they left on good terms,” Snyder said. “Listen carefully. Are they negative when referring to their last employer? Or are they positive, or at least diplomatic, when describing their interactions with the employer?”

In an ideal world, you would sift through lots of qualified applicants and set up rounds of interviews to pick the best one. That’s not always possible, but it’s a good idea to proceed in stages.

Amy Goyer, a family and caregiving expert at AARP, recommends a three-step process:

1. A phone interview to assess their personality and learn how they react to the job.

2. An in-person meeting at a neutral site, such as a coffee shop, to share more details about the job while getting a better sense of how they present themselves. (Don’t bring your parent.)

3. A visit to your home so that you can observe the interaction between the candidate and your parent.

The phone interview can weed out applicants. When she sought a live-in aide for her parent, Goyer recalls a candidate who kept asking about the living situation (“What’s the bed like?” “Where can I park?”).

“She didn’t want to hear about the job,” Goyer said. “That was a red flag.”

During the home visit, note how the aide communicates to you and your parent. If they talk to you and ignore your loved one—or if they talk down to your parent as if addressing a toddler—that’s a bad sign.

“Also see if they’re interested in learning about [your parent’s] interests, their lifetime of experience and what makes them happy,” Goyer said. “And watch out if they talk too much about themselves. Self-centered people” can be annoying, boring or worse.

Like any hiring manager, invite the candidate to ask questions. The depth and perceptiveness of their questions provides another clue about their qualifications and devotion to the job.

Someone who asks about what worries you the most, what activities or hobbies your parent enjoys or how you will measure their effectiveness in the role is probably well suited to thrive. In reality, however, some aides may have a limited work history or lack the wherewithal to pose such questions.

You might end up going with your gut. If your intuition tells you to pass on a candidate, you may want to heed that message. A bad hire can leave you and your family even more frazzled and upset. 

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