Why hire a personal care aide?

When I meet with spousal caregivers for therapy, they often describe being afraid of leaving their partner alone. I understand what scares them. When your spouse acquires a disability because of stroke, TBI, or other medical event, they often see themselves as more capable than they truly are. This can lead to power struggles and relationship challenges. In the worst cases, your partner may risk re-injury if they are intent on doing things for themselves. It’s challenging for your relationship and your emotional well-being to try to be your spouse’s partner and their primary caregiver. Many of my clients find hiring a personal care aide is the solution their family needed. When you hire the right personal care aide, everything seems to click into place.

What a personal care aide does can vary widely depending on the client’s specific needs. It also matters how the care is being funded. If a funding source like Medicaid is paying for the service, there may be some restrictions regarding what qualifies as personal care. But if a client is paying completely out of pocket for personal care services, what the job will entail is just between them and their aide.

What can go wrong if you don’t hire the right personal care aide?

Unfortunately, the real challenge seems to be finding that ideal care assistant. Many people with acquired disabilities have horror stories to share of aides who:

• didn’t ‘do’ anything except scroll on their phone
• were disrespectful
• didn’t come when scheduled
• were abusive in some way

Take heart.

I’ve worked with many families over the years who’ve used these strategies to hire the right personal care aide.

How writing the right ad will help you hire the right personal care aide

I have seen firsthand that where and how you look to hire someone who you will trust so deeply really matters. Finding the best care assistant requires that you be very specific in asking for the exact help you need and want.

Not doing so usually results in them hiring someone who ultimately throws up their hands and exclaims “this is NOT what I signed up for!” and walks out.

Your best bet to avoid a revolving door of aides is to be overly detailed in asking for exactly what you want and need.

Consider these two ads:

The first ad is an example of what most people use when looking for a personal care aide. Consider how it is different from the second ad. The second ad is great because it:

• Identifies internal, personal factors that will make the aide the right fit (such as being reliable and punctual), rather than ‘selling’ the job to help someone supplement their healthcare major.
• Is specific about what physical tasks the aide must be able to complete, such as lifting or showering. Someone who would be uncomfortable showering someone else or physically unable to assist with lifting isn’t the right person for the job. The first ad does not caution these applicants that they ‘need not apply’, because it doesn’t clue them in that the job requires these tasks.
• Details times and pay. Someone who has an 8am class wouldn’t be able to do this job. Neither would someone who wants to make $20/hour at their part time job. By giving details in the ad, the Professor ensured that he only heard from applicants who were a good fit for what needed.

Should my spouse participating in writing an ad for a Personal Care Aide?

I encourage caregiving partners to allow their loved one to have a voice in writing the ad. You may fear that your loved one will want to gloss over their needs. You worry that they won’t be realistic in describing what they need help with.

By inviting them to collaborate though, you are showing them that you value their input. You’re communicating that you want to hire the right personal care aide for them, not just someone who meets your criteria.

I once worked with a college student with physical disabilities and TBI because of a car accident. He posted an ad like the second one, and had three people reply. He wound up hiring two of them who split the position between themselves. This was a fantastic decision on his part, because it gave him the added benefit of having a back-up aide if one of them was sick or needed a day off.

It was wise to hire two aides for another reason as well. As my client put it, writing the ad made him realize that being his personal care aide was a physically demanding job. He wanted to split the work between two people as a safeguard against one person ‘burning out’ and leaving him without any assistance.

Talk about insight!

Now that you’ve written a detailed ad, what do you do with it?

Where you place your ad can matter as much as what you write. Here are some options for where to place the ad for your personal care aide, as well as other sources you might check to find and hire the right personal care aide.

Contact local disability support agencies
Even if you’re not looking for ongoing, formal supports through them, most good, service-oriented agencies will be able to put you in touch with some of their better Direct Support Professionals who may be looking to pick up a side job.

Ask at a local hospital
Like contacting disability agencies, even though you’re not directly asking for their services, many hospitals can put you in touch with nurses, CNA’s, volunteers, or students who may be looking to take on some side work.

This is especially helpful if you have physical needs including catheterization, wound care, etc.

Ask for recommendations from others
Whether you personally know others who’ve hired a personal care aide, or if you’re asking in an online forum such as a Facebook group, it can be helpful to ask others if they can recommend specific aides they’ve had good relationships with in the past.

Try an online ad, and don’t just limit yourself to Craigslist
Idealist.org is a job posting website that specializes in posting non-profit jobs, and could be another great resource for finding someone who is already familiar with the role of Personal Care Aide.

Care.com has a whole division dedicated to Special Needs care.

Religious, cultural, or other values based organization
If your faith or other values are extremely important to you, you may want to consider that it might be important for you to share these values with your aide.

Especially if the person will be assisting with very intimate personal care, it may be comforting for your partner to know that their aide is also Native American, or Catholic, or vegan. Sharing similar values and cultural experiences can be a really strong foundation for developing the trust that they’ll have with the aide that’s the right fit.

Now all that’s left is to meet and interview everyone who replies to your super-detailed, perfectly placed ad

My recommendation here is pretty simple. I suggest that you take a ‘see one, do one’ approach to interviews.

In your first meeting with the person, work with your partner to write down or otherwise describe exactly how you want the aide to assist. Give these instructions in the same way that you’d like to give them instructions in the future; this is a ‘test run’ for how well this potential aide responds to you and your partner’s ‘management styles’.

If possible, have the applicant watch someone else (probably you) perform the tasks you’ll be asking them to do.

This is also the time to request references, so that you can call them to discuss the applicant’s work history and work ethic before inviting them back for the second part of the interview.

The second part of the interview is a ‘trial run’; ask them to show up on time and assist your partner using the instructions/observed techniques from the first meeting as if they’ve already got the job. This will give you a good sense of how well you and your partner will work with this person.

Be sure to pay attention to:

• Did the person balk at being asked to come for two interviews?
• Is the person on time?
• Are they cheerful and easy to talk to?
• Do they do the tasks you’ve asked them to do, and do they seem comfortable doing them?
• Are they asking questions if they’re not sure what to do?
• Does anything about them make it unpleasant for them to work with you (for example, maybe they smoke and the lasting cigarette smell is offensive to you)?
• In general, how does this person make your partner feel? Even if they don’t mean to, does the aide belittle your partner, and make them feel incapable or pitied? Or do they feel like a natural extension of your partner, doing exactly what’s needed to help your partner accomplish the things that are important to them?

Usually, by writing an ad that attracts the ideal applicants for your needs, and by using this ‘see one, do one’ interview process, the right aide for you will prove themselves to be just that.

Do you have other strategies to suggest to help others hire the right personal care aide? If so, please leave a comment and offer your tips!

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