In running a home health care agency specializing in live-in care for the elderly, we have found that finding qualified caregivers is the most critical factor in an agency's success. A criminal background check, face-to-face interview, a high score on a pre-assignment competency test, TB screening, relevant experience, and two references still may not guarantee that the caregiver is uniquely qualified to assist elderly clients with the activities of daily living. Although caregivers may meet every criteria required by the state, there are certain intangibles that make a caregiver excellent, rather than merely good.
Flexibility: Is the caregiver willing to do live-in care for the client? Is the caregiver willing to travel to care for a client? Is the caregiver able to go to a client on short notice? If a caregiver is flexible, it makes it far easier for the agency to place them.
Continuing Education: In addition to experience, has the caregiver taken courses relevant to caring for the elderly in addition to home health aide (hha) certification? This kind of evidence of commitment to the field of eldercare is a great predictor of the caregiver's success with clients.
Referral by another caregiver: Was the caregiver referred by another caregiver who already works for the agency? Typically, this would be an ideal reference. However, we have found that just because a caregiver is excellent, that doesn't mean that their sister/cousin/friend is just as good. Each caregiver needs to be evaluated on their own merit.
Quality of References: We require two references for caregivers. The ideal reference is one from a former client (or former client's family member), or a direct line supervisor. We have found that personal references from friends (who are not related to the caregiver) are a less than reliable barometer for predicting a caregiver's performance.
Timeliness: Was the caregiver on time for the initial interview? If they came in late for the interview, did they call the agency to inform them? First impressions really matter.
Preparedness: Did the caregiver bring in all the required documents to the initial interview? If the caregiver was asked to bring in results for the required TB test and a criminal background check, did they bring it?
Willingness to comply with regulations: If the caregiver has recently moved to New Jersey from another state, are they willing to complete the forms for a federal criminal background check and apply for it in a timely manner? Are they willing to stay after the interview and fill out all of the agency's required forms?
Performances evaluations: Clients are requested to complete performance evaluations for caregivers periodically throughout a case. Pay special attention to the client's comments on these evaluations, as well as the client's rating of the caregiver in areas such as communication skills, attitude, dependability, and punctuality.
Beware of inconsistencies/untruths: If the caregiver provides a TB screening form that is not consistent with forms typically completed by doctors or clinics, let them know that the documentation is unacceptable. If a caregiver has a driver's license that shows one name, and a green card that shows another name, ask them why.
Beware of Red Flags: Is there anything out of the ordinary about the caregiver's file? Is there any paperwork that requires further investigation?
Ideally, when interviewing a caregiver, you should get a positive feeling that this caregiver will be a good fit for the client. In this case, it is prudent to put together all the information you have available to determine whether a caregiver will work out. Sometimes, the documentation required by the state is not enough: it is important to take into consideration things such as continuing education, quality of references, caregiver performance evaluations, and other intangibles that can indicate that a caregiver is a great match for a client.