Home-care hiring: Developing a good working relationship

Special to the Los Angeles Times

Megan Cowles’ friends envy her good luck.

“Everyone wants my job,” she says.

This summer, her employer is taking her to Paris, where she’ll see the Eiffel Tower, stroll along the Seine and eat buttery, melt-in-your-mouth croissants for breakfast.

Her wonder job?

She’s a home-care worker. Her employer, a 76-year-old Orange County woman, is so grateful for her help that she’s taking her to Paris on a vacation.

Part 1: How to choose a caregiver

“She’s very excited about it,” Cowles said. “She took me to the movies to see ‘Midnight in Paris’ and pointed out all the places we’d see.”


Generally speaking, home-care workers have a rough lot. The pay is rock-bottom, the job is difficult and the perks are usually nonexistent. But that’s not always true. Some employers are so appreciative that they reward workers with unexpected dividends.

One family I know gave their parents’ caregiver free rent for more than a year after their mom and dad died. She’d cared for the elderly couple with compassion and kindness for 10 years.

Another woman was given a car by a grateful family; many home-care workers receive bonuses at holidays and birthdays.

It’s not necessary to reward workers with large gifts, say experts, but it is important to develop a good working relationship.

It all starts with respect, says Debra Cherry, clinical psychologist and executive vice president of the Alzheimer’s Assn. in Los Angeles.

Cherry, who wrote a workbook for the organization called “How to Hire and Train Help in the Home,” recommends employers relay their expectations from the beginning.


“If you expect a worker to keep an eye on someone or to clean the house or to do hands-on bodily care, let them know specifically what you want,” she says. “As time goes by, adjust the duties as needed, but always discuss them with the employee.”

She said the organization has found that many problems develop because workers didn’t expect to do the things employers want them to do.

Whenever you add a new task, be specific about how you want it done. For instance, if your dad likes his eggs cooked a certain way, take the time to make sure the worker knows how to prepare them.

Experts advise a five-step training process for in-home workers:

— Tell them how to do the task, writing down step-by-step instructions if necessary.

— Show them how to do it.

— Have them do it while you watch.

— Praise progress.

— Give workers time to ask questions.

You’re the boss, which means you have to make everyone, your parent and the worker, happy.

“Make an attempt to know the individual and be interested in that person,” says Claudia Ellano-Ota, director of the state-funded Caregiver Resource Center in Orange County. She advises asking open-ended questions such as “How’s it going for you?”

Keeping lines of communication open can resolve problems before they get out of hand. Regularly ask both your parent and the caregiver about the arrangement. Find out whether they’re happy or whether some element of the situation needs to change.


If Dad hates the food that the caregiver is preparing, or if the caregiver needs a break but can’t take one, you need to seek solutions before the situation deteriorates.

Dawn Miller, who operates a Fountain Valley agency called Senior Helpers, requires her workers to keep a daily log that includes incidents, activities and medications. It’s a tactic every family — whether they’re hiring through an agency or by themselves — should consider using.

“It’s basically a notebook that documents doctor’s appointments, changes in medication, instructions from the doctor and other occurrences,” she said. “It helps family members stay informed and communicate with each other.”

The log can include a checklist of tasks and changes in mental or physical status, such as aggressive behavior or the onset of a cold. It should also include emergency phone numbers.

Miller stresses accountability. “I drop in unexpectedly all the time. It’s good for workers to know that can happen.”

Ellano-Ota takes that suggestion one step farther. She advises people to depend on the eyes and ears of other friends and neighbors to help.


“Tell them about the situation. Stop by with a bag of fruit and say, ‘Hi, I’m your next-door neighbor’s daughter.’” Describe your parent’s condition and let them know there’s a home-care worker. Ask them to let you know if anything seems amiss, and give them your phone number.

Check your parent’s condition regularly. “If you see things that don’t seem right — if Mom’s clothes aren’t clean, if she looks disheveled, unduly stressed or less alert than usual — check it out,” Ellano-Ota said. “Ask questions, and make sure you get definitive answers.”

Sometimes, no matter how hard you try, the situation doesn’t work out, and you need to terminate the employee, or the employee walks out with little notice.

Anticipate this by having the names of a few people you might call upon in a pinch to fill in while you begin the hiring process again. Try to pinpoint what went wrong and learn from the experience.

Then keep your fingers crossed that it will work out better the next time.

This is the second of two parts. Part 1 was about the pitfalls of hiring an in-home caregiver. For earlier installments of Rosemary McClure’s monthly column on caring for and staying connected with aging parents, please go to our L.A. at Home blog. Comments: