Q&A

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It is easy for family and friends, as well as professionals, to suggest finding someone to help with housekeeping tasks and care responsibilities. Having someone else take on some of your housekeeping or personal care tasks might sound appealing to you too. But what does it mean to have someone in your house “to help” you? Where do you begin to find someone? Can you afford it? How do you respond to your loved one who proclaims that they don’t want “a stranger” in the house? This fact sheet will help guide you through the process of hiring help at home.*

Do I Need Assistance?

Long-Distance caregiving, working full-time and caregiving and/or caring for someone 24 hours a day/7 days a week will take a toll on anyone. With a loved one who needs personal care and who can’t be left alone, you must be vigilant and “on duty” day and night. With constant care and companionship responsibilities, you may have very little time to yourself. If you are caring for someone who needs to be transferred from bed to wheelchair or out of a chair when sitting, you may be at risk for injuring your back. For those caring for a family member living with dementia, you may be also be dealing with challenging behavior, wandering risks, or actions that might be harmful or dangerous such as leaving cooking burners on. If you don’t have time to do the shopping, banking, and taking care of your own medical needs, you are at risk for stress-related illness. Are housekeeping routines and cooking being done with great difficulty or being left undone?

Consider your needs as a caregiver and the needs of the person you are caring for. Here are the main areas to assess:

Personal care: Bathing, eating, dressing, toileting, grooming

Household care: Cooking, cleaning, laundry, shopping

Health care: Medication management, physician’s appointments, physical therapy

Emotional care: Companionship, meaningful activities, conversation

Hiring help can relieve you of some of the tasks you are responsible for, freeing you to have some time for yourself. Having trusted help can give you the opportunity to run errands, go to the doctor for yourself, catch up on sleep, and socialize with friends. For long-distance caregivers and working caregivers, help can provide the care and assistance needed when you can’t be there on a daily basis yourself. Interestingly, caregivers have found that in some instances the person receiving care can be more cooperative with someone other than the primary caregiver, so that, for example, taking a shower might not be the battle that it can otherwise be. Engaging an attendant can help to preserve your relationship as daughter or partner, rather than always having to be the chore person or task master. Attendants come in fresh for a certain number of hours and therefore have the energy to be engaging and encouraging in a way you might be too exhausted to do around the clock.

My Loved One Only Wants Me to Help?

It can be hard for your loved one to accept help from a stranger. Initially, it will be important for you to be present to help the attendant and the care receiver to establish a successful relationship. You can show the attendant how you do things, so the help that is given will feel familiar and comfortable. Let your loved one know that YOU need help, and that this is something they can do to help you care for them. Reassure your loved one that hiring help does not signal that you are going to abandon them.

If your loved one lives alone, you might hear, “I don’t need any help.” Suggest that it will make YOU feel more comfortable knowing someone is there part of the day. You can also suggest that they “just try it for a week.” This will give your loved one some control in decision making and help them be open to having an attendant.

The transition to an attendant might be easier if the attendant shares a similar cultural background or language. The care receiver may have a preference for a male or female attendant. However, wonderful attendants come from all backgrounds, and being open to a caring, competent attendant from a different ethnicity or cultural background than your own can lead to rewarding bonds. This gives your loved one time to become familiar with the attendant and build trust.

“I Don’t Want a Stranger in My House!”

We all react differently to interacting with someone we don’t know. For some people, meeting someone new is an enjoyable and interesting opportunity. But for others who are naturally more reticent or are feeling vulnerable due to their illness, there is great reluctance to exposing their private life and personal living space.

Hiring someone through an agency will give you some choice for attendant selection. Most agencies have done background checks and bonded the people who work for them—be sure to ask if this is the case. And if you feel uncomfortable with the person who is sent, you can always ask the agency to send someone else. But typically an agency will attempt to match the attendant to your specific needs and requests, so if you aren’t immediately comfortable with the attendant sent, consider giving it a day or two to warm up to them.

How Do I Find Help?

There are formal and informal ways of finding an attendant. The formal way is to contact a Home Care Agency located near to where your loved one lives. A long list of agencies will be available in most urban and suburban communities. This can make it difficult to figure out who to contact first. Far fewer agencies serve rural areas, limiting options for hiring care. People who can help you select the right agency for your needs include your doctor and their staff, your friends/family who have used an agency, and others in your community whom you trust, such as your faith community, your local senior center, etc. Also check for agency reviews from trusted online sources, and consider contacting your local Area Agency on Aging to ask whom they hold contract(s) with for their clients.