As senior veterans grow older, they will often need assistance to continue living at home.

There are different types of in-home caregivers, including family caregivers, personal aides, home health aides, licensed nursing assistants and certified nursing assistants.

Many times, home care is provided by an unpaid family member. This includes help with activities of daily living (ADLs) such as standing up or sitting down, bathing and dressing, maintaining continence, and transportation.

Personal Aides (home care aides) provide assistance with daily living tasks as well. They also prepare meals, provide transportation, run errands, and help with household chores. You do not have to be licensed or certified to be a personal aide. The average rate of pay for a personal care aid is $15 to $25 an hour.

Home Health Aides help with ADLs and, in some states, basic medical care. They are usually supervised by a licensed medical professional. The average cost of a home health aid is $20 to $25 an hour. The federal requirement for an HHA is 75 hours of training.

Licensed Nursing Assistants (LNA) and Certified Nursing Assistants (CNA) provide medical care as well, including taking vital signs, wound care, cleaning catheters, monitoring infections. and assisting with some types of treatment. CNA’s will also help with daily living activities and household tasks. Medical services are directed by an RN or nurse practitioner.

When a veteran needs medical care, it is typically provided by licensed practical nurses and registered nurses.

The first step in hiring a caregiver is determining what tasks need to be performed, such as help with ADLs, household chores, transportation, etc.

To qualify for the VA Aid and Attendance benefit, which can help cover the cost of a home caregiver, the veteran must need assistance with some of the activities of daily living. If you plan on applying for the benefit, make sure your home caregiver job description includes help with at least two ADLS – bathing, dressing, mobility, toileting and/or feeding.

Once you have a job description, start your caregiver search.

There are different ways to find caregivers, including personal referrals from family, friends and neighbors, online registries, and home care agencies.

An online registry is a type of referral source that helps families find independent home caregivers. You provide the directory with information on the type of caregiver you are looking for, and they give you the names of potential candidates. You will usually need to pay a one-time fee to access the registry.

Keep in mind that you will be responsible for some management tasks if the caregiver has been personally referred or found through a registry, such as conducting background checks and handling payroll tax withholdings.

Here are some questions to ask a potential caregiver who has been referred or found through a registry:

  • What kind of caregiving experience do you have?
  • Do you have a reliable car and a good driving record?
  • What kind of training do you have?
  • Why did you leave your last job?
  • What is your availability?
  • Why did you choose to become a caregiver?
  • What do you like best about the work you do?
  • Is there anything you dislike about being a caregiver?

Home care agencies on the other hand, will screen their applicants before they are hired. This typically includes criminal, abuse, and reference checks, and collecting information about a caregiver’s background, experience and skills.

An agency will also handle employment related issues such as payroll and taxes, and make sure the person can legally work in the United States.

Here are some key questions to ask an agency:

  • Is the agency licensed?
  • Can you call the agency at any time, including evenings and weekends?
  • Would service begin immediately?
  • Is there a minimum number of hours for each shift?
  • Do they conduct background checks on their employees?
  • Are the caregivers bonded, licensed, and insured?
  • Will there be backup coverage if the caregiver cannot work?
  • What kind of training has the caregiver received?
  • If the caregiver does not work out, will they find a replacement?
  • Are there any extra fees involved besides caregiver costs?

You can find a complete list of in-home care agency questions at AARP.

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