Before hiring a caregiver to work long-term in your home, it’s wise to consult with a type of professional called a geriatric care manager. This person—typically with a background in nursing, social work and/or gerontology—can help you choose the best caregiver solution for your health needs, living situation and budget. To find a geriatric care manager, contact the Aging Life Care Association ( Insurance doesn’t cover the cost of consultations with geriatric care managers, but they are usually well worth the fee (hourly rates range from about $50 to $250).

Here are important questions to ask a geriatric care manager when you’re considering hiring a caregiver…

Should I hire a caregiver directly or through an agency? A home-care agency will have a variety of caregivers for you to choose from and handles scheduling, payroll taxes, etc. This means less administrative work for you but, of course, agencies charge for their services, so using an agency generally costs more than hiring a caregiver directly. A geriatric care manager can give you more details on the pros and cons of using an agency in your situation. For a listing of agencies in your area, consult the National Association of Home Care & Hospice, If you choose to hire a caregiver directly, your geriatric care manager might be able to give you referrals…and you can contact your local Area Agency on Aging,, for potential referrals as well.

What kinds of expertise should I look for in a caregiver? Caregivers may be trained in nutrition, toilet help and bathing and, of course, offer companionship. Some have additional specialized skills. A geriatric care manager can assess your situation to determine your needs or those of your loved one.

Will you help me evaluate any caregiver I am considering hiring? A good geriatric care manager can assist you in choosing a caregiver—including those offered through agencies—by helping you create a list of the tasks you need done, the hours you require coverage, the personal qualities you’re looking for in a caregiver, etc. You may want your care manager to be present at interviews so he/she can help you ask questions and discuss candidates’ qualifications.

How much do caregivers cost in my area? Rates typically range from $10 to $40 per hour for in-home caregiving. Your geriatric care manager can describe rates for different types of caregivers in your area.

Will insurance or Medicare/Medicaid help me pay for a caregiver? Health insurance plans and Medicare/Medicaid will typically pay at least some of the cost of home health care that’s medically necessary, as will long-term-care insurance if you have such a policy. If you don’t think you’re getting the insurance coverage that you’re entitled to, your geriatric care manager can put you in touch with an insurance specialist who can help.

What should I do for backup coverage? You will need someone to call if your in-home caregiver gets sick or can’t work for some other reason.

What precautions should I take when bringing a caregiver into my home/my loved one’s home? Speak with your homeowner’s or renter’s insurance company to make sure that you’re covered for personal injury to the caregiver, property damage, theft, etc. If the caregiver will use your car, that’s another insurance issue to discuss. And ask your geriatric care manager about any other precautions you should consider for your individual situation.

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