Home care agencies — both independently-operated agencies and nation-wide chains — supply live-in or live-out staff who can provide a variety of services, such as nursing, personal care, homemaking, companionship, respite care and palliative care. Agencies typically screen their employees, handle the record-keeping and scheduling, co-ordinate care, bill insurance companies directly, know insurance requirements and limitations and have familiarity with community services.

Steps to Take

• Do a preliminary needs assessment.
• Work with the care recipient to identify the areas where outside help and/or professional assistance is needed.
• Make a list of the main concerns.
• Determine the type of help that is needed — nursing/medical care, personal care, homemaking, companionship, respite, counselling
• Estimate where, when and how often help will be needed.
• Note any special requirements.
• Take into account the available resources — who is available to help, ability to pay for services.
• Ask family members, friends and co-workers for recommendations.
• Ask for a referral from a family physician or other health professional.
• Check yellow pages listings under Home Care, Home Health Services and Supplies, House and Apartment Cleaning, Nurses, Nursing Assistants, Personal Services Bureaus and any other relevant categories.
• Draw up a list of agencies to call.
• Compare agencies. Check references.
• Select the care provider that best meets the care recipient's needs.
• Let the agency know how to reach you, in case of emergency.
• Monitor the work of the agency employee to ensure that it is satisfactory.

Questions to Ask

• What services does the agency provide?
• Are any of the services covered by government-funded home care programs?
• Does the agency work with your insurance company (if applicable)?
• How long has the agency been in business?
• Is the agency insured or bonded? Are the workers bonded?
• Does the agency supply references for itself and its employees?
• What type of training is required of employees?
• Will the same person come to the home each time?
• Will a supervisor oversee the quality of care that is being received?
• Does the agency perform an in-home assessment?
• Does the care plan explain which tasks are the caregiver's or care recipient's responsibility?
• Will the caregiver or care recipient get a copy of the care plan?
• What are the agency's operating hours?
• How flexible is the agency?
• What are the fees? Is there a sliding scale? Are there payment plan options?
• What are the financial procedures for billing, fee payment, insurance coverage?
• How does the agency deal with emergencies, holidays, and sick days?
• Who does the individual or caregiver contact, if dissatisfied with the quality of care or experiencing other problem?
• Does the agency have a 24-hour line?

Be sure to mention any special requirements — for a specific language, a driver's licence and/or special circumstances such as the care recipient has dementia, the household has pets.

Steps to Take

• Determine the type of help that the individual is needed to provide — nursing/medical care, personal care, homemaking, companionship, respite, transportation
• Involve the care recipient in the needs assessment, as much as possible.
• Determine where, when and how often help will be needed.
• Note any special requirements.
• Create a job description.
• Find out the going rate for the required service(s).
• Set a rate, taking into account the available financial resources.
• Let people in your social network know that you are looking for someone.
• Contact local organizations — churches, synagogues, community centres, senior's centres, support groups.
• Place advertisements in community newspapers. Include the job title, duties, salary range, contact telephone number.
• Interview applicants. Ask them for references.
• Check the references.
• Look for care workers with professional training and experience who can not only do the job but also get along with the care recipient.
• Draw up a dated, signed job contract
  • tasks to be performed
  • wages and benefits
  • hours of work
  • vacation and holidays
  • term and method of payment
  • employee's social insurance number
  • emergency absence plan
  • termination guidelines
  • signatures of employee and employer
  • date
• Let the care worker know how to reach you, in case of emergency.
• Keep a written record of the employee's work schedule and payments.
• Contact Revenue Canada for relevant tax information and forms.
• Monitor the work of the home care worker to ensure that it is satisfactory.

• Why are you interested in providing home care?
• What are some of your past experiences with home care?
• What training do you have in home care?
• Are you currently providing care for others?
• Why did you leave your last position?
• How much time can you commit to this position?
• Are there any duties that you are unwilling or unable to do?
• What will you do if there is an emergency?
• Have you handled an emergency situation before? What happened?
• How would you deal with someone who may resist your care?
• What will you do if you are sick and cannot come in?

Be open with the applicant about specific tasks he or she may be required to perform, such as bathing, changing catheters, running errands, driving the care recipient to and from appointments.

• Are you and the care recipient comfortable with the applicant?
• Does the applicant have the skills the position requires?
• Do you trust the applicant, especially in emergency situations?
• Are the personalities of the applicant and the care recipient compatible?

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