Arranging for Live-In Care

A cost-effective option

One of the most cost-effective and flexible arrangements for home care can be finding someone to live with your loved one. If there is a spare room in the family home, this can be a viable option for some caregivers.

Your provision of room and board will considerably off-set the overall cost of care. You might want to check your newspaper housing section for the going rate for a room rental. You can then establish wages based on a reasonable hourly rate or a monthly stipend.

Finding the right person

• There are a variety of places to look for live-in help.
• List an ad in a local newspaper or college paper.
• Post an ad in a local school of nursing's newsletter, bulletin board or via e-mail.
  
• Post a notice in a local senior center, community center or with a church group.
  
• Contact home care agencies or community referral services which list individuals seeking live-in work (or looking for room and board in exchange for extra work).
  
• Contact a local independent living center to ask for referrals.

Screening applicants

To prepare for interviewing prospective live-in helpers, you will want to make sure you have taken the time to clearly define your needs. It will be important to prescreen applicants by phone in order to get a sense of their experience and schedule. For example, could a student fulfill your work needs if she has classes during the day or in the evening? Be prepared to explain the basic duties the person is expected to do, your loved one's physical condition and special needs (e.g., worker must be able to lift the person, or have a valid driver's license). To learn more about the interviewing process, read CareGuide's guide to hiring a home care worker.

Preparing the room

You should be able to provide your live-in worker with a bedroom, bathroom and kitchen privileges at a minimum. Other accommodations such as access to your television, computer, stereo or car should be worked out on an individual basis. An intercom can be a useful tool to call the person from the care recipient's bedroom.

Before you start interviewing people, make sure you have your spare room ready and presentable. A furnished room is typically offered, but you may provide an unfurnished room. Make sure there is adequate closet space for the person's clothes and personal belongings. Determine whether the helper will have a bathroom apart or share one with others. Don't offer your storage or junk room without clearing it out. You might consider getting help from a friend or a professional cleaning service to get the room ready to show. At a minimum, a furnished room should have a bed, dresser, nightstand and lamp, chair, and closet (not already full).

Defining your expectations

• Remember, the person you hire will not become a family member, nor should she be treated as a guest. She will be an employee. For this reason, setting boundaries will be important to both of you. Consider the following:
• Limit the hours. Don't expect a live-in helper to work 24 hours a day. Provide a reasonable schedule with time off. If your situation requires flexibility, be sure that you establish how extra hours worked or "on call" will be compensated.
  
• Respect privacy. Make sure your helper has adequate privacy during non-working hours in her bedroom or the bathroom. Establish appropriate common areas of the house where she can relax.
  
• Establish a meal schedule. Give your worker the choice of having meals at established mealtimes or on her own, so long as it doesn't interrupt her duties (e.g., cooking, serving, cleaning up).
  
• Food and fridge. Decide if the helper will share your food or buy her own. Will she have free range of the fridge, or have a designated shelf?
  
• Set a phone policy. Installing a second phone line for your live-in helper is a good idea and can eliminate issues about phone use and paying for long-distance calls. If you don't plan to have a separate phone, establish a clear phone policy (e.g., when friends may call, how long to stay on the phone, paying for calls).
  
• Visiting rules. Your helper lives in your home, so it is reasonable to allow guests. However, you should discuss and agree upon limitations on visiting such as late night, overnight and long-term visitors.

While sharing your home with a home care worker will take some adjustment, it can provide some key advantages for those willing to try. Your loved one gets a convenient, economical source of help at home, potentially avoiding or postponing placement in a residential care facility. The home care worker gets an important fringe benefit -- a place to live. And, you (and other family members) get additional support and help on caregiving duties.