Working Effectively with Professional Caregivers

Over the past few months, I have shared how my mom experienced a fall that resulted in left-sided fractures of her shoulder and foot and prevented her from bearing weight on her left side for 12 weeks. In preparation for her return home from the skilled nursing facility that she was in for more than three weeks, I hired private caregivers to assist for four hours each morning, so that I could work and my dad could rest.

The efforts of these incredible women have helped my mom make tremendous progress, accomplishing all she can for herself within her physical limitations. Additionally, the time their involvement returned to me allowed me to coordinate care for mom, so that I could be her care partner, rather than her caregiver. I could not have done this without them.

What is a professional caregiver?

There are many job titles and certifications among professional caregivers. In general, all of these roles involve assisting another person to live as independently as possible. More specifically…

  • Basic Caregiver Certification — ideal for family members who want to assist their loved one with activities of daily living
  • Certified Nursing Assistant (CNA) — prepares caregivers to work in a range of settings from the hospital to the home
  • Home Health Aide (HHA) — knowledge of the fundamentals of medical care, caring for the elderly, how to handle emergencies, and caring for individuals aging in place
  • First Aid and Emergency Care — prepares caregivers to perform things like CPR and teaches critical skills that can make all the difference in an emergency
  • Certified for Hospice, Palliative, and End-of-Life Care — requires knowing how to support individuals through a terminal illness and at the end of life
  • Certified for Specific Needs and Conditions — training that requires more specialized care such as dementia care, diabetes care, or Parkinson’s disease care

I need a caregiver, where do I start?

First, identify how much time in a day is needed to care for your loved one.

Then ask:

Do I need this person to assist with…

  • Rehabilitation?
  • Maintenance of the status quo and/or slow decline?
  • Assistance through end-of-life?

The knowledge, skills, and abilities required are different for each setting.


In this case, the caregiver will assist with activities of daily living (ADL), encouraging the individual to do as much as possible for themselves. Over time, the individual does more and the caregiver does less.

Also, with physical and occupational therapists coming to the home just twice per week, the caregiver will follow through and reinforce what the therapists have worked on. In my mom’s case, this includes encouraging and overseeing a daily exercise program. It is my belief that without this support, mom would not have made the tremendous progress she has achieved.

The goal in this setting is for the number of hours needed from the caregiver to gradually decrease until care is no longer needed.

Maintenance/Slow decline

Here, the caregiver does more for the individual as the person is able to do less for themselves. In these circumstances, the caregiver’s involvement may start out small, but play an important role in allowing an individual to remain in their home longer and with some degree of independence.

Over time, responsibilities increase and time spent with the individual may grow. Eventually, the situation may require multiple caregivers working in shifts.


Here, adjustments must be made continuously to do as much for the individual being cared for as possible, to promote their comfort and safety. Sometimes, caregivers even participate with the decision making, along with the family, to administer medications to relieve pain and suffering. Flexibility, empathy, and critical thinking are definitely needed in this setting.

In these circumstances, the caregiver’s services often wrap around care that a family provides. Privacy and quality time with one’s family must be taken into consideration when a schedule is outlined. Nighttime is often when these caregivers support families, allowing them to rest and be present for their loved one during the day.

Where do I find the right person/team?

To keep it simple, think about individuals in your life or network whom you trust. Then ask for suggestions. You can also turn to professionals like us to assist with the process.

Most of the time, we hire from reputable private homecare companies with whom we’ve worked. We can trust that the caregivers have been adequately vetted, hired, and trained, and that they are insured and actively managed. Other times, families establish private employment arrangements in which the family takes on the role of recruitment, interviewing, hiring, managing, insuring, paying, etc. In both scenarios, I have had mostly positive experiences.

How do I manage a caregiver?

Although I knew the skills and abilities of mom’s caregivers, I still had to take on the role of outlining expectations and providing background information/training. It was important that they knew of mom’s restrictions, that we agreed on a means of two-way communication, and that they provided continuous feedback as her situation improved.

Overall, it’s critical that someone in the family take on this quarterbacking role. Don’t assume that the agency or caregiving individual will manage this for you.

What can I learn from a caregiver?

The skills and experience of professional caregivers are amazing. The observations and feedback mom’s caregivers relayed to me were invaluable; they noticed things I missed and always had fabulous suggestions for troubleshooting challenges and providing care.

For example, it was the caregivers who taught my dad and me how mom could be transferred with help from just one other person. What a relief this was because dad and I struggled with this for the first three weeks she was home, and we were exhausted!

Final Thoughts

Private caregiving is a profession that does not always receive the respect it so rightly deserves.

Should you require caregivers for your loved ones, be prepared to invest in developing relationships with these wonderful professionals and be open to learning and growing from the experience they bring into your home. I am eternally grateful for the incredible women that I trust completely to care for my mom. That says it all!