Providing the Best in Senior Care


If you are like tens of millions of Americans you have found a caregiver for a frail, elderly person in your life - or you will need to find a caregiver one day.

"What you might not know is that there are several types of caregivers who provide care for the elderly. They have different skill levels and they charge different rates. How do you know which one - or combination of them - is best for the needs of the person in need of care?" said Dr. Cathleen Carr, Executive Director of, one of the nation's oldest and most respected organizations that provides certification, training, and job placement assistance for caregivers.

"First, be clear about the healthcare and daily personal needs of your loved one," said Carr, an elder care attorney. You can hire a Geriatric Care Manager or a social worker to perform a Needs Assessment. The National Institute of Health suggests this report contains a summary of functional and cognitive assessments, a list of medications, a home environment and psychosocial assessment, and a written care plan that includes a summary of recommendations. This plan then needs to be incorporated into a long-term elder health care plan for your frail, elderly person. This way it is easier to provide the right services at the right time to help and protect them.

Next, you need to find and hire the right person or team to meet the needs of the loved one and the requirements of the long-term plan. So, which type of caregiver do you hire?

There are three general types of caregivers:

1. Family Caregiver - a relative or friend who steps up to the plate to provide care. Depending on their own personal skills and ability, they provide all care for their loved one that they are able to and rely on others for special needs they cannot meet. Family Caregivers usually provide their services for little or no cost; however, the trend is toward government subsidy of these caregivers who must usually give up their own employment to be able to care for another. There is also a movement toward requiring certified Family Caregivers to reduce the incidence of elder abuse and neglect.

2. Personal Care Aide - a professional caregiver who comes to the home to manage all domestic home care needs, such as cooking, cleaning, laundry, transportation, home management, as well as personal grooming. They also tend to a client's psychological and social needs. Personal Care Aides (PCA), sometimes referred to as personal home aides or home care aides, are not specifically licensed to administer drugs or to provide invasive medical therapies. Personal Care Aides' pay generally starts at $8 per hour with certified PCAs starting at $10 or more per hour. Most states do not require caregiver certification for PCAs but this trend is rapidly changing nationwide due to the growing need for this service.

3. Home Health Aide - a state licensed provider of routine individualized healthcare such as changing bandages and dressing wounds, and applying topical medications at the patient's home or in a care facility. They monitor and report changes in health status. A few might also provide personal care such as bathing, dressing and grooming. Due to the expensive training required by all states, Home Health Aides are the most expensive in-home care provider with pay starting at $14 per hour.

"Now you can see why that Needs Assessment is important, right?" Carr said.

So, after you determine which type of caregiver your loved one needs, the next step is to find the right caregiver for you and your elder. Where do you find the best person for the respective job?

Personal Care Aides can be found by referral from friends, hired from agencies, located online in directories and registries. These are especially helpful when locating a PCA in a geographic location different from your own.

Home Health Aides are best assigned by your elder's hospital, hospice or physician's office.

"Last, be certain that your caregiver is at least a certified caregiver. Elder care is a very tough job. Only the physically, emotionally and psychologically strong, well-informed and reliable need apply," she said. "Make sure that person is educated about the specific needs of the elderly. Someone who thinks caring for an elderly person is similar to caring for a child is not going to be the best choice. The elderly have their own set of dietary, social and emotional needs that are vastly different than a child's."

For more information about caregiving and caregiver certification, visit or