Hiring Caregivers for Children with Disabilities

At some point, you might need to hire someone to look after your child. It may be for respite care, so you can get a break, or to have someone attend to your child’s daily needs while you are at work or with your other children. It can be scary to leave your child’s care to someone else. After all, you have been learning about their needs since the day they were born. How can someone else have as much knowledge?

We know how you feel, and we’ve put together some tips to help you hire and manage caring and capable caregivers.

Finding the Right Caregiver

The first step in finding a caregiver is to decide what you’re looking for. Ask yourself questions like:

• For which hours will you need someone? How often?
• Will they need to be able to drive or cook?
• What specific skills do they need to care for your child?
• Is there any special training they need to have?
• Are there any other qualities your child responds well to?
• How much can you pay?
• What things would be deal breakers? For example, do they need to have their own transportation? Would you consider someone who smokes?
• Write down your thoughts and use them when writing an ad and creating interview questions. If you do place an ad, don’t include your name, address, or other private information. Just a short description of the job, the hours, and your phone number or email address will be enough.
• Sometimes, finding someone who is eager to learn might be more important than finding someone who has exactly the right skills and experience. After all, even if someone has a lot of experience working with people with disabilities or special health care needs, they will still need to learn about your child’s particular needs, likes, and dislikes.
• When you’re getting the word out that you’re looking for a caregiver, here are some places to try:
• Your own network of friends, relatives, and other people who may be helpful. Forward your ad to them and ask them to share it with their circles too.
• Staff who work in special education programs in public schools.
• Students at local universities and junior colleges, particularly students majoring in education, special education, social work, nursing, health and human services, occupational therapy (OT), physical therapy (PT), and other medical or helping professions.
• Members-only websites like Care.com
• Local agencies or service organizations and non-profits. Search for Services, Groups, and Events here.
• Neighborhood, church, and community organizations; and parent listservs or newsletters.
• Other parents who have children with disabilities or special health care needs.

Interviewing and Hiring

Once you have a candidate (or a few) that you like, it’s time to start the screening process. Often the first step is to call them and talk through the most important things about the job: hours, basic skills needed, whether they smoke, and what you can pay. This is a time to be very open and honest about what your child needs, like help in the bathroom, diaper changing, or managing challenging behaviors. Then, if you both think you want to work together, schedule a face-to-face interview.

If the candidate is someone you already know, like a teacher at the school or a friend’s niece, you can be a little more casual about your process. But if you don’t know someone well, it’s good to take extra caution. Maybe you meet them in a public place, like a coffee shop.

Get ready for the interview by looking over the job description and questions you wrote earlier. When you start the interview, take some time to get to know the person a little more so they feel more comfortable, and then ask your list of questions.

If you think that this person fits your needs and family, then bring up money: what the pay rate is, how often they will be paid, and if you will reimburse (pay them back) for mileage or food or other expenses. Get references and permission to do a criminal background check You will need their full name and date of birth for a background check. Some agencies will do the background check for you.

After the interview, check their references and do the background check. If they seem good to go, it’s time for the person to meet your child. You can meet them at a coffee shop, in your home, at the park, or wherever is most comfortable for you.

Watch how your child and the caregiver respond to each other. Pay very careful attention to your child’s cues – verbal and nonverbal – to see what they think about the caregiver. Your child’s opinion about the caregiver is probably the most important one of all.

Training

Once you’ve hired a caregiver, it’s time to train them.

Here are some key training topics and ideas:

• See if your new caregiver has CPR and first aid training. If they are driving your child places, think about paying for them to take defensive driving.
• Make a written schedule that includes hours you expect them to work and instructions for things you want them to do with your child. Spend time explaining the schedule and instructions, and let the caregiver ask questions.
• Have the new caregiver shadow you or, if possible, link them with another person already doing the job. This will give them valuable on-the-job training.
• Be very clear about your expectations and how to contact you. Do you prefer a phone call or a text? If there’s a problem, how do you want them to tell you? Do you want them to check in with you at other times?
• Go over the things they most need to know: handling your child’s behavior, how your child communicates, any red flags to watch for, and other important details about your child's care.
• Watch them interact with your child and give them feedback – share what worked and what to avoid doing or saying.
• Explain that you want to set up the first month as a trial period and then talk about if the job is working out for everyone.

For the first few times, you may want to stay at home and leave the caregiver in another room with your child. Then, leave home, but stay close in case something comes up. Make the transition to the new caregiver a gradual handoff, so you can all build trust.

During this time, it’s good to watch your child’s verbal and nonverbal cues about the caregiver. Check in with your child regularly – no matter how much you trust the caregiver. It’s the best way to be sure that your child is being treated with care and respect.

In the Long Term

When you find a good caregiver, you want them to learn, grow, be happy, and work with your child for a long time.

Here are some tips for managing a caregiver and supporting a good working relationship:

• Talk openly. Encourage them to bring up concerns early on, before things get worse. And do the same yourself.
• Check in with your child to see how they are responding to their caregiver.
• Meet with the caregiver regularly to talk about what's going on, what's working well, and what’s not working well. Give the caregiver a chance to talk too.
• If your child is in a program (such as a waiver program or Medicaid that requires a formal evaluation), tell the caregiver several months ahead of time about this evaluation and what’s in it.
• Let them know when they do something well.
• Give a bonus or gift at holiday time.
• Give a bonus for staying and when they’re doing a good job.
• Have occasional teambuilding get-togethers for all your child’s caregivers (if you have more than one).
• Set up a process for each caregiver to note what went on during their time with your child each day to share with the team and family. This can be as simple as a spiral notebook, a binder, or computer file.

We’ve found that respect is a very important piece of this relationship. You can treat a caregiver with respect by giving clear directions, speaking kindly, and giving them a chance to grow in their job. If you do need to ask them to change something, have the conversation privately, not in front of your child, other caregivers, or family members.

Sometimes we’re in a tough spot as parents, because this is not an ordinary working relationship. The caregiver may be in your home and may bathe your child, dress them, feed them, and entertain them. They get to know your child, home, and family in a close way. You may end up developing a strong relationship, even a real friendship. Yet, there are also times when you have to point out what’s going wrong to make sure your child is getting what they need. Having a good caregiver can be a real support and relief, but it's also a delicate balance that takes practice.

Sample Ad

Here is a sample ad that you might use on a members-only website like Care.com or send out to your network of friends and family members:

I'm looking for care for my 31-year-old daughter who has autism, as well as a vision and hearing disability. The ideal candidate is a very patient and calm person, willing to learn, and interested in developing a relationship with my daughter.

You would receive training in her communication system (knowledge of sign language not necessary) as well as training from an autism specialist.

We provide a car, gas, and insurance to transport our daughter on community outings. We are not able to provide transportation for you to and from work. Good driving record is a must.

I need care for her on Tuesdays & Thursdays. I also have some hours open on Friday evenings, Saturdays, and every other Sunday. Ideally, I'd like to hire 2 people. There would also be additional hours when we travel.

You would not need to commit to all of those days, but I am looking for a regularly scheduled position. Starting pay is $13.50 an hour.

You must have at least a high school diploma and pass a criminal background check. You must be a non-smoker.