10 Questions to Ask Before Hiring a Caregiver or Home Care Agency!

In a recent study, it was shown that:

  • Only 55 percent of the Home Care Agencies did a federal background check. 
  • Only one-third of the agencies test for caregiver skill competency.
  • Supervision ranged from non to weekly, and included home visits, telephone calls, and caregivers visiting the office.

By being an educated consumer, you can find a qualified, reputable agency that employees caregivers who will care for your parent with compassion and skill. 

 Here are ten questions to ask before you hire a caregiver.

  1. Go through a well known agency.  This doesn't necessarily mean a large franchise, but get references before choosing.
  2. What recruiting methods do they use? How are they finding job candidates? Newspaper ads? Staff agencies? Craigslist?
  3. What are their hiring requirements for prospective employees?
  4. What screenings are preformed on caregivers before they are hired? Criminal background checks-federal or state?
  5. How does the agency assess what the caregiver is capable of doing?
  6. Does the agency train caregivers? What does the training entail? Are they knowledgeable about elderly health conditions?
  7. Are the caregivers insured and bonded through the agency?
  8. IS the agency diligent about sending the same caregiver to their home, rather than a revolving door of strangers who parents don’t know or trust?
  9. If you are not satisfied with a particular caregiver, will the agency provide a different person?
  10. Does the agency provide a supervisor to evaluate the quality of home care on a regular basis?  How frequently?

These ten questions will provide you with a great start to getting into the type of care and response that you will receive with the agency that you are questioning. 

Helpful Tips for People with TBI's to Maintain Independence

People who get their TBI later in life, often feel that their independence has been taken away.  Here are some helpful tips to help you maintain some of that independence!


To address problems with memory, attention span, and organization:

Try creating daily schedules and checking things off as you do them. 

Use alarms to remind yourself of things you need to do throughout the day, such as taking medications.  Keep calendars where they are easy to see, and review and update them every day.

Have specific places for things that you use a lot, such as your house keys. 

If reading is challenging, listen to recorded books from the local library.

Play games that use memory and problem solving skills, such as cards, dominoes, checkers, chess, word search puzzles, and board games. 

Reduce distractions such as noise and clutter to help make you concentrate and make fewer mistakes. 


If you want to feel more in control of your emotions and behavior:

Try to avoid things that make you angry or frustrated.

Make time to do the things you enjoy, such as hobbies or being with friends.

Allow yourself to grieve your losses.

Accept help from people you trust.

Get enough sleep and rest.  Being tired and in pain can make it harder to cope.

Join a support group to share your experiences and learn from others.


To ensure that you are being as safe as possible:

Keep emergency contact numbers on the refrigerator, where they are easy to find, and see. 

Remember that you may need more help than you realize.  Ask for support from a family member or friend. 

Use household appliances that have fewer risks until you have been evaluated.  For example, use the microwave instead of a stove.

If you want to drive, have an evaluation before getting behind the wheel.  If you can’t drive, look into an alternative transportation in your community.

Install safety grab bars near the toilet, and in the tub if you have poor strength and balance. 

Look into some sort of an emergency call button so that you are able to call for help if need be.

If you would like to get back into participating in work, school, or volunteer opportunities:

Think about things you enjoy and are good at.  How can you apply these to work, school, or volunteer positions?

Meet with your employer or school administrator to talk about your skills, and what you need help with.

Consider taking a different job in the same company if you are having trouble at work.

Ask for feedback or assistance from a trusted friend or colleague.   

Understanding an Individual with a TBI

A brain injury occurs every 23 seconds.  3.1 Million Americans live with a Brain Injury.  Obtaining knowledge of Traumatic Brain Injuries will help you understand a client or family member who has one and it will improve the quality of services that you provide to individuals with brain injuries. 

The brain controls everything that we do.  Breathing, walking, talking, thinking, behaving, and feeling are all connected to the brain. Damage to the brain may vary in extent, area, and type of damage, depending on a variety of factors relating to the nature of the injury, the severity of the injury, how the injury occurred, and the quickness of medical response.  Brain Damage occurs in a TBI in 3 different areas.  The Focal Damage would pertain to damages such as skull fractures, contusions or bruises under the location of a particular area of impact.  The Fronto-Temporal Contusions/Lacerations refers to the bruising of the brain, or tearing of blood vessels in the frontal and temporal lobes of the brain caused by the brain hitting or rotating across the ridges inside the skull.  The Diffuse Anoxal Injury refers to when the shifting and rotation of the brain inside the skull will result in tearing and shearing injuries to the brain’s long connecting nerve fibers or axons.  If the brain damage is from a medical incident that results in an infection, swelling of the brain or anoxia, the damage tends to be more diffused.  If the brain damage is related to a medical incident like a stroke or aneurysm, the damage tends to be more focal.

Every person with a brain injury is vastly different because every individual is different prior to an injury, and all brain injuries are different within themselves.  Damage to the brain may vary in extent, area, and type of damage depending on a variety of factors relating to the nature of the injury, the severity of the injury, how the injury occurred, and the quickness of medical responses, among other factors.  Every person adjusts differently to the changes that result from brain injury. Therefore, every person with a brain injury needs differing types and levels of support.  The results of brain injuries can be categorized into the following areas:   Physical, Cognitive, Executive Functioning, Affective Behavioral, and Psychosocial.    

Since every person is different, it is very important to get to know your family member’s or client’s abilities.  A good acronym to remember for this is ROAD.  This stands for Read/Review, Observe, Ask questions, Don’t assume.  ROAD will help to support an individual with a brain injury. 

There are some things to keep in mind and remember while you are with an individual with a Traumatic Brain Injury.  Remember to stress the individual’s strength’s.  Be honest, but gentle and tactful when helping them.  Don’t take things personally; people with brain injuries tend to not have a filter.  Treat everyone with dignity and respect, and never talk down to this person.  Avoid arguments and blame.  Respect differences, and understand you’re own and the person’s cultural and personal values.  Remember that progress may be slow, but keep at it-it works!!  Lastly, make sure you give yourself a pat on the back for a job well done! 

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