Questions to ask when choosing a carer or agency

Choosing a carer or agency can start with little more than a few names and a notepad by the kettle. Below are questions that published guidance suggests putting to a carer or agency. No set of answers marks an agency as safe or right for your parent, and this hub does not recommend providers; the questions are there to gather a picture for you and your parent to weigh. None of this is medical advice.

Ask who will actually come

The Alzheimer's Association in the United States, in its general questions for choosing a home care agency, suggests asking whether the same person will provide care on a regular basis. The UK's Alzheimer's Society adds asking whether carers can be changed and whether you can meet them before they start, and the NHS in England raises how the agency will choose the most suitable carer. The Family Caregiver Alliance in the United States counts it as worth finding out, before care begins, whether the agency would send someone else if your parent or the family were not comfortable with the first carer.

Ask what happens when plans change

Guidance points to the ordinary disruptions. Among the questions the NHS in England says you may want to ask are whether a carer will keep to a set time slot, and whether you will be told if they are running late. The Alzheimer's Association's questions cover what happens if a care worker does not arrive, whether back-up care is provided when a worker is ill or unavailable, and what the arrangement is if a carer goes on holiday or leaves. The NHS list also includes how to reach the agency during the day, outside office hours and in an emergency.

Ask how staff are trained and checked

The Family Caregiver Alliance's questions take in how an agency trains and supervises its workers, and the Alzheimer's Association's take in background checks on staff and the experience or certification carers have before they are hired. The Alzheimer's Association and the Family Caregiver Alliance both suggest asking for references and following them up. A general question such as "Is the agency licensed or accredited?" may be worth asking, but how home care is regulated differs by where your parent lives.

Get costs and the contract in writing

The NHS in England suggests asking what charges, if any, you will be expected to pay and which services count as extras, and asking to see the standard contract, if there is one, before anything is signed. The Alzheimer's Society's list covers whether costs are hourly, whether weekends and public holidays cost more, whether there is a trial period, and what the complaints process is. Independent Age, a UK older people's charity, says an agency should put several things in writing: the contract itself, a clear list of prices with any extras shown, how the contract can be ended, and how to complain.

Bring your parent into the choice

NICE (the National Institute for Health and Care Excellence), in its guideline for England, asks services to find out whether a person wants carers or advocates involved in planning their care, and to respect what they choose. The Family Caregiver Alliance, among suggestions others have found helpful, notes that having a say may make a decision about help sit more comfortably with the person receiving it. Respecting their independence and choices goes further into that ground.

Meet before you decide

The Alzheimer's Society says you may want to arrange a meeting to learn how a carer works and how you feel about them. The Family Caregiver Alliance suggests that your parent be there when you meet a possible carer, and that you pay attention to how the two of them are with each other; the first weeks after that, including a job description written with your parent, are the subject of Bringing a carer into your parent's home. Questions about what kind of care your parent's health calls for are a separate matter, worth bringing to their doctor or other health professionals. Whether a parent is able to make a particular decision for themselves is not something a family is asked to settle on its own; where that is in question, it is for their doctor or care team, and the formal side differs by where your parent lives.