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How to Choose the Right Live-in Caregiver for Your Elderly Parent?

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By Anglo Caregivers
We help you find your right caregiver.
author-anglo-caregiver
By Anglo Caregivers
We help you find your right caregiver.
Download a copy of our resource(s) for your use.
The following tool is available to help you.
How to Choose the Right Live-in Caregiver for Your Elderly Parent?

About Anglo Caregivers

Our agency specialises in helping families find experienced or certified caregivers to live in and take care of their elderly or disabled loved ones.

With so many caregivers available to choose from, how do you find the right caregiver for your elderly parent? We have compiled a list of top 11 things to check for to help you shortlist and find your ideal caregiver.

#1 Expected salary

Does her expected salary match your family’s budget? If her asking salary is a lot higher than what you are willing to pay, it may not be worthwhile to negotiate. In the scenario where she decides to lower her expected salary to meet yours, you can run a risk of hiring someone who is dissatisfied with her pay and performs her duties half-heartedly.

#2 Rest day preference

Check for the rest day preference of a potential caregiver to see if it matches your family’s preference. If you are looking for someone with 1 rest day a month, then someone who is asking for weekly rest days would not be suitable for you. You can also check if the caregiver is willing to meet your rest day requirements.

READ: Does a Live-in Caregiver get a Weekly Rest Day?

Pro Tip!

If a potential caregiver that you are keen to hire did not seem willing in adjusting her rest day preference, it is better to ask yourself if you are able to make arrangements to accept her rest day preference.

Rest days must be mutually agreeable. Otherwise, it might open up possibilities of future rest day disputes.

For example, a caregiver might hesitantly accept your proposal of taking 1 rest day a month initially, only to begin to ask for weekly rest days when she starts working for you or risk ending up with a disgruntled caregiver

#3 Height and weight

A caregiver’s height and weight would give you an idea of your caregiver’s build. Normally if you are hiring someone for housekeeping or babysitting, your caregiver’s build may not be important. However, when it comes to caregiving, you would ideally like to hire someone who has sufficient strength to be able to:

  • For ambulant care recipients: Break the fall of the care recipient in a safe manner if it happens.
  • For wheelchair-bound care recipients: Transfer the care recipient from bed to wheelchair and vice versa, independently and confidently, several times a day.
  • For bedbound care recipients: Turn and position or perform sponge-bathing in the bed for the care recipient independently.

The height and weight of a caregiver can give you some indication as to whether a potential caregiver might have the necessary build and strength to care for your loved one independently and in a safe manner without injuring your care recipient or herself. It is also important to note that, apart from having the requisite strength, a potential caregiver also needs to use safe and proper techniques in handling your care recipient.

Pro Tip!

If your care recipient is quite heavy, for example weighing 80kg and above, and does not have much strength to assist in standing up while being transferred from bed to wheelchair, you may want to consider having someone at home to help with a 2-person transfer. This will be preferred over expecting 1 caregiver to perform the transferring all by herself.

It is safer for both your care recipient and your caregiver. Otherwise, you might have difficulties in finding a caregiver or run a risk having your caregiver injure herself.

#4 Medical history

In the standard biodata, there is a section on self-declared medical history. Check that a potential caregiver does not have any pre-existing medical conditions, allergies or disabilities that may compromise her ability to provide safe care to your care recipient.

#5 Dietary restrictions and food handling preferences

Some caregivers may have dietary restrictions or food handling preferences due to personal or religious reasons. As the caregiver would be the one preparing food for your care recipient, the person you hire would need to be able to handle foods that are in your loved one’s diet.

#6 Language abilities

Does a potential caregiver’s spoken language(s) match the language that your care recipient speaks or understands? Your caregiver would need to be able to understand what your care recipient is requesting of her and communicate effectively with your care recipient to be able to assist in her daily activities like showering, toileting.

For example, a simple command from a caregiver like “Ah ma, I am going to help you to stand now and transfer you to your wheelchair” needs to be understood by your care recipient in order the care recipient to respond and coordinate in the activity accordingly. Communication difficulties can often result in frustrations for your care recipient.

After screening for the language requirements, you should continue to evaluate the level of competency and fluency a caregiver has during the interview.

Pro Tip!

If you are looking for someone who can converse in English, higher education levels like senior high school or college levels may indicate better competencies in English.

Prior working experience in a country may also indicate their abilities to speak the language commonly used in that country. For example, ex-Singapore caregivers usually converse well in English; ex-Taiwan caregivers may be able to converse in Mandarin; ex-Hong Kong caregivers may speak some Cantonese.

#7 Cooking

One of the primary caregiving duties of a live-in caregiver is to prepare meals for her care recipient according to the diet. In the biodata, look out for evidence where she has performed grocery shopping, cooking or meal preparation for her previous care recipients. If your care recipient has medical conditions like diabetes or cancer and requires a special diet, look out for experience with care recipients with such conditions and check if she prepared meals in these experiences.

#8 Caregiving experience

Looking at a caregiver’s experience would help you evaluate if a caregiver has the necessary skills and knowledge to care for your care recipient. Below are some key questions to ask when looking at a potential caregiver’s experience stated in her biodata.

Was it a 1-to-1 caregiving job or a job in a facility?

Working in a home setting providing 1-to-1 care is different from working in a facility like a nursing home or a hospital. The job scope, environment and acquired skillset are some key differences.

Facility environment

In a hospital or nursing home environment, a caregiver, or more commonly known as “nursing assistant” or “nurse aide”. Typically, she overseas the activities of daily living like showering, diaper changing or toileting, and monitors vital signs for a given number of patients. Housekeeping is limited to changing the patients’ linens and bedsheets.

The caregiver may or may not be allowed or required to perform additional care duties like NG Tube feeding and suctioning. In most settings, the facility forbids the caregiver from administering oral medications.

The focus is on fulfilling the performance of these functions for a number of patients during a shift of typically 8 – 12 hours. The shifts are usually on rotating basis, sometimes in the day and sometimes at night.

The environment is typically at a faster pace due to the number of patients they need to care for. In light of the number of patients a caregiver has to attend to, the interpersonal interaction between the patients and a caregiver is usually limited.

When any incident arises, it can be escalated to the medical team on site immediately.

Home environment

On the other hand, in a home environment, the caregiver oversees the activities of daily living for 1 care recipient.

The focus care goes beyond assisting in the activities of daily living to all other aspects of care needs and support that a care recipient needs. This typically includes giving medication, accompanying for medical appointments, taking stock of medication and home care supplies, grocery shopping, cooking and preparing meals according to care recipient’s diet and some housekeeping to keep the environment clean and hygienic.

In a home environment, the caregiver would need to perform additional care duties like NG Tube feeding and suctioning independently.  

The environment is at a slower pace with high degree of interpersonal interaction between a care recipient and caregiver. A caregiver is expected to provide companionship and emotional support to her care recipient.

She needs to be confident to manage and handle the care independently. When any incident arises, she would need to know how to respond independently and escalate the respective parties.

Generally, given the number of patients that a caregiver working in a facility has to care for, you can expect her to be very skilled in her caregiving techniques as well as in additional care areas like suctioning or tube feeding if she was allowed to. The caregiver would need to adjust from working in a facility to a home environment where it is slower-paced with more interpersonal interaction, with an expanded job scope and on a live-in arrangement.

Pro Tip!

If a caregiver stated that she had worked in a facility, be sure to clarify if she was hired by the facility as an employee or if she was hired by a care recipient’s family for 1-to-1 personal bedside care for a care recipient residing long-term in the facility. The job scope and duties differ widely between these two scenarios.

Was it a live-in or live-out role?

When a caregiver works abroad in domestic setting, it is typically on a live-in arrangement. A live-out arrangement is typically applicable when a caregiver works in her home country as a private caregiver. When a caregiver is on a live-out arrangement, you should find out:

  1. What were the working hours? Was it day time or night time?
  2. How many days in a week did she work? Was it on a full-time or part-time or ad-hoc basis?

Working hours?

Some caregivers are engaged for 8 hours, some for 12 hours. Working in a caregiving setting of 12-hour shifts can be said to be more similar to working in a live-in environment in terms of work hours and duties, compared to working on 8-hour shifts. For example, someone who has worked on 9am – 9pm shifts may have experience in putting an elderly care recipient to bed which can be challenging at times compared to someone who has only worked 9am – 5pm.  

Day or night care?

While live-out caregivers are usually employed during the day time, it is also not uncommon for them to be employed as nighttime caregivers. Typically, most of the activities of daily living are performed in the day time. Most care recipients sleep through the night, mainly calling for caregiving assistance a few times for toileting assistance. Ideally, you would prefer priortise daytime experiences over nighttime experiences.

Full-time or part-time?

Check if she was engaged on a full-time or a part-time basis as the job demands are very different. Some caregivers may state that she had worked for a period of time but it could be on a part-time, 2 – 3 days a week, or on an as-needed basis. Such information is typically left out from a biodata. If she stated that it was on full-time basis, do also check how many days did she work in a week. Her interpretation of ‘full-time’ might be different from yours. It is good to be prudent to be specific and check on this.

Was her previous care recipient(s) ambulant, chair-bound or bedbound?

Experience in caring for ambulant care recipients is different from experience in caring for chair-bound or bedbound care recipients. It is not as simple as ‘knowing how to push a wheelchair’.

Caring for disabled care recipients includes transferring from bed to wheelchair and vice versa multiple times a day, turning and positioning every few hours to prevent pressure injuries, performing sponge-bathing on the bed etc. All these assistance in movement and positioning of a care recipient requires strength and stamina from a caregiver and must be supported with the right techniques.

Caring for frail, ambulant individuals who need assistance or supervision in walking also requires a caregiver to know how to provide proper support and breaking a fall if it happens.

Ideally, you should look for a caregiver who has experience in caring for care recipients who share similar mobility status as your care recipient.

Pro Tip!

‘Care of elderly’ is not the same as ‘care of disabled’ under areas of work found in a standard FDW biodata. ‘Care of elderly’ refers to taking care of an elderly person. It may or may not include caregiving duties. It does not reflect if the elderly is healthy or requires caregiving assistance.

If your loved one has caregiving needs, you should refer to the ‘care of disabled’ instead, look out for what were the specific duties performed by this person to see if it included the caregiving duties, such as showering or toileting, that your loved one needs.

What was the medical condition(s) of her previous care recipients?

If your care recipient has a specific type of caregiving requirement due to the medical condition, it would be ideal if a potential caregiver has prior experience in caring for a care recipient who share the same medical condition.

One common requirement would be the care of persons with dementia. The care of persons with dementia stands out amongst care of other types of conditions as it requires the caregiver to be able to manage her care recipient’s changes in moods and behaviours.

Pro Tip!

Persons with dementia can present with different types of changes in mood and behaviours.

If you are looking out for someone with prior experience with dementia, ask what were the dementia symptoms that her previous care recipient had and check if they are similar to your care recipient’s.

What were her job duties?

In order to determine if a potential caregiver’s experience matches what you are looking for, you should always look at what her specific job duties are. It is common to see generic descriptions ‘elderly care’ or ‘take care of bedridden ah gong’. If her specific job duties are not listed in her biodata, you should check and find out:

  • What were the specific activities of daily living that she assisted with?
  • Was she the only caregiver or did she have extra help?
  • Did she perform other supporting care duties like cooking?

For example, a caregiver stated that she had taken care of an ambulant care recipient with diabetes - the same medical condition as your loved one. Upon probing, you found out that while the caregiver assisted with showering and walking, the care recipient had measured her blood glucose levels and given diabetic injections by herself; without the caregiver’s help. In this case, the caregiver’s experience might not be relevant to what you are looking for.

Another example - a caregiver stated that she had cared for a chair-bound male care recipient. Upon probing, she shared that she had not performed showering or toileting for her care recipient. The care recipient’s wife was the person who handled these areas due to religious and personal reasons. The caregiver, then, would not have experience in attending to a care recipient’s hygiene which you would require for your loved one.

Did she perform additional care areas?

If your care recipient requires additional care like suctioning, tube feeding, giving diabetic injections or caring for indwelling urinary catheter, you can look out for experience in these areas. You should also check to confirm that a potential caregiver had performed such care independently and, during interview, to ask her to share with you step-by-step on how it is done to test her knowledge.

Did she work abroad?

Having prior experience working in other countries may indicate that a potential caregiver is better adjusted to being away from her family for extended period of time for work compared to someone who have not had experience working abroad yet.

#9 Employment history

Look at the duration of work with each employer. Does the potential caregiver finish most of her contracts or does she have a pattern of terminating early? What are her reasons for premature termination?

Typically, the contract for working abroad lasts for 2 years. The exception applies to experience in Taiwan where it is common to see a 3-year duration with each employer - it is a 2-year contract with an option to renew for 1 year.

Pro Tip!

It can be common for caregivers to be transferred in Singapore after a short period as the care recipients may have passed away or recovered. It is a good practice to find out what were the reasons for premature termination and evaluate the reasons for yourself.

Verifying employment history in Singapore

You can verify a potential caregiver’s employment history in Singapore through WP Online using a SingPass. There are three ways to check the employment history in Singapore:

  • Caregiver’s Work Permit (WP) Number; or
  • Caregiver’s Foreign Identification Number (FIN); or
  • Caregiver’s Name, Date of Birth, Sex and Nationality/Citizenship as indicated in the passport. Passport number is optional

It is a good practice to check and verify a potential caregiver’s records even in cases where her biodata stated that she has never worked in Singapore previously.

Verifying other employment history

There are some ways of verifying employment history in their home country or abroad. You can ask for the following (if available):

  • Certificate of Employment (COE) which may include the period of employment, job title and job duties  
  • Employment Contract
  • Entry and exit stamps in her passport if she had worked abroad

Some of these documents listed above may not be available for every potential caregiver. It is a good practice for employers to verify a potential caregiver’s history. If you would be relying on a potential caregiver’s self-declared experience and employment history for hiring and placing your loved one in her care, you would probably like to know that the data you have been given is as accurate as possible.

You should also find out on gaps in her employment – whether she had been working during these periods or she had other personal reasons like as starting a family, giving birth etc.

Pro Tip!

Check if there are inconsistencies within her biodata. For example, if a potential caregiver stated that she has a child aged 3 and the year of birth coincides with a period that she is stated to be working abroad, you may want to clarify with your agency or potential caregiver.

Feedback from employer

Feedback from previous employer is something that would provide helpful insight into a potential caregiver’s job duties and performance but is not typically available due to the informal nature of the domestic sector. If a potential caregiver is on transfer in Singapore, you can ask for the feedback from her current employer.

#10 Training and certificate(s) in caregiving

Ask for copies of the caregiving certificates that are stated in the biodata.

The certificate would typically state the duration of the course or programme. Some caregiver training can be quite brief like a 4-hour session or 1-day training. Some can be extensive like a 2-year diploma in nursing aide.

Generally, caregiver training sessions conducted in Singapore is less extensive compared to those conducted in a caregiver’s home country. It ranges from a few hours to a few days and to every rest day for a period of time. This may be attribute to higher costs and limited time off from work in Singapore.

On the other hand, training that are held in a potential caregiver’s home country are typically more extensive like a full-time 6-months programme with 100 hours of on-the-job training.

The topics covered by the training can be stated in the certificate or on a transcript. This would provide you with an overview of the breadth of the training that a caregiver has undergone.  

A more rigorous and extensive training accompanied with on-the-job training can translate into a better grasp of caregiving skills along with better understanding of what caregiving is like. This would be an important factor in shortlisting new caregivers without experience.

READ: What is a Certified Caregiver? Types of Qualifications and Things to Look Out for

#11 Estimated processing time

The estimated time before a caregiver joins you varies, depending on whether:

  • Your caregiver is in Singapore or residing overseas; and
  • Your caregiver currently holds a valid passport.

Current location

For caregivers who are in Singapore for transfer, the process is typically faster compared to caregivers who are still abroad. Usually, for caregivers on transfer, employers can expect to pick up the caregiver within 7 days – as soon as her new work permit is approved and her current employer signs the final release declaration.

For caregivers who are abroad, employers can expect additional processing time for contract verification with their respective embassies and pre-departure orientation.

Passport validity

If your caregiver does not have a valid passport, it may take an additional 2 to 4 weeks for the passport to be processed before your agency can make a work permit application for her.

The estimated processing time ranges widely from 1.5 weeks to 8 weeks. The procedural requirements and processing times vary from agency to agency. It also largely depends on your caregiver’s home country requirements.

If the estimated processing time is not provided to you, ask your agency to provide you with it. Typically, employers are in a rush to find a suitable caregiver due to impending discharge from the hospital or the current caregiver needs to leave urgently.

You may check with your social worker or hospital on the expected timeline and shortlist caregivers who are able to meet your timeline requirements. A care recipient may be transferred from an acute care hospital to a community hospital for a step-down care for a few weeks before finally being discharged home. Knowing this would give you additional runway in your search for your ideal caregiver.

Age(s) of children

For many employers, one major concern is whether the caregiver would prematurely terminate her contract due to family matters. It is common for employers to look out for the ages of a potential caregiver’s children, preferring to hire caregivers who do not have young children aged 3 years and below. Some employer may have worries that the caregiver may miss her young children and resign prematurely. For caregivers who have worked abroad, they are typically well-adjusted to spending long periods of time away from their loved ones for work.  

It is important for employers to exercise caution when shortlisting caregivers using this criterion. There are also many other family reasons for premature termination. Some reasons that employers have heard of may include ‘to get married’, ‘to finalise divorce proceedings’, ‘hospitalisation or death of a family member’, ‘to discipline teenage child who is going through a rebellious phase’ among other reasons.

How do I look out for someone who will finish her contract?

A major worry for employers is that a caregiver quits halfway and be left without someone to look after a loved one. Based on what was discussed in previous sections of this article, look for:

  • A good match with your requirements such as salary, rest day preference, language ability and build
  • Someone who has prior experience or training that is relevant to your specific care needs
  • Someone who has prior experience in working abroad
  • Someone who has a history of finishing contracts, supported by relevant documents

With your shortlist of caregivers, you are ready to proceed with interviews.

READ: 74 Interview Questions to Help You Hire the Right Caregiver
Download a copy of our resource for your use.
The following tool is available to help you.

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About Anglo Caregivers

Our agency specialises in helping families find experienced or certified caregivers to live in and take care of their elderly or disabled loved ones.

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Originally published
February 11, 2022 4:57 PM
Updated
February 11, 2022 4:57 PM

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