Month: June 2020

Whether you are looking for a caretaker or are considering becoming a professional caregiver, this guide will walk you through the basic duties of a caregiver and some of the potential caregiver responsibilities that home care agencies and families may expect. While there is no one caregiver job description that covers all that a caregiver job entails, this post will explore some of the common areas of focus that can serve as a guide for would-be caretakers, hiring agencies, and families in need of senior care. 

When seeking a caregiver for their loved one, individuals may find themselves confused by the various options for care. Should their loved one stay in their own home or take up residence in an assisted living facility? What are the typical caregiver duties families can expect or inquire about? Read on through this caregiver duty checklist to understand some of the most frequent areas of focus for caretakers, whether they are working in a home or in a nursing facility. 

Developing a Care Plan

One of the first steps in outlining the level of care provided by a caretaker is developing a care plan. If a plan of care can be worked out before the individual needs full-time care or while the individual in question maintains appropriate levels of decision-making abilities, then this is the best-case scenario. In many cases, however, the development of a care plan is left up to the family members who are trying to make the best choices for their loved ones. 

The care plan covers the agency or family expectations for the caretaker, and a good care plan takes the wishes of the person being cared for into consideration. Although most caretakers are not medical professionals, experienced caregivers have worked with and around the clinical and medical staff in a support role and have an understanding of what they can and cannot provide. 

The care plan serves as a sort of contract between the person needing care (or their power of attorney or designated representative), health care professionals, and the one providing care. Care plans are especially important for individuals with dementia or Alzheimer’s since they help keep everyone grounded about what can and should be done every step of the way. 

Assistance With Activities of Daily Living and Instrumental Activities of Daily Living

One of the clearest areas in which a caretaker can provide support is by helping the individual with their activities of daily living, or activities of daily living. There are six to seven basic activities of daily living to be considered when assessing a person’s ability to function in their own home or space, and most of these activities of daily living are related to personal care. Additionally, there are also instrumental activities of daily living (IADLs), and these are assessed as a way to determine how or if the individual can live independently in the community. 

For the most part, individuals lose some of their instrumental activities of daily living before they begin to lose some of their activities of daily living. Qualified caregivers should be able to assist with basic activities of daily living, and many caretakers can also assist with instrumental activities of daily living. 

Assistance with Mobility and Transferring

Whether the individual walks alone, uses a wheelchair, or uses a cane or other assistive device, a caretaker can help them get where they want to go. When mobility is limited or restricted, the caregiver can assist with getting the things they need while working to prevent unnecessary falls or injury. Transferring, or moving from one body position to another, is another ADL that is often related to ambulating. Getting out of bed and into a chair, or standing up from a sitting position, can be difficult, and the caregiver’s job is to use proper support and lifting techniques to assist the individual with these two important daily tasks. 

Assistance with Nutrition: Preparing Meals, Grocery Shopping, and Eating

While the act of eating, specifically, of moving food from the plate or bowl to one’s mouth, is a primary ADL, the whole process of planning meals, acquiring food, and preparing nutritious, tasty meals is something that a caregiver can assist with. Making lists and taking your loved one shopping may be part of the duties of the caretaker if the individual is ambulatory, but the caregiver may also do these things independently.

 Food preparation and assistance with eating is one of the more common expectations for caregivers, and they may be asked to work within a specific diet plan that ensures optimal health while limiting possible medication interactions or physical reactions to food intake. Monitoring and encouraging fluid intake and appropriate calorie intake (which through solid foods or through nutritional supplements like Ensure) can help keep your loved one from experiencing malnutrition or dehydration. 

Helping with Personal Hygiene: Oral Care, Bathing, and Toileting

This area is one that can send the most dedicated family caregiver looking for help from a professional. Experienced caretakers can take over these intimate duties by helping the individual with maintaining dental health (brushing teeth, encouraging mouthwash when appropriate, soaking dentures) and by helping the person with toileting, bathing, and cleaning up after being sick. It is especially important for the caregiver to have experience working with the elderly individuals and to demonstrate patience and compassion, as this kind of assistance helps your loved one maintain a level of dignity and relative control over their bodily functions. 

Other personal hygiene tasks may include some that people do not usually think about. Trimming and cleaning toenails and fingernails, for example, is often difficult for those with arthritis or trouble bending over, and this is one more thing the caregiver can take off the plate of family members. 

More Than Robes and Socks: Help with Dressing and Grooming

Fastening buttons, managing zippers, and lifting arms and legs can seem like a bit much for individuals with joint and ambulation issues. A caregiver can help select appropriate clothes as well as assist with getting the clothes on and off. In addition, caregivers can provide basic assistance with brushing hair, and, in some cases, even with applying make-up or other products to help the person in their care look and feel their best.

Memory Support

For loved ones with brain damage, dementia, or Alzheimer’s, the loss of short- and long-term memory and its side effects can be especially troubling. Caregivers can help orient your loved one to time and place, and, in some cases, conduct basic memory exercises and assessments. 

Medication Management and Medical Advocacy

Management of prescription medication is another caregiver task that can prove invaluable. Picking up prescriptions, sorting them, and providing medication reminders is one of the ways a caretaker can ensure that your loved one is taking their medications as prescribed and any side effects are noted and reported. Getting to and from doctor’s appointments and following a care plan are other ways a caregiver can provide support to the senior loved one as well as the family, and they should also monitor for new symptoms, such as bedsores or worsening short-term recall. A dedicated caregiver can also keep tabs on medication supply and proper storage, such as ensuring pain medications are counted and locked away for safekeeping. 

Light Housekeeping and Household Management

An in-home caregiver may also provide light housekeeping, especially as it relates to the comfort, safety, and hygiene of the person they are supporting. Washing dishes, changing bed linens, and sweeping or vacuuming are all duties that a caregiver may perform as part of their daily duties. Other things, like making sure pathways are clear for wheelchairs, maintaining appropriate temperatures in the home, and organizing refrigerators and/or pantries are all things the caregiver can do to assist with the independence and quality of life of the individual. 

Depending on the agreement between the caregiver and the individual (or the individual’s authorized representative), an in-home caregiver may also pick up and take up trash, pick up mail, and do laundry. Simple repair and maintenance tasks, like unclogging a drain, changing a light bulb, or watering flowers can also fall within the duties of the caretaker. 

Providing Companionship 

One of the less talked about concerns of having a loved one who wants to maintain their independence is the probability of increased loneliness, depression, and anxiety. Simply by being around, the caregiver provides an antidote to the emotional isolation felt by some older adults. In addition to the personal care tasks the caretaker takes charge of, they also serve as part of the person’s de facto emotional support system, and this aspect of care is as important in many ways to the well being of the individual as all of the other activities that support activities of daily living. 

Reading newspapers, books, or religious texts is something that many seniors enjoy, and when they struggle with vision or focus, a caregiver can read aloud to them. Finding and putting on movies or videos, putting together jigsaw puzzles, playing cards or board games, and just sitting together are all activities the caregiver can assist with as a way to give emotional support and intellectual engagement for the person in their care. Sometimes, things as simple as looking up a telephone number and helping someone make a phone call is exactly what your loved one needs to feel empowered and connected. 

Getting Around Town: Transportation Support

Providing transportation can go beyond ferrying your loved one back and forth to doctor’s appointments. In addition to ensuring the individual makes it to medical appointments and helping them run routine errands, some caregivers can offer scenic drives to help get the senior out of the house, and they can coordinate other types of outings as well. Going to the zoo or aquarium, taking a walk in a park, attending religious services and study groups, or just window shopping are all ways the caregiver can help your loved one with experiencing the world outside their home or nursing facility.

Financial Management and Paperwork Support

Some advanced caregivers can also provide insight and support for some of the financial aspects of household management and medical advocacy. Although the senior person may have a family member who is serving as a financial power of attorney, the caregiver may be able to help with filling out forms for health insurance or Medicare/Medicaid, paying bills, and reviewing billing statements for accuracy. Of course, any individual who has access to bank accounts, credit cards, or checkbooks should be someone who has a history of dealing with someone else’s finances and be someone the family trusts to make good and timely decisions regarding when and how the individual’s money is used.

Monitoring and Reporting, or The Caregiver as the Eyes and Ears

Although the caregiver may be limited in what kind of medical care they can provide without a clinician or physician present, they can provide the sort of home health care tasks that help maintain and monitor the individual’s status quo. Taking and reporting blood pressure readings, 

monitoring home physical therapy tasks, and watching for bedsores or other sick bed manifestations all fall under the umbrella of the home health aide or caretaker. Activities that range from the daily monitoring of blood sugars and other vitals to communicating with caseworkers about any gaps in the care plan can often be shouldered by the caretaker. 

Since it is not uncommon for a person who needs a caregiver to have multiple treatment providers, some caregivers can also help coordinate visits and communication between physical therapists, PCPs, and specialty providers. Whether they report health status and any relevant changes to the physician, designated family representatives, or to the person in their care, the professional caregiver can serve as the eyes and ears that others can rely on for objectivity and consistency. 

• 

Putting It All Together

Whether you are beginning to plan for acquiring a caregiver for yourself or loved or assessing your current caregiver, hopefully, this guide has provided some examples of the wide-ranging scope of a caregiver’s myriad responsibilities. Caregivers may not do each of the things listed here (and you may not even want them to do all of these things), but the checklist below will give you an idea of what to explore when you are considering what level of caretaking you and your loved one need. 

Caregiver Duty Checklist of Items to Discuss or Consider:

• Mobility: This activity of daily living involves walking, using a wheelchair, or ambulating with or without assistive devices. In other words, mobility is generally about helping the person get around the house or facility. 

• Transferring: Another activity of daily living, this includes things like moving from the bed to a chair, from the wheelchair to toilet, going from sitting to a standing position or getting into bed.

• Nutrition: Proper nutrition is a concern for elderly individuals as well as those with chronic health conditions, and this includes planning for meals, shopping for groceries, preparing meals, feeding, following specified diet plans, as well as monitoring and encouraging fluid intake.

• Toileting: This area is critical as it involves getting to and from the commode, cleaning up afterward, and dealing with any urinary or fecal incontinence.

• Bathing: Another aspect of daily living, bathing can mean providing sponge or bed baths, washing hair, and using the shower or bathtub in a safe way.

• Oral hygiene: Many common conditions are exacerbated by poor dental health, and this focus area includes using mouthwash, brushing teeth, or cleaning dentures.

• Dressing: This involves picking out clothes and well as dressing and undressing.

• Grooming: This is not an ADL, but it may include drying or styling hair, applying make-up, using lotions or powders, and trimming fingernails and toenails.

• Medication management: One of the biggest problem areas for anyone on multiple medications, this area may include picking up prescriptions and vitamins, sorting and monitoring timely dosages, and keeping high-risk medication in a safe place.

• Medical advocacy and support: Ensuring compliance with the care plan, maintaining a medical appointment schedule, taking vitals, monitoring blood pressure, testing blood sugars, and monitoring basic memory functions is part of what many expect from a caregiver.

• Transportation: Driving to and from doctor’s appointments, attending church or community activities, traveling, taking scenic drives, and visiting friends or family is also an important function. 

• Companionship: Engaging in activities, reading aloud, playing games, watching programs, chatting, and making phone calls is another set of tasks. 

• Housekeeping and home management: This may include doing laundry, dusting, sweeping, mopping, changing bed linens, doing dishes, watering plants, checking mail, unclogging sinks or toilets, or changing light bulbs.

• Paperwork and finances: This is not something all families want, but it can include paying bills, reviewing billing statements, and filling out health insurance or other forms.

The list above is not meant to be comprehensive, nor is it meant to indicate that any given caretaker will provide all of these services. The checklist is simply meant to be a guide for families and would-be caregivers as a framework to discuss tasks they consider essential, tasks they cannot or will not support, and tasks that may depend on changing circumstances. 

If you are a caregiver or would like to find a caregiver for your family or facility, Care As One’s job board and hiring platform can help you on your journey. 

Building a strong nanny resume is not that different from building a traditional resume. A note-worthy nanny resume contains several key pieces of information, such as education and work experience, but many of the free online resume builders are geared toward corporate jobs. The best nanny resume examples will often look more like the resume of a teacher or healthcare provider, and they go beyond the standard sections to include things that are unique to the position of a childcare provider, particularly if the position desired is a full time or live in nanny. 

This post will take the would-be nanny or the experienced child care provider through the steps necessary to build a resume that catches the eye of potential employers, but it can also be used by former nannies and even babysitters who are transitioning to a new job.

What’s the Goal of a Resume? 

Many job seekers think the goal of a resume is to get the job they are applying for, but that is not the case! The goal of a good resume is actually a little more straightforward than that. The goal of any successful resume is to get noticed by a prospective employer enough to land an interview. Many job seekers struggle with balancing how much information to include as well as the best way to describe their experiences (work experiences as well as education, volunteer, and life experiences). Since studies have shown that most employers spend no more than seven seconds on each resume, having a succinct, memorable resume is critical to getting to that next step. 

Look, Brainstorm, and Compare

A resume is your best way to make a positive first impression, so investing some time to make your nanny resume showcases your skills and abilities to their best advantage is critical. Before you even pull up that blank page (or pull out that resume that has not been updated for five years), start by researching target job ads for positions in your field. As you review the postings and job descriptions, make a list of the knowledge, skills, and abilities (KSAs) that seem important in the nanny jobs that are most attractive to you. 

Now, set that list to the side and start brainstorming. List everything you have done that seems remotely relevant or that you would want a potential employer to know about you. Job history, childcare experience (anything from watching your little brother to working in a pre-K), volunteer experiences, special projects, skills, hobbies — anything you can think of should be written down.

Compare your brainstormed list to the KSAs you found from searching through available nanny jobs. Highlight any items from your list that map to the desired knowledge, skills, and abilities of the job description of your desired nanny position. Take special note of the terminology from the job posting, and, where appropriate, update your own list of KSAs using language (key words and phrases) that is similar to the descriptions on the posting. This background work and preparation will equip you with what you need to draft a nanny resume that highlights how well you fit with what the prospective employer is seeking. 

Resume Formatting Basics

The first basic question in resume writing is what format to use. May employers will specify if they prefer a Word document, a PDF file, or some other method, but as far as templates go, you can find a number of sample nanny resumes and nanny resume templates simply by searching for nanny resume examples online. In addition, Google Docs and Word and a variety of other programs offer downloadable templates that can be filled in and then saved to whatever format you desire. In many cases, the templates can be finicky with very defined spacing, embedded tables, and prescribed color schemes, so lean toward simpler templates if you decide to go that route. 

As you draft your resume, you may be tempted to make it appealing through creative fonts, unusual color schemes, and specialized formatting. In many cases, this can make the resume appear unprofessional or amateurish. Judicious use of bold, UPPERCASE, italics, different font sizes, and bullet points can add visual interest while also making the resume easy to read and scan for key information. Remember, if you only have seven seconds to catch someone’s attention, you need to make it easy for them to put your resume in the interview rather than the discard pile. 

How Long Should My Resume Be?

Most of the best nanny resumes are only one page. If you challenge yourself to limit your resume to one page, you will force yourself to use words that are descriptive without being repetitive, to consolidate similar tasks and experiences, and to use the space you have to its best advantage. Don’t panic, though, if your resume runs a bit longer. Just make sure you are being as concise as possible. Two pages of relevant, non-repetitive information may be what you need, especially if you have a longer work history.  

Headings, Objective Statements, and Summary Statements

Your name, usually in a larger, bolder font than the rest of the resume, should be listed at the top of the resume, along with your address, phone number, email, and any social media handles. It is poor form to use an email from your current employer, e.g., nannylady@bigcompany.com, so use your personal email in your contact information. If you run a blog or website, have a LinkedIn profile, or have links to creative works or projects, you may also wish to include that information in the header. 

The first section of many resume templates also includes a section for an Objective Statement or a Summary Statement. While objective statements are often considered outdated (after all, the objective is usually some version of “to get the job I am applying for”), summary statements can be useful, especially to the nanny resume. Summary statements are just that — a one or two sentence statement that quickly summarizes the resume. For example, something along the lines of, “Patient, capable nanny with 3+ years of experience caring for children from newborn through age 15. Former swim instructor and lifeguard with CPR certification, a clean driving record, and familiarity with potty training as well as pre-teen outdoor adventures.” is really all you need in this section. 

Education and Training

If you do not have a lot of relevant work history or if you are still attending college or university, the next major section of the resume is typically the Education and Training section. Lead with the highest level of education (even if that education is still in progress). If education is still in progress, list the expected graduation date. If your GPA is 3.5 or higher, you may wish to include that info as well as noteworthy achievements such as the Dean’s List, Honors College, leadership positions, awards, or scholarships. 

Resumes of college students or college graduates do not usually include high school, but if there was something noteworthy about your pre-college academic experiences, such as attending a performing arts school or exclusive prep school, you may wish to include as it provides a possible way to connect with or stand out for potential employers. 

Work Experience

If you have an impressive work history or if it has been some time since you have been in school, the Work or Professional Experience section may come before the Education section. For many parents and prospective employers, this is the most important section to determine if what you have done before has adequately prepared you for the task of managing young children. 

As you list your jobs and job duties, be flexible. If you have had lots of similar jobs back to back, it is acceptable to group them together under a primary job title, though generally the work experiences are listed in reverse chronological order. Freelance Nanny, Full Time Nanny, and Part Time Nanny are all perfectly acceptable ways to categorize past experience as a nanny. If you have worked in high-population areas such as New York City or have worked for a well-known family, be sure that you include that kind of information (with the family’s permission, of course). 

Babysitting and other types of nanny services are common, so do not shy away from your experiences with younger siblings or neighborhood children, and make sure that you list anything unique about your past childcare experiences. Resume experts and recruiters alike will confirm that anything that makes you stand out in a positive way can be useful. For example, if you have ever worked with a child who had special needs or provided care to an elderly person with dementia, make sure your resume reflects that desirable skill, even if you are not applying for a position that involves those particular situations. 

If you find yourself stuck trying to remember what exactly your duties were, take a look at current or former job descriptions. It is likely that someone has already spent a lot of time describing what a past, current, or desired job entails, so you can use the job description as a jumping off point. 

Use bullet points and brief summary statements in this section. Good active verbs for nanny duties may include taught, modeled, supervised, promoted, sparked, administered, and so on. 

Do’s and Don’ts of the Successful Nanny Resume

The best nanny resumes, like most other resumes, can be counted on to include certain characteristics, so below are some resume tips on what to do and what to avoid when crafting the perfect resume. 

Do:

• Employ strong verbs

• Consolidate experiences when possible

• Use present tense for current work

• Use past tense for previous work

• Include fact and details that convey the scope of responsibilities

• Borrow words and phrases from job descriptions if appropriate

Don’t:

• Talk about religion, politics, ethnicity, sexuality, or disability unless the job description explicitly states that this information is relevant. Now, if you led the Pride Parade, served as secretary for the Black Student Alliance, or ran your church’s daycare, that can be included as evidence of organization skills, leadership, or community engagement.

• Be passive. Passive tense or phrasing that puts you in a passive role does not do you any favors. For example, rather than saying, “Helped manager with Spring Fling,” consider “Coordinated meal and venue services for Spring Fling, a 500-person event that raised $100,000 for cancer research.”

• Be redundant. Say it once, and say it well. 

• Use empty or self-evident phrases such as, “managed time wisely” or “handled other duties as assigned.” Instead, lean toward the facts. For example, did you manage budgets? If so, what was the budget and how long did you manage it? 

• Exclude meaningful or long-term work experiences, even if they do not feel 100% relevant to the nanny job. For each job, ask yourself questions like, “Did you provide mentorship to peers or other workers? Was your team or shift recognized for efficiency, service, or teamwork? What did other people say about you? How can what you did before translate to the responsibilities of your desired nanny position?

• Overemphasize or underemphasize scope and nature of former or current job responsibilities

Maybe:

• Include a photo. These are optional unless requested. If you do choose to use a photo, consider using a headshot with good lighting and a winning smile. 

• Include noteworthy successes of the children you have nannied, e.g., taught French to both toddlers. In a resume the focus should be on you, not your former young charges, so consider limiting anything about them to one or two details that include any measurable progress you helped the child make in any significant areas if applicable.

• 

You Gotta Have Those Skills (and Certifications and Licenses)

While in many standard resumes the skills section can be an afterthought or even left off altogether, the skills section of the nanny resume is crucial in conveying what specific skills, talents, or prerequisites you bring to the job. Nanny resume skills can be divided into hard skills, such as first-aid certified in newborn resuscitation or the ability to teach piano, as well as soft skills, such as creative approaches to learning or high-energy activity planner. 

The Skills section may also include things that are not so much skills are they are key facts, such as having a clean driving record or the ability to speak other languages. If you have the resources or connections to schedule desirable play dates (especially important for high-end nanny jobs in more exclusive zip codes), include that info as well! If you have other skills or hobbies that a potential employer can connect with, like running an Ultimate Frisbee competition, finishing a marathon, or solving a Rubik’s cube in under a minute, the Skills section may be a good place to include that info. 

Nannies are typically expected to have certification in Infant CPR and Pediatric First Aid, and some positions require Water-Safety Training, Child Development Associate Certification, and/or nutrition and fitness training. Be sure to include any type of training and certification that is typically expected (remember those KSAs we talked about earlier) as well as any that may set you apart from other applicants. 

Groups and Associations

It is usually a good idea to include any associations, clubs, volunteer experiences, publications, or presentations that you have to your credit. If you have been a member of an orchestra, an athletic team, or something similar, you will want to include that as well. Any position of responsibility with your roles should also be highlighted. 

Nanny Resume Example Outline, a Recap

Below is a high-level outline of a sample nanny resume that can be customized into your desired template or format. The order and key components will, of course, vary based on your own preference, your background, and your desired position. Even if you have been a nanny but are now moving into a different role, the nanny resume sample statements throughout this post should be able to help you see how to list nanny experience on a professional resume. 

When building your own resume, be flexible. There is no one right way to do a resume, just as there is more than one way to be a successful nanny. Explore a variety of nanny resume templates as you work to create a resume that uniquely represents you.

• Name and Contact Info, along with links and social media handles
• Summary Statement, descriptive statement with years of experience and relevant summary info
• Education and Training, university status and relevant studies
• Work or Professional Experience, including relevant as long-standing work experiences
• Skills, Certifications, and Licenses, along with dates of expiry if applicable
• Other Associations and Experiences, such as groups, teams, and volunteerism

Now What? 

Now that you have drafted a strong nanny resume, what next? When you reviewed job postings, did anything catch your eye? As a job seeker, one easy way to connect with potential employers is to register yourself and your resume with a job posting forum such as Care As One that specializes in supporting employers and job seekers in the childcare and elder care industry.  

Families navigating care options for their elderly loved ones are faced with a dizzying array of choices to make in order to ensure the best care for their loved ones. Although many seniors are not interested in moving to a nursing home or assisted living facility, families may find that their loved one still requires more care and support than can be provided by family members or part-time home health aides. In these cases, families and seniors may wish to consider working with a live-in caregiver. 

This post will explore what live-in care entails, who may benefit from live-in care, and other considerations for families and seniors when evaluating if live-in care is the right choice for their situation.

What Is Live-In Care?

Live-in care is focused on allowing an individual to remain in their home while receiving round-the-clock support and monitoring from a caregiver or home health aide. Live-in care can be a temporary arrangement following a surgery or a health crisis, or it may be a long term solution to support someone with chronic health conditions or declining abilities who wants to remain in the comfort of their own home. 

Live-in care can provide peace of mind to families who want to ensure consistent care, familiar surroundings, and the best quality of life are available for their loved ones. Even though many consider residential care in one’s own home as a better option than a nursing home or other alternatives, it is important to understand what to expect and what to look for when considering live-in home care. 

Although having a full-time caregiver who moves into the home with the care recipient is what many people think of when they think of live-in care, there are actually a few options regarding how full-time care is rendered. After working through a care plan to evaluate wants and needs, families may consider hiring care providers for eight, ten, or twelve-hour shifts so that someone is available during waking hours only, or they may opt for alternating care providers who take over for each other (or for a family member) at the end of each individual’s multiple-hour shifts. This latter arrangement can be compared to in-home elder daycare, especially if a family member or close friend is able to provide care overnight or in the evenings after work. 

It is also important to understand that, in most cases, a live-in caregiver does not actually move into someone else’s home. Caregivers typically have their own homes, but they can stay and even sleep in your loved one’s home in shifts that can last for 24 hours or several days. Since the focus of live-in is to have a constant presence in the home, some live-in care providers alternate shifts with other in-home care providers so that your loved one always has a familiar face providing support. Home health agencies can help validate and coordinate care among their available care providers. 

Another factor to consider is whether the individual who needs care actually needs 24 hour, full-time care. In other words, do they need someone to be awake and monitoring their condition at all times, or can the caretaker sleep in their own room while their charge also rests? If so, then live-in care from a single person is an option since they can adjust their own rest schedule to provide waking care with the person they are caring for. If the individual truly needs care and monitoring for 24 hours a day, then alternating caregiver shifts will be required. 

Who Can Benefit From Live-In Care?

People who need live-in care typically experience difficulty with one or more activities of daily living (ADLs). Activities of daily living include the ability to do the following things without assistance: 

• Walking or ambulating: This may include getting around the house, checking the mail, and the ability to do these things without a significant fall risk (with or without assistive devices). 

• Transferring: This involves moving from one position to another, such as getting out of bed or moving from a sitting to a standing position.

• Toileting: Toileting covers everything from one’s ability to maintain fecal and urinary continence to sitting down on the commode to appropriately cleaning oneself. 

• Feeding: This activity of daily living is not about procuring and preparing food, but rather about the ability to get food from a plate or bowl into one’s mouth.

• Bathing: Showering, bathing, and generally keeping oneself clean is another fundamental activity of daily living. 

• Dressing: Pulling on pants and shirts, fastening buttons, and closing zippers all fall under this ADL. 

• Grooming: Things like clipping fingernails and toenails, drying and styling hair, and applying lotions or powders are examples of grooming actions. 

• Performing Basic Memory Functions: Although short-term or long-term memory loss is not necessarily an “activity,” it is often considered under the umbrella of functional ADLs since short- and long-term memory is essential to completing most of the other activities. 

Early indicators that an individual’s ability to perform functional activities of daily living is declining may include observed limitations in the instrumental activities of daily living (IADLs), such as preparing meals, doing housework, shopping for groceries, managing medications, making phone calls, paying bills, and/or getting to and from places in the community. 

Some of the people who benefit most from live-in care include individuals suffering from conditions that affect the memory and the person’s ability to orient to time and place. This is commonly seen in individuals with Alzheimer’s, dementia, or other neurological conditions. 

Other medical conditions that can create the need for live-in care include neuromuscular conditions like amyotrophic lateral sclerosis (ALS, also known as Lou Gehrig’s disease), Parkinson’s, multiple sclerosis, and muscular dystrophy. Individuals who have experienced strokes or severe injuries, patients recovering from surgery, and individuals with disabilities may also benefit from in-home assistance or live-in care. 

What Are the Benefits of Live-In Care? 

The clearest benefit of live-in care is the person in need of care remains in the comfort of their own home. For elderly people or people with chronic conditions, in-home care can support a sense of independence and a higher quality of life than the individual would find in someone else’s home, a nursing home, or an assisted living facility.  

Live-in care includes a care plan that is personalized for the needs of the individual and is based on the expectations set forward by the individual, doctor, family members or other representatives, and any social workers and others who are invested in the care and treatment plan of the person. The overall goal of any care plan is to improve or maintain the individual’s quality of life. 

Some of the other benefits and services that can come from in-home care include improved safety for individuals who have a high fall risk, regular exercise or physical therapy support, and appropriate nutrition. Grocery shopping, meal planning, meal preparation, and assistance with taking in food and fluids are all areas in which the in-home caregiver can help support the dietary needs of the individual. Medication management, from picking up prescriptions to ensuring timely and appropriate dosages, can be overwhelming, and this is another of the burdens that an in-home caregiver can take off the plate of the individual and their family.

Light housework, running errands, and socialization, either through outings or simply through companionship, are all things that a caregiver can provide as a way to ease the mind of families and friends alike. Simple activities like a conversation, watching a program with someone, or playing a game can engage the individual and ward off feelings of isolation. Lower levels of depression and anxiety are also a positive outcome for individuals who have an in-home companion, and families also experience lower levels of stress when they know their loved one is in good hands. 

Depending on the details of the care plan, an in-home caregiver may provide transportation to and from doctor’s appointments, as well as to community and religious events. Taking the dog for a walk, watering plants, and helping with letters, phone calls, and even bill-paying can all be areas in the in-home caregiver can help support a high quality of life for the individual in their care. 

What Kinds of Questions Should I Be Asking of My Loved or the Caregiver?

It is critical for anyone considering live-in care to understand what kind of and what level of care is needed. Some of the types of questions to explore before or during the development of a care plan include the following:

• Do they need assistance with catheters? Do they struggle with urinary or fecal incontinence? Can they go to the bathroom in the middle of the night by themselves? 

• Do they need support all day or does their condition only get worse during certain times, like sundown or during the night? Can they sleep through the night but struggle to get out of bed in the morning? 

• Are they isolated or alone? Are you worried about depression, anxiety, or other aspects of their mental or emotional health?

• Are they missing or confused by medications? Do they need assistance monitoring blood pressure or blood sugars? Do their medications have side effects that need to be addressed? Are they compliant with medical recommendations? 

• Does their condition require special attention to diet or fluid intake (as with most diabetics and patients with heart disease)? Are they able to chew and swallow without medical support? Are they able to plan meals and acquire food? Can they prepare meals consistently and safely? 

• Can they get where they need to go, both inside the home as well as in the community? If not, can the caregiver support them with mobility? If they need transportation assistance, will the caregiver be able to drive them? If so, will the caregiver be driving their own vehicle, their client’s care, or escorting them on public transportation like busses, taxis, or subways? Does the caregiver have an unrestricted and a good driving record?

• Is their condition chronic or temporary? Are their symptoms stable, improving, or getting worse?

• Is your loved one open to the idea of in-home care? Do they have (or have they developed) personality traits or behaviors that you need the caregiver to be aware of and okay with? 

• What kind of expectation do you and your loved one have about privacy? Should the caregiver report changes or concerns to the individual, an agency, a specific doctor, a family member, or someone else? Who has “final say” in decisions made by or on behalf of your loved one? 

• Do they need specialized support due to memory loss or other chronic or progressive conditions? Does their condition put them at risk for wandering off? Are they prone to bed sores or other conditions that need monitoring? 

• What kind of references and experiences can the caregiver provide? Did the agency do a background check? If you or your loved one has a concern with the type or method of care provided, what options exist for replacements or breaking a care contract? 

After reading through the questions above, you may find that you have other questions you will need to explore with your loved one and any potential caregiver. These questions are provided to give you an idea of the scope and focus areas that may need to be addressed as you explore the options for ensuring you or your loved one has the best quality of life possible. 

How Much Can I Expect to Pay for Live-in Care? 

Given the variety of live-in care options in terms of the level of service provided, length of shifts, and experience and training of the live-in caregiver, costs can vary. Other factors, like the location and reputation of the agency providing access to live-in caregivers, can also affect costs. In some cases, at least some aspects of live-in care costs may be covered by medical insurance or Long Term Care insurance, so always be sure to check and file the necessary paperwork to get financial assistance if needed. Medicare does not typically cover costs associated with live-in home care, though low-income seniors may be eligible to receive some assistance with costs through Medicaid. 

When working with a caregiver who stays and sleeps overnight, the hourly cost can be less because the caregiver is not actively monitoring and supporting the individual during the night. For caregivers or agencies that bill by the shift (rather than by the hour), most people can expect to pay anywhere from $100 to $300 per day for high-quality care, and hourly costs typically range from $15 to $25 per hour. National Public Radio (NPR) shared a MetLife Market Survey that was conducted in 2011. The study evaluated care costs for the elderly, and the low, average, and high hourly costs are broken down by state (including major cities within each state), by facility or type of care (nursing home, assisted living, adult day care, home care), and by care provider (home health aide vs. homemaker). Note that hospice and end of life care are different from live-in care, and hospice services are often covered by local government and charitable agencies and/or Medicare or health insurance. 

How Do I Find a Live-in Caregiver? 

Organizations like Care As One provide job applicants, home care agencies, and individuals with access to databases that match job seekers with available positions. Home care agencies, like live-in caregivers, may be licensed or unlicensed, and it is important to check the credentials of any agency or individual you choose to interview. 

Licensed agencies and/or agencies authorized by Medicare follow local regulations and governmental guidelines for hiring and screening caregivers. Screenings for qualified caregivers may include mental and physical health assessments, criminal background checks, verification of any treatment specialties (such as dementia care and medical certifications), as well as evaluation of references and past experiences. 

Local assisted living facilities and government organizations may also provide support and direction for individuals seeking high-quality live-in care. Doing a couple of online searches and making a few calls is a good way to feel out the resources available in your area. In addition, church groups and community organizations are often filled with people who have experience with the many considerations that come from caring for disabled or elderly family members, and simply talking through options with someone who has gone through it all before can be reassuring for all involved. 

As you work through the questions, the various alternatives, and the best- and worst-case scenarios for your loved one’s care options, consider what you would like or expect if you were in the position to need care yourself. A quality caregiver is an employee, but they are also intimately involved in some of the most private aspects of your loved one’s life. As such, it is important to find a live-in caregiver who is trustworthy, dependable, and dedicated to ensuring a high quality of life for your loved one. The right personality and experience of the caregiver help ensure that everyone benefits from the in-home care experience. 

As a parent, one of the toughest and more important decisions you can make is finding the right childcare solution for your little ones and young teens. Babysitters are a good option for a weekend or a night out, but most babysitters tend to be young (in some cases, they are not much older than the children they are babysitting) and relatively untrained. Daycare centers are another option, particularly for parents who have regular work and activity schedules, but they offer little flexibility, are geared toward younger children, and they can become cost-prohibitive quickly if more than one child is in daycare. 

Many parents are also concerned than babysitters and daycare workers are not as invested in the care of infants and very young children, whether due to lack of training or because they have other children to attend to, so parents find themselves looking for someone who can meet their children’s needs as well as provide a level of reassurance to everyone in the household that the children are in good hands. 

Since some of the most common childcare options leave many parents wanting more out of the childcare experience, parents turn to services or individuals who can offer at-home care for their children while providing the social, physical, and intellectual stimulation children need to thrive. Au pairs and nannies can both be good options, but what factors should parents consider when evaluating the option of au pair vs. nanny? 

This post will review the cost of childcare for each option, the types of services a family can expect, and the benefits and drawbacks of au pairs as well as nannies. 

What Is an Au Pair? 

First, it is helpful to understand exactly what an au pair is (and is not). The term au pair comes from French, and it means at par, or equal to. In other words, an au pair is not an employee or a domestic worker, but rather a temporary member of her host family with a status that is similar to that of the other family members.

Au pairs are further understood to be young people, at least 18 years old but no more than 26 years old, who leaves her home country to live with a family in another country. As part of the arrangement between the au pair and the host family, the au pair provides childcare and other basic services in exchange for room, board, and a weekly stipend or allowance. Au pairs are expected to have completed about 32 hours of specialized training in child safety and child development. 

In the United States, au pair programs and placement services are monitored by the U.S. Department of State, and the arrangement between the au pair and the host family is considered part of a broader, regulated cultural exchange program. The host family of an au pair in America provides the young person an opportunity to improve their English language skills (note that most au pair programs require the au pair to be able to communicate effectively in their host’s language) while incorporating the au pair as part of their family for many of their vacations, events, and meals, through the host family and the au pair can expect to have time apart. Au pairs are expected to have a private room as well as free time for socializing or studying, and they can live and work as au pairs in the U.S. for anywhere from three months to two years. While in the U.S., many au pairs are required to complete university coursework as part of their ongoing education and cultural exchange. 

How Would I Find an Au Pair? 

A number of au pair agencies and placement services exist across multiple continents, all with varying laws about required training, fees, services provided, and visas or documentation that is required for work in and travel to the host country. Au pair agencies facilitate placement of au pairs from different countries to host families, and the U.S. State Department has designated 12 to 15 sponsoring au pair agencies, including Cultural Care Au Pair and American Cultural Exchange/Go Au Pair. These agencies are authorized to serve as intermediaries for au pair placement in compliance with the foreign and domestic regulations. In the U.S., these agencies may also conduct background screenings and verify that the foreign au pair has met all of the training requirements to serve as an au pair in the United States.

How Much Does an Au Pair Cost?

When working with reputable agencies, the host family can expect to pay anywhere from $7,500 to a little over $10,000 in application fees and program fees. These fees go toward the arrival expenses of the au pair, medical and other insurances, training and compliance verification and documentation, and fees to the agency for their placement and host family matching services.

Weekly au pair costs are typically estimated at about $350 per week, but this can be variable based on the number of children, the expertise level of the au pair, and the family’s own spending patterns for meals, travel, and lodging. The minimum allowance or weekly stipend for an au pair to use for her own personal expenses is just under $200 per week. The host family may have to pay an additional amount for car insurance expenses for a foreign national as well as contribute up to $500 toward the au pair’s credit hours and education. Since the au pair is part of the host family, dinners out, travel expenses for vacations and other costs are assumed by the host family on top of the weekly payments to the au pair. 

Some programs allow au pairs to work fewer hours per week for a lower minimum weekly stipend, through the family may pay up to $1,000 toward the au pair’s education. This option is popular for parents with children who are in school. However, for families with children under two, au pairs must acquire an additional 200 hours of childcare training, and au pairs are not allowed to assume the sole responsibility of infants who are less than three months old. Families with children under age two, multiple children, or special needs children may pay more to find the right kind of professional au pair or to have an au pair who has more training and experience. 

What Kind of Services Can I Expect From an Au Pair?

An au pair is not a live-in housekeeper or a household manager. Au pairs can perform a variety of tasks, including ferrying children back and forth to school and to various activities, light cooking and cleaning (especially as it relates to feeding and caring for the children), and overall babysitting, but specific duties vary according to the agreement or contract between the au pair and the host family. Au pairs can generally work up to 10 hours per day and up to 45 hours per week for a flat cost, and they are permitted at least one full day off each week as well as one full weekend each month. 

What Are Some of the Benefits of Having an Au Pair?

Since the ostensible purpose of au pair programs is to provide an opportunity for cultural exchange, it will come as no surprise that one of the largest benefits of inviting an au pair into your home is exposing your children (and the rest of the family) to the language, food, and culture of another country. Most au pair agencies verify that the au pair has completed the necessary training for working with children, and the agencies also have the au pair complete basic psychiatric evaluations and background checks before matching them with a host family. 

Many families enjoy having an extra member of the household who can integrate with the family’s normal routines, and they appreciate the symbiotic nature of providing room, board, and allowance for someone in exchange for receiving basic childcare services that are flexible based on the family’s needs and schedules. 

What Are Some of the Drawbacks of Inviting an Au Pair into My Home?

When acquiring an au pair, the family is not hiring an employee. If the family is not equipped or ready to invite a young woman (although some au pairs are male, the overwhelming majority of au pairs are female) into their daily lives, they will find that the au pair is not a good fit. 

Since au pairs come from a different country, families can expect to have an online interview, but they will not likely meet the au pair in person until she arrives in the States, and this will be well after the host family has paid in the initial application and program fees. Au pairs are typically expected to live with their host family for at least a year, and this concept is great as long as the au pair and the family have similar communication styles, agree to expected childcare duties and methods, and have personality traits that are acceptable to each other. Although no one wants to spend a year with someone who just does not mesh well with the family, many families and young children, in particular, are distressed when the au pair returns to her own country after fulfilling the terms of her contract.

In some cases, a program that supports cultural exchange may also find that there is a cultural disconnect, although au pairs generally try to adapt to the culture of the host country and host family. In addition, families with infants or with children who have special needs may find it difficult to find a qualified au pair with the appropriate skills, personality profile, or experience level to support the family. 

What Is a Nanny? 

Nannies are, first and foremost, in-home childcare providers employed by the parents or guardians. They may live with the family or live in their own homes, and they may work part-time or full-time. They provide all the services that an au pair provides, but nannies typically come from the same country and live (or move to) the same area as the family they support. Unlike au pairs, nannies are employees who earn at least the minimum wage of the local economy, though they can be hired without all of the upfront fees associated with au pair agencies and State Department regulation. As employees, they can be let go if the family finds that the nanny is not a good fit, but many nannies work with families for years and develop long-standing relationships with the children and adults alike. 

Nannies typically offer families a great deal of flexibility for the family in terms of work hours and duties, and they typically have some level of child development training and education, a valid U.S. driver’s license, and safety certifications. 

Where Would I Find a Good Nanny?

Good nannies are in high demand across the United States, and in high-profile areas like New York City or other big cities, finding a good nanny can be as time-consuming as searching for and buying a new home. Short of receiving a personal reference, your best bet in finding a nanny who fits the needs of your household is by working with an agency like Care As One that specializes in childcare and/or home health care services. Validating references, facilitating interviews, assisting with onboarding, and providing a database of nanny profiles is part of what you can expect from a full-service placement agency. 

How Much Does a Nanny Cost?

A good nanny is an investment in the safety and well-being of all members of the household, especially the youngest ones, but many assume that the weekly cost of having a nanny is much more than full-time daycare. In fact, for families with multiple children, special needs children, or infants, hiring a nanny may be as cost-effective as the less flexible option of daycare. So when you ask, “How much is a nanny?”, you must consider all that a nanny can provide. 

Nannies earn at least the local minimum wage, but the average hourly wage for a nanny ranges from the average of $19 per hour to $25 or more per hour, and the rate of pay is highly dependent on location, the education and experience of the nanny, and the needs of the family. Nannies are paid on a weekly or monthly basis, although the specific terms will be laid out in the contract between the nanny and the family. 

Although childcare costs for daycares are on the rise, nanny costs are relatively stable. Like any other employee, nannies may also require consideration for paid time off, insurance benefits, and hours and responsibilities that are spelled out in a nanny contract. 

What Services Does a Typical Nanny Provide?

Nannies are not programmatically restricted in the number of hours they can provide, and qualified nannies can work with children of all ages and need levels. Unlike au pairs or babysitters, nannies are generally expected to create daily schedules for children that include some combination of educational opportunities, social outings, and physical activity. They can drive the children to school and various appointments and activities, and many nannies specialize in providing infant care. 

In addition to the scope of their childcare responsibilities, nannies may also agree to take on housework, shopping, and cooking tasks for the family. Some families also appreciate that a nanny can be any age, and some parents prefer to work with more mature individuals, including those have raised their own children.

What Are Some of the Benefits of Hiring a Nanny?

A nanny’s primary job is ensuring the safety and intellectual, physical, and emotional well-being of the children in her care. Unlike au pairs, nannies have chosen childcare as a profession, and they often have degrees or advanced training in early childhood development or education. This level of investment helps ensure that the children are in the experienced, capable hands of a nanny when their parents are not available. 

Nannies are an investment, so it is important for the family to make sure the nanny is a good fit for the parents as well as the kids. Since nannies are employees, they can be let go if needed. In addition, they are not limited to the types of children they can provide care for, and they can work with the same family for years while taking on full responsibility for the children for days or weeks when the parents are away. 

A nanny’s credentials and references are generally easier for American families to assess, and they generally have their own lives so that families are not the nanny’s only social outlet. Many nannies can offer a sort of co-parenting support in childhood development as well as in helping the children cope with stressful situations. For this reason, nannies can often be a lifesaver for new parents who appreciate working with someone who has done it all before.

What Are Some of the Drawbacks of Hiring a Nanny?

The nanny is an employee rather than a temporary family member, and the parents will need to make sure they managing salary and taxes as well as paid time off and vacation schedules. If the parents are not working with a reputable placement agency, they may also have to conduct their own background checks. Like au pairs or babysitters, nannies do not come with a backup plan when they are sick or unable to work. 

The biggest drawback of hiring a nanny is the same as it would be with any other childcare provider, namely, potential conflicts with childcare philosophies. This can usually be resolved with good communication, but the pre-screening and vetting process provided by companies like Care As One can limit the chance that this will happen.