Families often ask me how to find someone to help with a loved one who has dementia. Usually a spouse or child has been the sole caregiver and now, as dementia progresses, they are increasingly overwhelmed. Being anyone’s 24/7 caregiver always results in burnout and less than optimal care, so how do you go about finding someone to help?

Schedule those volunteers. Often there are friends and relatives who would like to help but don’t know how. Respond by being specific. Identify a time when the primary caregiver would most benefit from being off duty. Ask the friend if they would be able to come at a specific time weekly, every Tuesday morning or every Thursday afternoon, for a few set hours. I have several clients who benefit from having a longtime friend come visit for an afternoon each week; I know their friends are glad to be able to be in their lives helping in a constructive way. The secret lies in setting up a schedule. It’s much easier to cancel a set visit when something comes up than to attempt to arrange random visits.

Family first, then referrals. The first place to look for help is within your family. Is there someone who would benefit from a paycheck, who already loves the person with dementia? If not, turn to friends and personal networks such as your church or the organizations you belong to. Put up a flyer; ask for referrals. A number of families I know have found that someone who is already providing household services, such as cleaning or gardening, is happy to add a few visits a week as a companion and helper. Turning to people within your network provides accountability, for a friend’s housekeeper needs a good reputation with you to protect her business with your friend and her other customers.

Pay a good wage, always. Whether you hire someone from within the family, or a friend or professional caregiver, set up a schedule for shifts, but also be sure to pay more than minimum wage. Caregiving takes dedication and dementia requires long-term caregivers. Having a constantly changing cast of workers in the home is stressful for the family, but very distressing for the person with dementia, because dementia takes away the ability to learn new things and handle change.

Hire a payroll clerk. I always recommend to families that they have an accountant set up payroll so that the caregivers are covered by federal and state employment benefits and workers’ compensation. In some states, payment for care “under the table” creates a gift rather than expense, hence is recoverable when Medicaid is needed later. Payroll clerk services are surprisingly inexpensive and having proper coverage for those who work with your loved one also protects you from possible employment claims.

What should I look for? When I interview potential caregivers, I look for punctuality, integrity, and compassion. Everything else is teachable if those traits are present. I want someone who is punctual because in the earlier stages of dementia people lose the ability to track time and read clocks and calendars. My clients need to be able to trust us to track time for them; it’s the beginning of learning to feel safe in care. And integrity and compassion are essential when we care for people in their own homes.

Even if you think the caregiving situation is fine right now, always be looking for a good caregiver. One of the kindest things you can do for your loved one is to ensure that his or her primary caregiver has regular, scheduled time off.

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