Hiring in-home care professionals: a step-by-step guide for families

Most families hire in-home help in a hurry: after a hospital stay, a fall, or the moment it becomes clear that one person cannot do it all. Hurried hiring is hard on everyone, including the people you hire. This guide lays out the steps in order, so that even a fast decision is a considered one.

Step 1: Decide what kind of help you need

“Home care” covers very different work. Be specific about the tasks, the hours and the skills. Companion care is company, conversation and supervision. Personal care is bathing, dressing and toileting. Medication support, post-stroke support, dementia care and skilled nursing need training or a license. Around-the-clock care, respite care for family caregivers, end-of-life care, meal preparation, homemaking and transportation are each their own kind of job. The Marketplace has a page for each kind of care.

Write down the schedule you need, the tasks in each shift, anything that needs a license, and what you can afford. Ask the Care Team what level of help they recommend; the family decides who, but the clinicians can say what is needed.

Step 2: Agency or independent?

Agencies recruit, schedule and replace staff, handle payroll and often provide backup when someone is sick. Hiring an independent professional directly can give you more say over who comes and how the work is done, and it puts more of the organizing on you. Many families do both: an agency for some shifts and a trusted independent professional for others. Whatever you choose, check the tax and employment rules that apply to you with a qualified professional.

Step 3: Ask agencies for quotes without sharing the record

You can describe the job without handing over the patient's medical details. In ExpressAgain, Agencies and Quotes lets a caregiver-role account write a de-identified overview, the care tasks, the area and timing, and the schedule options, then share one link. Agencies answer on a public quote page with no login and no access to the care plan, and their quotes come back into the app to compare side by side.

Step 4: Search for professionals near you

The public Marketplace lets families search real professionals who have posted a profile, by the kind of care and a ZIP code. Results are real people, never invented. Names show as a first name and an initial, and contact details stay private until the professional answers a request. You can also post an open care request; professionals see it with your name masked, and a response delivers their message and contact details to you by email.

Step 5: Ask the same questions of everyone

Comparing people is easier when everyone answers the same questions. In ExpressAgain, Find a team member sends a person you are considering a short questionnaire: what you need and whether they can do it, the schedules they could fill, whether they are open to a background check, three references and a proposed rate. It carries nothing about the patient. They answer on their phone without a login, and the answers come back laid out for a decision: accept, propose a different rate, or decline.

• Have you done this kind of care before? Tell me about a hard day.
• Which tasks on our list have you been trained for, and which would you need shown?
• What would you do if our loved one fell, or refused a medicine?
• How do you like to hand over to the next person?
• Which days and hours can you commit to, and what happens if you are sick?

Step 6: Check credentials and sign an agreement

Decide which credentials you require, such as CPR, a license for nursing tasks, a TB test or training in dementia or stroke basics, and ask for copies. In ExpressAgain a professional uploads what they have, or taps I don't have one yet and gets 30 days and a list of where to get it; a card close to expiring turns amber and an expired one red. See Credentials.

Put the arrangement in writing: duties, schedule, rate, how hours are recorded, how notice works. ExpressAgain's Home Team agreements include an Independent Service Agreement drafted from a template, which the professional signs and the family countersigns, or an agency's own contract with its rules listed. The professional fills in the W-9 in the app.

Step 7: Get the first shift right

The first day sets the tone. Walk through the house, the routine and the person's preferences. Share the written day plan and the shift checklists. Give them their own door code rather than the family's. In ExpressAgain, each professional has a Getting started checklist, one next step at a time: learning the app, screening consents, tax documents, how they get paid, credentials, learning about the patient, skills, the house entry code and the pay-release acknowledgment, then I'm ready to work.

Step 8: Keep talking

Check in after the first week, then regularly. Ask what is working and what is not, and listen: the people in your home often notice things first. Pay on time, with the method they chose. And if it does not work out, end it respectfully, with notice, a final invoice and access that ends on the last day.

If you are a professional looking for families who need your care, you can join the Marketplace: a live profile and a real login in one step, with your name masked on the public profile.