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Selecting a senior caregiver

Check professional credentials. What is the person's level of training? How long has he been doing this? If someone lists schools or professional accreditation, verify it. Don't forget references. Ask for at least three and call them all, says Elinor Ginzler, manager for independent living and long-term care at AARP. "If someone is not reputable, they may have one person to speak on their behalf. Three is not as easy."

If the worker will be driving mom or dad, get proof of a clean driving record and verify license, insurance and the dependability of the car. Don't be afraid to ask for a test drive, Ginzler says.

Finally, get your parent involved in the process. For Annette Malinsky Sandler, director of the senior program for the city of Plymouth, Minn., that was the litmus test. As she screened workers for her late mother-in-law, she watched how they interacted. If the prospective assistant spoke only to her and ignored her mother-in-law, Sandler knew the worker "wasn't compassionate enough."

Hall monitor
Hiring is only the first step. Continual monitoring is critical with any kind of care, Barlam says.

Discuss with the caregiver the kind of feedback you want. If you need a call after every visit, that's reasonable. If you'd rather have an e-mail note that you can share with your family, that's fine, too.

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"Families should be looking for an agency willing to give them whatever feedback they need to establish a comfort level," says Cathy Lonas, geriatric care manager for Aging Network Services in Bethesda, Md.

Tell the worker upfront that you, family and friends will visit often and unannounced, Ginzler says. If anyone is uncomfortable with the idea, that person might not be the right one for the job.

Look at formal controls. Does an agency or care manager regularly review and monitor workers? Is there someone workers can go to with questions? Establish a plan that allows you to talk to everyone who regularly goes into the house. How are workers getting along and what do they say about each other?

If the helper is doing the cooking, ask to see menus and talk to your parent about the meals. On visits, check that the cupboards are well stocked with fresh food.

Another smart strategy: Before you have a lot of people traipsing through the house, inventory anything that is valuable and portable and secure it, Bartelstone says.

And be sure to explain the house rules. Every home is different and parents have certain expectations. If mom demands shoes come off before a foot is set on her spotless Berber carpet, make that clear in advance.

Follow the money
For some adult children, bills are the big worry. Is mom sitting in the dark because the electric company wasn't paid? But money is an emotional minefield, and a caregiver could complicate, rather than ease, the situation.

Some advocates warn against letting a caregiver take over the bills; most probably are not financial experts. Plus, the worker could conceivably write his own salary check -- a big conflict of interest.

That leaves the family finances to you. Consider getting the least amount of help your parents need, along with appropriate checks and balances. An automatic debit system could ensure regular payments (utilities, mortgage) are made on time. Find out the safeguards that guarantee the debit is equal only to the bill. AARP has a money-management program in many areas for low-income seniors where trained, screened, volunteers help with bill-paying duties.

Could you set up a system to electronically pay these bills yourself and be reimbursed? Or should you add your name to your parent's bank account? If your parent is comfortable with that, says Ginzler, it doesn't take away control from your family member, it simply expands accessibility.

It's also a good idea to check with a CPA or elder-law attorney to make sure any financial move won't produce tax complications for either party, Bartelstone says.

Then there's your bank balance. If you're paying for the care, does that make you eligible to claim your parent as a dependent on your taxes? The short answer: Probably not.

If you want to claim a parent as a dependent, you must meet some steep criteria, says Barry Picker, a New York-based CPA and author of "Barry Picker's Guide to Retirement Distribution Planning."

First, an adult child must pay more than half the cost of the parent's support. If siblings share the allowable expenses, only one gets the deduction. The parent's income, not including Social Security, also must fall beneath Internal Revenue Service thresholds ($3,000 for 2002; $3,050 for 2003.)

If you meet the support standard but your parent makes too much money, Picker says you could still get a bit of a break from Uncle Sam. IRS rules let you deduct parental medical expenses that exceed 7.5 percent of your adjusted gross income. Just be sure to keep great records.

Dana Dratch is a freelance writer based in Georgia.

-- Posted: Feb. 26, 2003
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