People with spinal cord injury (SCI) often need help with tasks of daily living. These include dressing, grooming, personal hygiene, and eating. They also include home management tasks, such as cooking, paying bills, and cleaning. A caregiver or personal assistant can provide that help. In some cases, a family member can fill this role. But in many cases, the caregiver is a paid employee. This sheet gives you more information about hiring a caregiver or personal assistant.

A hired caregiver or personal assistant can help you as little or as much as you need. Work with your SCI care team to help identify the tasks you need assistance with. Caregivers or personal assistants may help with:

• Bowel and bladder care.
• Respiratory care.
• Giving medicines.
• Positioning, transferring, range of motion exercises, and skin care.
• Bathing, dressing, and grooming.
• Food preparation and eating.
• Housecleaning, tidying, laundry, and paying bills.
• Grocery shopping and other errands.
• Driving.
• Wheelchair maintenance.
• Childcare or pet care.
• Transport within and outside the house.

Once you have thought about the tasks you need a caregiver or personal assistant to do, you can create a job ad. Put as much information as possible in the job ad. Be clear about what is needed and expected. This helps to make sure that you will get someone who will fit your unique needs and preferences. Include:

• Kinds of skills that are needed.
• Duties that will be needed.
• Number of hours of work per week.
• Salary and benefits.

Post the ad both online and in public areas that allow job postings. You can ask applicants to mail you a resume and a cover letter. Or you can have people call or email you directly. You can also contact a home health care agency. Some nonprofit groups offer referrals for home health workers. Also ask friends and family. They may have referrals. Or be interested in the job themselves.

Hiring the right person can be challenging. This person will be helping you with intimate aspects of life. You want to find someone you trust and feel comfortable with. Your SCI care team can help you do this. When people respond to your job ad, schedule interviews with the applicants you want to meet. Have a family member or friend attend the interview and take notes. Review the applicant's resume with them. Ask about their experience and education. Describe the job tasks in detail. The person you hire should be comfortable with all aspects of the job. Also be clear about your policies for your home. Discuss schedule and salary. Ask for references from previous employers. Finally, encourage the applicant to ask questions.

When you hire a caregiver or personal assistant, you are their employer. You will need to supervise them. This means having good, clear communication. You will need to:

• Make performance expectations clear and give performance feedback.
• Lay down ground rules about your home.
• Explain the tasks and how to do them.
• Work together to set efficient routines that are helpful to both of you.
• Discuss confidentiality and privacy.
• Have a backup plan for when the caregiver or personal assistant is sick, on vacation, or has an emergency.
• Deal with disagreement or conflict.
• Compromise when needed to help retain a good employee.
• End the person's employment if necessary.

There are some programs that may help you pay for a caregiver or personal assistant. Medicare may help. Worker's compensation or private insurance may cover some of the cost. Ask your social worker for help in finding what resources you may be eligible for. Also note that you may have to pay social security taxes for the caregiver. Ask your social worker or a tax accountant to learn more.