Hiring Good PCAs

Alexa Dectis with personal care attendants in Disney Land.

Living as an adult with a disability means trusting other people to assist you with daily tasks, some of which are intimate or make you feel vulnerable. How you approach hiring personal care attendants (PCAs) to perform those caregiving tasks is a personal choice.

Some people prefer to use a home health agency, which streamlines the process of getting qualified caregivers. Others prefer to find and hire PCAs privately, which allows them control over every step of the process. This method takes commitment, but some people find it worth the effort.

Here, two individuals living with spinal muscular atrophy (SMA) share their experiences and tips for finding and hiring PCAs on your own.

Finding good PCAs

Alexa Dectis, 29, lives in Los Angeles, far from her family in Pennsylvania. She currently has 15 caregivers who provide care 16 to 18 hours per day, which allows her to live independently and work as an entertainment lawyer.

Alexa finds her PCAs through the University of California, Los Angeles. “While there are benefits to hiring career caregivers instead of students, I know that I have a unique opportunity to give a student the experience they need to help them get to their ultimate career goal,” Alexa says. “Students require a little bit more time, attention, and training than people who have been caregivers before, but the investment is well worth it when I get to watch my staff go on to reach their goals.”

Earl Higgins, 58, lives independently in a suburb of St. Louis, Missouri, and works as a software engineer. He also believes students make good PCAs and has recruited several from Washington University. In addition, he has found caregivers through word of mouth and by posting job listings on indeed.com and care.com. He currently has 10 caregivers providing care about 42 hours per week.

Top tips:

  • Consider recruiting at colleges, medical or nursing schools, or vocational schools in your area.
  • Approach the school’s placement office about advertising your PCA position. Or, with the school’s permission, post flyers around campus.
  • Post your open PCA position on job posting sites and social media.

Evaluating candidates

Earl has developed a multi-step evaluation process that starts with posting a brief description of the caregiving position. When he receives responses, he usually follows up with the candidate by sending a text or email with more details about what the position entails. If the candidate gets back to him — typically 2 times out of 3 they do — he schedules a half-hour Zoom interview. Then, if he feels the candidate might be a good fit for him, he sends them a job application form that he has created and asks them to provide two references.

“It’s really important that the references check out because I have to be 100% confident that they are who they say they are before I let them into my house,” Earl says.

There are services that perform full background checks for a fee, but most court records are public information. Checking state court websites for any records on a candidate can reveal past brushes with the law.

Once, Earl did an online check of Missouri court system records and found an applicant had recently been released from jail for check forgery. “Luckily, I found it and did not hire her,” Earl says.

Earl Higgins

Only after this step does Earl invite a candidate to come to his house for a face-to-face interview at a time when another one of his caregivers is present. He has found the face-to-face interview is an essential test to see if they’ll be reliable in showing up on time. If all goes well within the final step, he hires them.

Top tips:

  • Schedule a video call to get a feel for whether a candidate might be a good fit before an in-person interview.
  • Ask candidates for character references, and check them.
  • Ask candidates which states they’ve lived in, so you can check state court websites for records in each of those states.

Invest in good caregivers

Alexa and Earl both pay their caregivers privately because they maintain full-time jobs and don’t meet the monetary requirements for assistance for caregivers. They each have multiple caregivers working part-time schedules, which means they don’t have to offer them benefits (i.e., vacation time and sick days). However, they’ve both found that offering competitive pay and some benefits helps attract good caregivers.

“I negotiate pay every time, based on the experience of the applicant,” Earl says. “It’s important to be competitive with the pay structure. There have been times when the applicant and I couldn’t come to an agreement on pay, and we had to part ways. I want my caregivers to be satisfied with the rate.”

Alexa tries to avoid negotiating, but she also considers fair compensation a way to recruit quality caregivers. “When people feel good about their pay, their performance is ultimately better, so I make it clear to the candidate that I’m going in with my best offer from the start,” she says.

Good caregivers are invaluable, and when you find them, it’s important to show them they’re appreciated. Earl periodically offers his PCAs raises, from 25 cents to $1 per hour, depending on how well they perform.

Alexa takes her caregiving team on day trips to Disneyland a few times a year and writes letters of recommendation for those applying to graduate school programs.

“It’s important to treat your team exceedingly well,” Alexa says. “My caregivers are some of the most wonderful people I know. They are truly giving me the opportunity to live independently each day, and I am very thankful for each of them.”

Top tips:

  • Research typical caregiving rates in your area, and offer candidates competitive starting wages.
  • Reward good performance with periodic raises or other perks.
  • Treat your PCAs with respect, and let them know you value them.

Next steps and useful resources