Reference check questions for caregivers

Most of a caregiver’s work happens in a client’s home or room, with nobody from the agency there to see it. The client may not remember the visit, and the family usually sees only the result: a clean kitchen, a settled parent, a pill organizer emptied on the right days. The people who scheduled, supervised or paid for the candidate’s care are the closest you can get to watching them work alone.

A background check shows whether certain records exist. It cannot tell you whether the candidate arrives when expected, helps a frail client into the shower without rushing, leaves the client’s money and belongings alone, or answers the same question for the fifth time as kindly as the first. References can, if you ask about particular clients and visits.

Who to ask

• The agency scheduler or care coordinator, for missed shifts, late arrivals and which clients asked to keep the candidate.
• A nurse or care manager who oversaw the care plan, for how closely the candidate followed it and what they reported back.
• A family who employed the candidate privately, ideally one who saw many visits over several months.
• For assisted living or memory care, the shift lead or resident care director who saw the candidate across shifts.

Questions to ask, by competency

Choose the competencies that matter most for the position and two or three questions from each. Ask every reference the same set, and when an answer is a rating, ask for the example behind it.

Showing up as scheduled

A missed or late visit can leave a client without a meal, a medication reminder or help to the bathroom, often with nobody free to cover.

1. How often did the candidate miss a visit or arrive late, and how much warning did the client or the office get?
2. Did any client or family ask for the candidate to stay on their case, or to be taken off it? What reasons did they give?

Safe personal care

Bathing, toileting, transfers and medication reminders are where a client can be hurt, and at home the caregiver usually handles them alone.

1. What did the candidate do to make a client’s home safer, such as moving loose rugs, setting up the shower chair or keeping the walker within reach?
2. If a client asked the candidate to take pills out of the bottle and hand them over, rather than giving a reminder, what did the candidate do?
3. On a scale of 1 to 5, how would you rate the candidate’s help with bathing, dressing and toileting, and what did you see that puts them there? (rating)

Honesty in the client’s home

Caregivers work around cash, bank cards, medications and keys. A background check cannot show how the candidate behaves with them.

1. Did the candidate handle a client’s money, for example for groceries or a prescription? How did they account for it?
2. How did the candidate respond when a client offered them a gift, cash or something from the house?

Patience with dementia

Clients living with dementia may repeat questions, refuse care or become agitated late in the day, and patience is tested on every visit.

1. Tell me about a time a client refused a bath, a meal or their medication. What did the candidate try, and what happened?
2. How did the candidate respond when a confused client accused them of taking something or did not recognize them?

Noticing change and passing it on

A caregiver may see the client more than anyone else does, so they are often first to spot a new bruise, an untouched meal or new confusion.

1. Has the candidate ever arrived to find a client on the floor or unwell? What did they do first, and who did they call?
2. What did the candidate write in the visit log or tell the family at the end of a shift, and was it useful to you?

Close the reference

End every reference the same way: ask whether they would hire or work with the candidate again and why, what support would help the candidate do their best work, and whether there is anything else you should know. The general question bank explains why the first of these matters most.

Checks a reference does not replace

• The background check your state requires. Home care rules differ by state. CMS’s National Background Check Program has supported checks on direct patient access employees of long-term care providers, including personal care providers, in the states that took part.
• A state registry or license, where one exists. In California, for example, home care organizations have been licensed since January 2016, their aides are fingerprinted for a criminal record check, and a public registry shows each aide’s status.
• The federal exclusion list, if your agency bills Medicaid or another federal health care program. The HHS Office of Inspector General warns that hiring a person on its exclusion list can lead to civil monetary penalties.
• A driving record and proof of insurance, if the job includes driving clients.

Warning signs to follow up

• A family reference who cannot say how often the candidate came or what an ordinary visit involved.
• Vague answers about money, gifts or missing belongings, or a reference who steers away from the topic.
• Several cases that ended at a family’s request, with no reason the reference is willing to give.
• References who are all friends or relatives, with nobody who scheduled, supervised or paid for the candidate’s work.

One warning sign is a reason to ask another question, not a verdict. Reference check red flags covers how to check a concern fairly.

Questions to leave out

Ask only about the work. Before an offer, the EEOC’s guidance says an employer may not ask a third party, such as a former employer, any question it could not ask the candidate directly. Leave out health, medical leave, age, family plans and other protected characteristics. What to leave out has the full list.

This article is general information, not legal advice. Confirm the requirements that apply to your organization, and in your state, with your counsel or HR policy office.