The ABCs of hiring PCAs

Personal care attendant work pays little, and much of the work is menial - so the search for caring, competent, reliable people is arduous. Karen Breisky refers to her own experiences in offering tips for hiring assistants. Internet publication URL:

Imagine for a moment you have a long-term disability - and an ardent desire to live independently. Let's say you use a wheelchair (as I do), and you need help getting in and out of the shower or fixing dinner or doing a load of wash.

Unless you have a family member able to volunteer 20 or more hours a week, your answer probably is a PCA or personal care attendant.

Unless you're well-fixed financially, you probably have to apply to the state for help in paying for such assistance.

In order to survive the process of hiring the right applicant, you're going to need a large dose of patience and a sense of humor. I recently had to run classified ads over a three-week period in a major daily and 21 weeklies in the Boston area to find two PCAs willing to work part-time in my home, evenings and weekends.

Because the need for PCAs rarely is communicated in our newspapers, many are not aware of what can transpire when a person with a disability advertises for help. Here are some of the things that have happened to me.

Applicant A: A persistent woman called, seeking to persuade me that I should hire her 17-year-old son. I told her that a teen-age boy is not what I had in mind. "But he needs a job!" she insisted.

Applicant B: Over the phone, "Hilda" seemed perfect: she lived nearby, was available evenings and weekends, and said she had done personal assistance work. But when I mentioned cooking and light housekeeping, she backed away. "I do enough of that stuff at home," she said. What she wanted, she said, was another job like her last one: where she sat at the bedside of a person on a respirator and read magazines.

Applicant C: In the course of an interview with "Lisa" on a hot summer day, I learned that she had two small children who were waiting in her car. I asked who would care for the children if I gave her the job. She seemed puzzled by the question. "They're fine in the car," she said.

Applicant D: "Fun" was the operative word with "Ms. Laidback": age 22, sports car enthusiast, a daytime nanny who looked forward to a relaxing evening as a PCA at my place. She arrived at suppertime on her first evening with coffee cake and proceeded to make a pot of java while consulting the TV Guide. Asked to vacuum the feathers and seed on the floor beneath the birdcage, she responded, "OK, as soon as this program's over." Before long, she moved on to something less demanding.

Applicant E: An extraordinary applicant! A medical doctor from an Asian country who yearned to be doing something productive and useful while her husband completed his fellowship at a nearby university. But our government declined to give her either a Social Security number or a work visa.

Applicant F: I wound up for a while with a morning PCA from Indonesia and an evening PCA from Morocco. Competition ensued over the matter of housekeeping. One day, Indonesia inspected the bathtub and asked of Morocco, "She calls this clean?!" Morocco responded that evening, "OK, I'll do the kitchen and she can do the bathroom," averting an international incident.

Applicant G: "What's your condition?" this suspicious applicant asked over the phone. I told her I had a neurological problem, but she appeared to feel I was being evasive, so she got to the point. "Do you have a deformity?" And then, as if to help me understand: "Because I really don't want to work with someone who has a deformity." I thanked her for calling, and felt sorry for the poor soul who hired this woman as a PCA.

Sad to say, all too many Americans consider PCA work beneath them - and look down their noses at those who take such jobs. One of my back-up PCAs confided that she tells her friends and family she works with me as a "counselor" or "teacher" for fear she'd lose their respect if she acknowledged doing PCA work. Another tells her friends that she comes to my house merely "to visit."

PCA work pays little, and much of the work is menial - so the search for caring, competent, reliable people is arduous. But the search must go on. So, from my experiences, I've created a list of suggestions to help others in the process of interviewing, hiring and retaining good PCAs.

  • Trust your initial instincts. Character flaws have a way of showing themselves, however subtly.
  • Check more than one reference, preferably work-related.
  • Insist on a two- to three-week trial period during which either party may back out without a stated reason.
  • If the applicant fails to answer questions directly, or if you sense a serious personality clash, beware.
  • Before you hire, make sure the applicant meets any other PCAs you have so the applicant can be shown how the job should be done. You will also see whether the two are likely to get along and communicate well.
  • Invite your cat or dog to sit in on the interview. If your cat hides in the closet, or if your dog growls, move on to the next candidate. Pets know.

Karen Breisky teaches English as a Second Language in Cambridge, Massachussetts, USA.