All Things Caregiving

All Things Caregiving

Nobody likes needing someone to help them with personal things, but when you have a spinal cord injury, this is a reality for many. From showering to needing help going to the bathroom, all of this takes some adjusting.

Many people with spinal cord injuries hire caregivers to assist in their daily living activities. Caregivers can assist people with SCIs with getting in and out of bed, stretching their legs and arms, dressing, managing their bowel and bladder routines, and helping with homemaking activities such as laundry and cleaning.

Finding the right caregiver, however, can be tricky. The search can be long, and you may end up with several people that don’t work out before you find someone you are comfortable with. But, like anything, you need to keep trying. Some people will let their rehab specialists or a caregiving agency do the searching for them, while others search for caregivers themselves. Read below to learn how to find the right caregiver for you.

Finding a Caregiver

If you would like to find the right caregiver yourself, you may want to start your search online by placing a job posting on a website such as Craigslist (Note: Craigslist charges $25 to post a job ad, and seems to be increasing this amount every few years). Sites like are also good websites for you to look for caregivers. These sites are not as popular, but you may find better quality and more experienced caregivers on this type of site. You should also ask around to people you know — a family member or friend may know someone who would be perfect as your next caregiver. Let everybody know you’re looking for a new caregiver, and someone great may just give you a call.

After communicating with a caregiving candidate over or phone email, you will want to schedule a brief interview in a public place; this is both for your safety and theirs. The interview doesn’t have to be long — usually, you will know right away if you like them. It’s always good to have a list of questions to ask them so you don’t forget to ask anything important. If you decide to go with an agency to help you find caregivers, don’t forget to be very specific about who you are looking for. Let the agency know everything you want and what you don’t want in a caregiver so they can find the right caregiver for you.

Before starting your search, make a list of the qualities you want in a caregiver:

  • What hours are they needed? How many days a week?
  • What tasks do you need help with?
  • What attributes are you looking for?
  • What kind of personality should your caregiver have? (efficient, friendly, quiet, reliable, professional – what do you prefer?)

Finding good caregivers is difficult, but worthwhile. In addition to finding someone who can do everything you need them to do, your personalities and schedules need to match up. When the professional relationship does work, potentially embarrassing or awkward situations such as bladder or bowel accidents become much more tolerable.

Paying for Personal Care Attendants

Many people with spinal cord injuries require caregivers, or personal care attendants (PCAs), to help them with daily living activities once they are discharged from the hospital. However, PCA services do not come cheap, which means that most people with SCIs cannot afford to pay for PCA services out of pocket. Thankfully, there are several resources available that can help cover the costs of PCA services. Learn more about your options for PCA funding assistance below.

Minimum Wage Reality

While the minimum wage keeps getting higher in many states across the U.S., PCA wages have unfortunately remained stagnant, with most PCAs earning minimum wage or near minimum wage nationwide. Because of this low pay, it is important to recognize that it may be difficult to find a quality PCA. However, there are ways to guarantee that you find quality PCAs. One of the easiest methods: offering whatever you can in addition to their wages.

One of the best ways you can keep good PCAs on-staff despite the minimum wage is to offer them additional money, if you can afford to do so. If this is not possible, consider offering your PCA additional job benefits such as room and board or free meals. Fortunately, many kind and quality people become PCAs and accept the wages they are offered.

Public Funding Sources

Most people with SCIs use publicly funded insurance programs to pay for their PCAs. One of the most common publicly funded programs is Medicaid. This state program varies in coverage from state to state. Make sure to check with your local Medicaid employees to see if they offer PCA coverage. Other publicly funded resources that pay for PCAs are as follows:
– Department of Vocational Rehabilitation
– Department of Veterans Affairs (if you are a veteran)
– Crime Victims Compensation
– Other state-funded programs, including Medicaid waiver programs

Private Funding Sources

If you have private health insurance at the time of your injury, your policy may have a clause that covers PCAs in case of a catastrophic injury. You can also purchase a private insurance plan after your injury that may cover PCA wages, as well. In addition to private health insurance, there are two popular private funding sources for PCAs: Auto insurance payments and Workers’ compensation.

Managing Caregivers

After you’ve found the best caregiver for you, you want to keep them, and yourself, happy. Managing them the right way is key, and clear communication is critical to successfully managing them. Being polite, patient, and kind to your caregiver is also important, and this goes both ways. You and your caregiver should have a mutual respect toward one another.

One of the most important things about managing caregivers is not letting them walk over you. Remember, you’re the one in charge. If you let them, some PCAs only do what is necessary and then leave, so you need to manage them well to make sure you get the best possible care. Nobody cares more about you than you. It’s up to you to find and manage the best person for your situation.


After you’ve found a caregiver, you will need to train them. You can have another caregiver on-staff help with training by setting up a “shadow” session. This makes it super easy for new caregivers to learn how everything is done, especially when it comes to learning transfers.

You also want to make sure you are clear from the very beginning about what the job expectations are; that way, your PCA will know exactly what is required of them. Again, being clear about your needs is huge.

Having a visible “Checklist” for new caregivers is a great idea. This ensures that everything you need is done before they leave. You don’t want to be stranded without anyone around to help. Additionally, some people don’t recommend becoming friends with your caregivers, but this depends on you two and your personalities. Usually though, it’s a good idea to keep things more professional; that way, if you do need to fire them, it won’t be difficult.

Always remember that being nice helps keep good caregivers around. A smile goes a long way, and please, avoid a demanding demeanor. Remember to say please and thank you whenever possible. All of this can help so much—it’s never a bad idea to be polite.

Please watch the video below to learn more on finding caregivers, and make sure to read the Takeaway Points below.

Video: How to find a Good Caregiver

Takeaway Points

  • You may have to go through several caregivers to find the right one
  • You can search for your own caregiver or have an agency search for you
  • Look for compassionate, reliable, friendly, and patient people
  • Clear communication is critical for managing caregivers
  • Let them know from the very beginning what the job expectations are
  • Be as polite to your caregiver as possible

Helpful Links:

– Watch This Is My Journey: Jenny, PCA Program Participant:

– Read more on hiring PCAs from our blog:

– “The Business of Managing Your PCAs”

Caring for Caregivers (PDF) – UABSCIMS –


Spinal Cord Injury
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Phone Number: +1 703-795-5711