Many caregivers are surprised to learn that many senior caregivers have no formal training in care of the elderly. Every state requires that nurses and certified nurse aids be licensed or certified. Sitters, companions and homemakers, however, do not have to be licensed or certified.

A recent survey by The Caregiving Project For Older Adults uncovered an almost universal misunderstanding that might create unpleasant results among family caregivers seeking trained home care assistance. Although 78% of the people who took part in the survey thought that all home caregivers are required to have a specific amount of education, there is, in fact no such requirement.

A certified or licensed aide, terms will vary depending on where you live will have had classroom training and will have successfully completed a mandatory state licensing or certification examination. The simple fact that a caregiver has a current "license or certificate" will verify that she did receive this training and has completed any required annual continuing education.

A "sitter," "aide," or "companion," on the other hand, may not be able to document any training required for licensure or certification at all. If this caregiver is working for a professional agency, he or she may have had some amount of basic training from the homecare agency. Many agencies do not provide training, and those that do not have a "standardized" training curriculum to use.

Caregivers who work privately, without an intermediary agency, may have had prior experience gained by working for a previous employer. They will have learned what they know "on the job."

If a caregiver is working for you privately, it may be that your caregiver has simply had some on-the-job experience with families who came before you.

What is the significance of this lack of training oversight? While caring for children may become easier as they mature, the opposite is almost always the case for aging adults. A good caregiver will need the skills to make continuing subtle changes in how care is provided.

While a dose of common sense and a strong back in the beginning may be enough, expertise in how to work with a senior who is steadily becoming weaker and/or more confused is essential. A caregiver who manages in the beginning with a little common sense and physical strength may find herself in water completely over her head as her client's needs increase.

Does this mean you should never hire an uncertified or unlicensed caregiver? Not at all. There are thousands of perfectly competent, experienced caregivers who have never been certified or licensed because they never worked in a medical homecare agency or care facility that required it.

What it does mean is you should never take it for granted that any caregiver has had formal training unless he or she is working as a licensed or certified aid or nurse. You have to ask. If your elder has an illness or behavior that calls for a caregiver with particular experience or training, ask for evidence before you hire. You are always within your rights to ask to see the caregiver's current certificate or license.

If you plan to hire a home health agency to provide caregivers to your senior, discuss the availability of caregivers with a license or certification during your initial interview. Many agencies will employ caregivers both with and without formal training. You will want to know about the years of experience any caregiver has had, because a newly trained and certified aid may lack experience, while a non-certified caregiver may have decades of on-the-job experience, which can count for a lot.