Deborah Peteler was determined to proceed cautiously when she needed to hire a personal care attendant for her mother-in-law in Minnetonka. She was, after all, putting her loved one in the care of a stranger.

She consulted friends, researched several agencies, and chose carefully. But one day, after making an unannounced visit home, Peteler realized she had gotten it all wrong.

"I came home and the care attendant was watching television," Peteler said. "It was 2 o'clock and my mother-in-law was still in her pajamas, in bed and hadn't eaten."

When it came time to find an aide for her mother, she chose a different venue: Craigslist. "It's easy and it's free and you get a response within 10 minutes -- and you have a handful of candidates," Peteler said.

Despite the anonymity and risks associated with Craigslist, the practice of hiring personal care attendants (PCAs) online is becoming more popular, according to Neil Johnson, executive director of the Minnesota HomeCare Association.

Demand for home caregivers has skyrocketed in the last decade, fueled by the aging of Minnesota's population and new state programs that help frail and elderly people stay in their homes. The number of PCAs registered with the state reached 70,000 this year.

"I know it is a fairly common practice because more and more people are using social media," Johnson said.

Still, care experts warn that sites like Craigslist come with risks. In 2007, Katherine Olson of Cottage Grove was murdered after responding to an ad she thought was for a babysitting job. To complicate matters, the industry has grown explosively -- state spending for PCA agencies rose 164 percent from 2002 to 2007 -- producing a series of state investigations into fraudulent billing and other questionable practices.

"It is an industry that has a lot of jobs to fill,'' Johnson said. "You may reach out with many services, but you still want to make sure [applicants] are trained and screened.''

PCA Choice

The state Department of Human Services regulates the industry, and anyone receiving public aid to pay for care attendants is required to use a registered agency or, under a program called PCA Choice, hire someone of their choosing but have them get a background check and training through an agency.

For Peteler, who is paying out of pocket, the direct route worked fine. Within 24 hours of posting her ad on Craigslist March 22, Peteler hired a local graduate student studying occupational therapy. She helps Peteler's mother bathe and oversees her physical therapy, as well as keeping her company.

Although Craigslist can work for astute consumers, the Paraprofessional Healthcare Institute (PHI), a nonprofit advocacy group based in New York, says most states need a better system.

"Traditional recruiting strategies work fine for some people -- like posting on a bulletin board or using a website like Craigslist," said Dorrie Seavey, the institute's director of policy research. "But a lot of people have trouble finding PCAs. There is a big need for states to create a systematic method for matching PCA workers with people who need them."

State registry?

In a 2009 study for the state, the Lewin Group, a national health research agency, recommended Minnesota create an "online, searchable, PCA registry system that clients can use to find PCA workers." Some 22 states, including Wisconsin and North Dakota, have some form of registry, according to PHI.

Bud Rosenfield, supervising attorney at the Minnesota Disability Law Center, said Minnesota may not be in a rush to start a registry because most people use registered agencies or the state's PCA Choice system.

Still, he added, "a registry will be good if you don't have a cousin or a neighbor that can take care of you," Rosenfield said. "If you don't have someone in mind, you are at a void right now, and it can be very hit or miss."

Such a registry would, however, have to be updated regularly with new clients and applicants, he said -- a significant cost if the state undertook it.

Doug Bello of Maplewood posted an ad on Craigslist recently, looking for work as a personal care attendant. The 26-year-old former graffiti artist said that even with the risks, Craigslist is worth it. People just have to use a little common sense, he said.

"You can't just assume that everyone is a great person. There are weirdos out there, and, unfortunately, you have to watch out for that," Bello said.

"On the other hand, Craigslist is so well known that you can find anything from a couch, to someone to mow your lawn, to a job. You just need to do a little research and educate yourself."

Alejandra Matos • 612-673-4028