Costs: True or false? Is it less expensive to hire privately than through an agency? Most of you will say “privately” of course.
Well, the old saying about “penny wise and pound foolish” applies very well here. Did you know that when the senior caregiver is your own employee, you are responsible, by law, to pay various payroll taxes (including unemployment compensation, Medicare, and social security)?
You might want to look for an agency that pays these taxes and others so that you do not have the expenses or headache of doing their payroll, buying private insurance, and filing tax forms. Usually, you pay a flat per hour fee to such an agency and they take care of not only the payroll, but also the tax-related issues and forms. There’s much more to costs than the out-of-pocket fees.
Insurance, or lack of it, can cost one plenty… We’ll talk about insurance issues later. There are also costs associated with proper screening and hiring costs (such as ads). And if you’re weighing in-home care vs. a facility: did you know that it is usually less costly to hire in-home help, even full-time, than to pay for a facility?
If the person was recommended by someone you know, it’s still imperative that you check as many references as possible and request a background check (there’s a cost involved for doing this). Is the senior caregiver new in the area? Where has she lived before? Why did she move? Is she established in your area? Was the senior caregiver drug screened? Was the senior caregiver screened for communicable diseases such as TB? If the senior caregiver will be doing errands, and in particular drive the elder, does the senior caregiver have a good driving record? Motor vehicles will issue such a record (for a fee). Do not ask if the senior caregiver speaks English. Demand it! Instead ask if the senior caregiver has a valid Social Security # and if she is legal to work in the US. Illegal workers can be all kinds of headaches for you and there’s nothing to prevent them from suing, either. Look for agencies that have already done their homework so you don’t have to.
Many people assume that because someone has a certification (CNA, CHHA, etc.) that the person is qualified to assist an elderly person. These certifications train someone to provide care to a sick or disabled person, be they old or young. It does not necessarily focus on the issues of caregiving for an elderly person. When working with the elderly, the training should be focused on the elderly. Ask the agency how they hire and train the senior caregivers.
Plan of Care/Services Provided
When hiring privately, the senior caregiver duties are usually verbally discussed between the senior caregiver and elder only. This can result in misunderstanding. Ask the agency or the senior caregiver to put the plan of care in writing. For example, specific needs are written down, such as listing of services, special diets, calendar of events, as well as special instructions for personal and household issues. Oftentimes agencies make it a point to record the person’s medications, doctors and pharmacies, as well as emergency instructions to provide an up-to-date record for family, doctors, and anyone else caring for the person. Having this information recorded not only avoids misunderstandings, but also helps the family and the substitute senior caregivers.
Quality of Care/Supervision
Whom is the senior caregiver reporting to? In the case of privately hired help, as well as help from certain agencies, the senior caregiver is not supervised. Certain agencies get a fee for finding and screening the senior caregiver, but once the senior caregiver is placed, they will wash their hands of any responsibility or anything that goes wrong. Look for agencies who employ the senior caregivers directly, because they also supervise their staff and the agency is in control and responsible for the care services.
Does the senior caregiver have reliable transportation? What happens if the senior caregiver does not show up because of car trouble, sickness, family matters, vacations, or other commitments? Ask the agency if they provide a backup, or replacement.
Guarantee and Continuity of Service
What happens if the elder doesn’t get along with the senior caregiver? Personality conflicts can and do arise from time to time. Is there a guarantee of a replacement? If the senior caregiver is acceptable, is there continuity of service? Will the same person come on a set schedule, or will the agency send someone else each time or each week? Injury Insurance: Is the senior caregiver covered by Worker’s Compensation Insurance? If not, then the elder or family member may be liable for senior caregiver’s job-related injuries.
Homeowner’s insurance does not provide this type of coverage and shouldn’t be relied on. Automobile insurance policies do not insure household help. Privately hired senior caregivers sometimes sue the homeowner/client when they are injured, because they have nowhere to turn and have no insurance or no other means of making a living.
Does the senior caregiver have adequate insurance coverage? If not, and the senior caregiver gets in a car accident in the course of running errands for the elder, then the elder may be held liable for the damages caused to or by the senior caregiver.
Theft Insurance Bonding
Is there adequate theft insurance? If not, then the elder should consider obtaining such coverage. In the unfortunate case of theft by a senior caregiver, adequate insurance will help recover the losses. Call your insurance company and ask if they cover theft by a domestic employee. Do not be afraid to ask the agency or the individual senior caregiver about proof of insurance. Just saying one has insurance doesn’t make it so! I guess by now you understand that there are huge differences between hiring privately or through an agency and hopefully you now know all the questions you need to ask. If you do go the agency route, you should know there are different
Types of agencies
Most of the differences can be inferred by the way the agency deals with billing, or collects its fees.
- Some agencies collect an initial fee for providing a senior caregiver. Once the initial fee is collected, they’re done. You’re on your own after placement.
- Some agencies collect fees ongoing, the elder having to pay two checks, one to the senior caregiver and one to the agency. In this case, you’re on your own for payroll, taxes, forms, and supervision. They only guarantee a replacement if things don’t work out.
- Some agencies present one bill to the elder and take care of paying the senior caregivers and all the other hidden costs. These agencies supervise their employees, do their payroll, insure them, and work out any type of conflicts that arise.
Which type you choose is up to you and the criteria that suits you best, but don’t forget to ask all the other questions about insurance, supervision, reliability and quality of care and more importantly determine the role that you want to take.
Are you ready to start a new business and become an employer? If you answered No, you need to hire a Home Care Agency If you answered Yes, then you can consider hiring a private senior caregiver
Who is going to step in and provide care when the private senior caregiver is sick, on vacation or unavailable? Do you have family senior caregivers that can step in to help, oftentimes with little or no notice? If you answered No, you need to hire a Home Care Agency If you answered Yes, then you can consider hiring a private senior caregiver
What if the private senior caregiver isn’t caring for my parent the way I would like, what do I do then? You can look to hire alternate senior caregivers, but you need to know who is going to fill in while you are looking and training.
What am I going to do if the senior caregiver gets hurt in my home? If you elected to hire a private senior caregiver, then maybe you purchased workers compensation insurance, otherwise open yourself and your loved one up to potential liability and legal action. If you hire a home care agency, it will be covered under their workers compensation insurance and they will handle the injury and provide a replacement senior caregiver.