When the time comes for a senior to need additional care services in their home or in an assisted living community, you will have the option of hiring a senior home care agency to provide the services or finding an independent caregiver to hire directly.
Which is the right choice?It is far better to hire a quality senior home care agency to provide care services unless you are the rare individual who has adequate insurance coverage along with a care support team of family and friends to help direct and support the independent caregiver and provide back-up care when they need a day off.
Senior care is far different from child care. A family can successfully hire a nanny as an independent contractor to care for their children. This is because the parents are there every morning and every evening to supervise and monitor the care. In addition, the parents make sure the children understand the nanny is in charge. It isn't the same with senior care. There is usually no one else supervising the care. Seniors are older than their caregivers and because of this, sometimes do not choose to easily cooperate. When memory loss and other illnesses are present, the senior can become extremely difficult. They may know they need care but still be emotionally resistant. This creates a problem for the caregiver and for the family.
A senior home care agency solves this issue by providing a supervisor or case manager to manage the care and support the caregiver. They also provide a substitute caregiver when the regular caregiver needs a day off. And even more vital, the senior care agency is available for the caregiver to call when difficult situations arise (the senior won't take their medications, the senior won't take a shower, the senior won't let the caregiver in) or when they have survived a trying day (especially important when caring for seniors with Alzheimer's Disease).
This additional team support manages caregiver burnout and stress. It also prevents the negative situations which can develop when care issues are not addressed by a third party. Unlike child care, senior care involves managing many life issues such as dealing with the death of loved ones, adapting to new medical conditions and coming to terms with the aging process. And just as special training in children's education makes for a better nanny, special training in caring for specific age-related diseases makes for a better caregiver.
Senior home care agencies provide training and supervision for their caregivers. They also create a Care Plan for the daily routine to make sure the correct needs are being addressed. The care manager can also address changes in medical conditions to the family members to make sure the senior has appropriate doctors, medical equipment and other services to make their situation as comfortable as possible.
Another challenge with a direct-hire independent contractor is insurance and tax issues. Most home owner policies are limited in covering employees in the home. There are people who seek out work with seniors who know the opportunities that exist. One senior client my agency began care services for had previously hired an independent contractor caregiver who had been with her for more than a year. The senior was a widow with no family living nearby. Over the course of the year, the caregiver took out credit cards in the seniors name and used them for their own purchases. The invoices went to the financial manager who did not question them. The caregiver took many liberties with the petty cash purchases and the client's care was not their main concern. I have many more stories of starting care after a hire-direct had first been hired. Some families believe they will save money by negotiating a lower hourly fee, but this is rarely the case. Another client my thought they were paying their independent caregiver less than the agency fee but it turned out the caregiver would take $20 every time they ran a grocery store errand and charge the senior an extra fee for laundry and transportation. Many opportunities exist when no active management is involved.
Many people who hire nannies as independent contractors use a nanny agency for some of the same protections a senior home care agency offers. Maria Katris, owner of Nanny Boutique, says "Many clients repeatedly told me the value of using a nanny agency was in the background check, screening of the nanny candidate and access to additional resources such as our tax information. There is simply one more layer of assurance before allowing someone to work in your home with your loved ones. Furthermore, our clients were very aware of the tax liability involved in hiring a domestic employee and did not want to risk their careers by not paying taxes. We aided them in achieving this goal through education and partnership with a domestic employee tax company."
It is important to be cautious of "free" background checks. Usually such checks are just a name and address match to a social security number. If a website is advertising a free background check, be sure there is another fee they are charging to pay for this service as a solid criminal background check will cost at least $15 and a thorough background check will be closer to $100. Caregiverlist.com explains background check laws by state and what is typically included in a check.
A senior home care agency, as an employer of the caregiver, provides insurance protection and takes care of all the payroll taxes, as required by law. Worker's Compensation Insurance will cover on-the-job injuries (they do happen - dog bites, falls, back injuries). As an employee, the caregiver also has added benefits, including being able to collect unemployment benefits if they are laid off, collecting social security benefits when they retire and other agency benefits such as health insurance, training, team support and bonuses. The agency will also carry professional liability insurance and a fidelity bond to cover theft or financial loss.
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