As a Geriatric Care Manager, I am often asked about whether to hire a private Care Worker or go through a home care agency. The question is so prevalent that a colleague and I wrote a book about the subject titled, Ageing with Care: Your Guide to Hiring and Manageing Care Workers at Home.
Our story is personal and professional and takes us both on a journey of the pros and cons of hiring a private Care Worker (without going through a home care agency) for your loved one ageing in place. Now I’d like to take you through some of those pros and cons so you can make an informed decision about the type of care you’d like for yourself or a loved one who might need home care services.
What Are The Risks of Hiring a Private Care Worker and The Benefits of a Home Care Agency?
Let’s take a closer look at what is involved in hiring a Care Worker to provide in home care services. Hiring private Care Workers can be a full-time job and knowing the risks and responsibilities of hiring a Care Worker will help protect you.
Background Checks
When hiring privately, you will need to do the checks yourself. It can be tempting to skip this step. Don’t. The situation below may seem unusual, but sadly it is not. This happens more than you would think.
Example: A family member who has a privately hired Care Worker accuses the Care Worker of theft. Upon further investigation you find out that this Care Worker has a criminal history. But the damage is done. Valuable jewellery is missing and legal proceedings are the next step.
How can a home care agency help? An in home care agency will perform background checks and references on employees who provide care for the elderly prior to hiring. Some agencies also require drug testing. This ensures you’re bringing a thoroughly vetted Care Worker into your home.
Payroll Taxes, Minimum Wage, and Overtime
How will your Care Workers be paid? If you are handling payroll, then you will need to consider what taxes need to be withheld. You may decide to hire Care Workers as independent contractors. This means that they have the responsibility to report income, but it is your responsibility to know what the minimum hourly wage is and overtime pay.
Bottom line: Know the current tax laws on hiring workers.
How can an in home care agency help? Payroll, taxes, and overtime pay are handled by the agency. Agencies comply with state and federal regulations with regard to employment practices for those providing care in the home.
Liability Insurance
What do you do in the case of fraud, theft, abuse or exploitation? Talk to your insurance agency about additional protection in the event of illegal actions or accusations. In aged care services and in home care for the elderly there are real risks to seniors and/or their Care Workers that can include the following types of abuse or neglect:
- Physical
- Sexual
- Emotional
- Medical
- Financial
Example: Your father with dementia is being cared for by a Care Worker you have hired privately. The Care Worker comes to you and accuses your father of making sexual advances towards her. She threatens to sue. You have no way to independently verify what happened.
Our example above speaks to the issue of in home Care Worker misconduct. But what if the in home care provider makes accusations against the person they are caring for? What if they have an accident on the job and demand that you as the employer are liable?
How can an in home care agency help? Accusations of abuse, exploitation, or neglect are handled by the in home care agency. Complaints can come from the client being served or the in home Care Worker themselves. It can take some time and effort to sort out the truth but a good aged care agency will take complaints seriously.
Example: Your mother, who has dementia, claims that the in home care agency Care Worker has stolen her credit card. The in home care agency responds immediately by investigating the allegation. The in home Care Worker was carefully vetted by the agency by undergoing criminal background checks and drug testing. The in home Care Worker denies that she took the credit card. A few days later, the hired house cleaner finds the credit card in between the cushions of the couch.
Work Experience and Responsibilities
Checking references is critical to making decisions about whether to hire am in home Care Worker. Verifying experience of in home Care Workers is also your responsibility.
How can an in home care agency help? An in home care agency will check Care Worker references and verify the experience they say they have in providing in home care services. An agency is also required to be compliant with state regulations regarding tasks a Care Worker is allowed to do.
Scheduling and Care Plan Creation
Many people underestimate the time and stress of manageing privately hired in home Care Workers. How do in home Care Workers know what their responsibilities are? How do you give feedback to your in home Care Worker? That call in the middle of the night from a Care Worker who is calling in sick the next day comes to you. How do you replace an in home Care Worker who is essential to the care of your spouse or family member? Are you or another family member prepared to be the nurse at home for the day and cover that shift if there is no backup?
Consider these possible scenarios:
- An in home Care Worker does not show up for a shift
- An in home Care Worker quits without notice
- An in home Care Worker requests a schedule change
- An in home Care Worker complains about tasks
Example: Your mother who is ageing in place, requires help every day with getting up and dressed, going to the toilet and bathing. The in home Care Worker that you have hired calls you when you are taking your kids to school on your way to work. She says she is ill and can’t make her shift. You are in a panic because you have no back up and you have to be at work.
How can an in home care agency help? An in home care agency will do all scheduling and will replace an in home Care Worker in the event of a missed shift. That middle of the night call will not come to you. It is the agency’s responsibility to replace in home Care Workers and to make any necessary schedule changes. You can also let them know if you need to update your care plan or give feedback to your in home Care Worker.
Example: You are just sitting down to dinner when you get a call from the in home care agency saying that your father’s in home Care Worker can’t make her shift. Since your father has multiple care needs including meal preparation and help getting to bed, you are understandably alarmed. The in home care agency assures you that they have another care provider ready to go who has already reviewed your father’s care plan. She will be at your father’s in 15 minutes to get dinner started for him.
How Hiring Private Care Workers Benefits Ageing Loved Ones
Hiring private in home Care Workers for an ageing loved one can be the difference between ageing at home, known as ageing in place, and long-term institutionalised care in an aged care facility near me. During a medical crisis, in home Care Workers can be the stabilising force that helps someone recover sufficiently to stay at home. Other benefits:
- Monitoring physical therapy exercises and encouraging movement. When people are ageing in place and home alone, it is often difficult to remember to move. An in home Care Worker can give encouragement to someone to do their physical therapy exercises. This can decrease the likelihood of decline.
- Socialisation and stimulation. Loneliness is now recognised as being a significant health threat, especially for those ageing in place. It leads to poorer medical outcomes and increasing depression. Having the support of home care services can help provide company and social stimulation needed to support healthy ageing in place.
- Nutrition and hydration. Nutrition and hydration are very important determinants of overall health. Declining health leads to an inability to shop and cook. Hiring an in home Care Worker to perform these tasks can take the pressure off of family members, and ensure proper, healthy nutrition.
Dehydration is a serious problem for older people. It can lead to emergency room visits and hospitalisations. A personal in home Care Worker can give hydration reminders throughout the day to decrease the risk of dehydration.
- Medication reminders. Medication mismanagement is another potentially serious concern for older adults ageing in place. An in home Care Worker can give medication reminders, which can be a huge help in keeping people on track.
- Help with activities of daily living. This includes help with bathing, dressing, transferring and getting to the bathroom. Home care assistance from an in home Care Worker can help a family member stay home safely.
- Relief from family caregiving. Family caregiving is a noble and compassionate endeavuor, but the reality is that there are consequences. Most notably, loss of income, difficulty re-entering the workforce, and stress. Hiring an in home Care Worker from an in home care agency can provide much needed relief from the daily stress and strain of family caregiving.
If you make the decision to hire a private in home Care Worker, tread carefully and be fully prepared for what is involved. Plan ahead, if possible, for caregiving needs before a crisis occurs. Making decisions under duress can lead to poor judgment, so be flexible and willing to adapt as the journey continues!
