Ask Vanessa: Hiring A Caregiver, What Route Should I Take?

DEAR VANESSA,

My parents need in-home care. I know that there are options to choose from when hiring an in-home care provider, including finding a private caregiver as well as going through an agency. Which is the better route? 

- THELMA

DEAR THELMA,

Each caregiving situation is unique. There are several factors to consider such as cost, legal issues, and other valid concerns. The cost of hiring an independent contractor is typically lower than that of an agency. You can hire based on your best judgment. You may have more control and choice in the care plan which may provide more flexibility in terms of the caregiving schedule. If you choose this route, be prepared to locate potential caregivers, screen applications, conduct interviews, run background checks, and administer payroll, unemployment, social security and other taxes. You become the employer and the caregiver becomes your employee.

Although hiring an independent contractor is less expensive, it involves more risk and is where most fraud and abuse are likely to occur. Many home care workers represent themselves as independent contractors--thereby relieving the hiring family or individual of tax obligations. It is your responsibility to make sure that the home care worker truly is an independent contractor and is therefore paying his own taxes and carrying his own liability and workers’ compensation insurance. If the aide is not meeting these obligations, you (the employer) become responsible for him or her.

Hiring through an agency is more expensive but involves less risk. On top of the time-saving advantage that this route offers, an agency will handle all legal requirements of being an employer and help you avoid having trouble with the IRS. An agency who hires its own employees pays the payroll taxes, files tax returns, and has to deal with workers‘ compensation and liability insurance. These are all necessary to ensure that you and your family are protected.

Another concern is exploitation. While the vast majority of people who become home care workers do so out of a desire to help others and serve the needs of seniors in their community, there are individuals who see this type of work as an opportunity to take advantage of those who are frail, functionally limited, or cognitively impaired. This most often occurs when there is no one (agency or individual) to provide proper supervision of the home care worker. A licensed home care agency is required to supervise their aides, have their performances evaluated periodically by an RN, and provide ongoing in-service training.

This can reduce a lot of extra work, save you time, and alleviate some anxiety. A third concern is continuity of care. When you hire someone privately, what happens when he or she becomes sick or has family obligations elsewhere? Not having backup help when your caregiver is unavailable is a disadvantage. If a home care worker comes from an agency, that agency can provide another worker in such cases to make sure that your parents’ needs are met without undue interruption. Working through an agency is not foolproof. But most agencies work diligently to make sure that their clients get the best possible care experience from the best of caregivers. In the long run, this is a safer and more cost-effective option as an agency assumes responsibility and liability for their caregivers.

Whatever route you choose to take, I hope that you will find a devoted caregiver with a kind and caring attitude.

- VANESSA