While hiring a private caregiver may seem the most economical choice for the family, the legal implications are often not understood. According to IRS and Labor Law rules, a private caregiver is considered a “household employee” and the person hiring the caregiver is, by law, the “employer”. This means that if you or your loved one hire a person privately to provide caregiving services that you or they assume all of the obligations that a normal employer assumes. Another consideration is that seniors are vulnerable & can easily fall victim to various forms of abuse by even the most trusted individuals. Employer based agencies provide the oversight & ensuring professional lines are not crossed.
Choosing a professional Home Care Agency, while it may cost more, is most times the best choice. A quality home care agency should have a Home Care Organization license, be bonded and insured, conduct criminal & drug screen checks on their employees, and offer a free home assessment.
The easiest way to start your search is by going online & researching lists of home care agencies in your area. Key word searches such as "in home care”, or “senior care”. Visit their websites and review what services they provide & what makes them unique or best suited for your loved ones needs. You can often see local sources and see if they have Google or other online reviews. Other good resources of information include your local senior center, hospital, local senior non-profits & Area Agency on Aging.
Settle on a short list of agencies that appealed to you when doing your research before setting a date for an assessment. This will reduce the amount of time it will take you to decide on a provider and will eliminate wasted time in talking to providers that are unqualified or not a good match for your needs. A few questions we suggest you ask are:
- Does your agency have a Home Care Organization license?
- How long have you been in business?
- How do you screen your caregivers & what training or experience do they have?
- What do you do to ensure the quality and consistency of your service?
The next step is scheduling the in-home assessment with the agency representative. Take your time to get to know how the agency handles the process. Remember this is who will be managing the care for you or your loved one. Make sure that you understand and feel comfortable that all of your questions have been answered to your satisfaction. Ask if they have any specialty programs or other differentiators that separate them from the other agencies. After you complete your interviews choose the agency that matches your needs best.
If you have chosen to hire a private caregiver, be careful & get the following information ahead of time:
- Criminal history: Due to California privacy laws, you cannot perform criminal background checks on private individuals unless you are a company looking to hire them. However, the caregiver can request to have their own background check done & provide a copy to you.
- DMV record: if the caregiver will need to drive your loved one for either for errands or doctor appointments, the caregiver should provide you with a printout of his/her driving record. They can request a copy from the DMV.
- Three professional references. If the caregiver does not have a minimum of three professional references ask for at least that many personal references. (non-family members) Record the answers you receive.
If you have chosen to hire an agency, ask for testimonials & ask if they are associated with Home Care Pulse, which conducts independent third party interviews with that employer’s clients & employees. If they are, ask for their results. You can also check online to see if they have any Google or Yelp reviews.
Realistically, most people are resistant to the concept of a stranger coming into their home & view the help as taking away their independence. More times than not, they will choose to avoid making a decision about getting care for as long as they can. Therefore, we recommend you start having discussions with your loved ones as early as possible or at minimum by the time you start making inquiries.
- Discuss with them your concern & the peace of mind having help can provide not solely for themselves but also for you & the family.
- Go over the process & explain the steps in a way that they can easily digest.
- Review the list of questions you have for agencies or providers & ask for their input.
- Let them review any materials you have received.
- Let them know that a free home assessment is available & should be without obligation & that they have the right to end services or choose another provider.
These conversations can be difficult & overwhelming to some, so try to reassure them that you only have their best interest in mind & that they ultimately have the authority to make their own decisions. The exception to this is if your loved one has cognitive impairment such as Alzheimer’s & Dementia and you are the Power of Attorney making those decisions on their behalf.
The most important aspect is to ensure that your loved one is receiving the appropriate level of care for their needs to ensure safety supervision. It is our recommendation and hope that people plan early & start off with small hours to ease into the process, and over time, increase the frequency & length of shifts as their level of care increases. This is also a good way to start services for those who are completely resistant to care at first as over time they will start to appreciate the help & become more accepting of care.
After services have started ask your loved one questions to ensure the care needs are being met. Equally as important is asking if the home care aide is a good fit. If they are not a good fit, then ask for a replacement. Your loved one should enjoy spending time with their home care aide & feel secure. Continue to monitor the service & feel free to contact the agency with any questions or concerns. It is important you have peace of mind & to remember that you have hired the agency & their professional team to manage the care of your loved one.