Dad lives in his own home near the water and he likes it that way! But while he is socially isolating during the pandemic, his adult children and grandkids worry about him. They tried to video chat, but he couldn’t figure it out. Some of the neighbors have called to say, they noticed Dad wasn’t keeping up with household tasks or personal hygiene. He has had several falls, and sometimes he forgets to take his medications.
“It’s time for some help…,” everyone agrees.
Hiring a home care worker can be a daunting task. Where do you begin the search? Maybe you could ask your doctor? Maybe a friend knows someone? Or do you place an ad on Craigslist or another online site? And you worry about recent stories in the news telling of unscrupulous caregivers taking advantage of vulnerable clients. It quickly becomes apparent that to hire a trustworthy, reliable caregiver, you need the expertise and support of a home care company.
But be aware that not all of these companies are actually home care agencies. Some are instead registry services. At a superficial glance, their two types of businesses seem similar: They both connect families with home care workers. They even charge almost the same price…But that’s where the similarities end, and it’s important to understand the differences:
Professional in-home care agencies provide a variety of health and custodial services in the home. These agencies are licensed and regulated by the state.
They recruit, screen, hire, train and supervise their workers. The caregivers who come to provide care for your loved one are employees of the agency and are insured. You pay the agency, and the agency handles all payroll taxes and other human resources tasks.
A nurse registry (sometimes called a private duty registry, independent contractor agency or staffing service) is an employment service for home care workers. Registries refer, but do not hire, home care workers. They serve as a middleman, providing families with a list of possible candidates for the job. They charge a finder’s fee; once the worker is hired, the relationship usually ends.
This is the key difference: When you hire from a registry, you may become the caregiver’s employer, and you might have to assume certain responsibilities, risks and liabilities.
Here are 10 tasks to anticipate as you consider whether you would want to take on that role:
- Hiring.
If you work with a registry, you receive a list of potential caregivers to interview. Here in Florida, the registry pulls a background check, but you are expected to discuss duties, expectations, salary and experience—and then, to choose the caregiver whom you hope will meet your loved one’s needs and preferences. If you work with a licensed professional home care agency, such as #AssistingHandsHomeCare, the agency will take care of all these steps and more. They will send a trained, insured and appropriately licensed caregiver who is matched to your family’s needs, selected from their own employees with whom they have a relationship and know intimately.
- Training.
If you hire from a registry list or placement agency, the caregiver may or may not have experience in providing care for a person with your loved one’s needs. There could be a steep learning curve, requiring much of your time—and you may not be qualified to provide that training. A professional home care agency will send a caregiver who has received professionally developed training, overseen by a RN and who understands your loved one’s care needs, whether those needs are due to physical or cognitive challenges, or both.
- Supervision.
Once you have hired a caregiver, how do you know that the services you hired the person to perform are being done correctly? When you hire through a registry, it’s up to you to monitor the situation. Families experience greater peace of mind when a professional home care agency supervises and evaluates caregiver employees on an ongoing basis. The agency also will ascertain that the caregiver shows up for their shift and performs assigned tasks. This is an especially valuable plus when families live at a distance.
- Payroll taxes.
Professional home care agencies take care of payroll, including federal taxes, Social Security, Medicare, unemployment and Workers’ Compensation.
If you hire through a registry, YOU are responsible for understanding and complying with this often-confusing array of withholding taxes. And you might face civil fines and even criminal penalties if you are caught paying “under the table” without complying with tax laws.
- Work-related injuries.
Caregiving can be hard work, and elder care workers are at risk of injuries, such as sprains and strains from lifting clients, automobile injuries and falls. What if a caregiver you’ve hired through a registry is injured while in your home? As the employer, you could be responsible for the caregiver’s medical bills and disability. Would your home insurance cover this type of claim? In most cases, no: Home insurance policies usually exclude coverage for employees in the home. It’s much safer to work with a professional home care agency that carries liability insurance and workers’ compensation for their employees.
- Backup.
Even the most conscientious caregiver will miss a shift from time to time, due to illness or a personal emergency. The last thing you want is to receive the call that the care you were counting on won’t be happening…What if your caregiver quits on short notice? What if the independent non Covid Tested caregiver gets sick and isn’t following proper CDC guidelines? Families are hard pressed and find themselves scrambling to cover their loved one’s care upon those occasions.
Professional agencies are equipped to provide a backup caregiver if your regular caregiver can’t make it, even if it’s at the last minute.
All employees with #AssistingHandsHomeCare are routinely tested for Covid and are supplied with proper PPE to keep our clients as safe and protected as possible.
- Performance.
What if the caregiver isn’t performing up to your expectations? What if they arrive late, miss shifts or aren’t caring for your loved one as requested? If you hired from a registry, you are on your own—you have to have the talk and set consequences for not improving, which is unpleasant and uncomfortable for most people.
When your caregiver is an employee of a professional agency, you can report problems so they can be handled in a less personal way. Assisting Hands Home Care, has systems in place for helping the caregiver improve or, if it’s your preference, we will send a different caregiver.
- Ensuring your loved one’s safety…preventing exploitation and abuse.
It’s a subject families would rather not think about, but it’s important to know that every year unscrupulous, dishonest people abuse their position of trust to take advantage of vulnerable elders by stealing from, exploiting or even physically abusing them. Registries are not allowed by law to supervise them—so if a caregiver you hire steals from your loved one, makes unauthorized charges with your loved one’s credit card or worse, YOU are on your own in dealing with law enforcement. Professional home care agencies perform criminal background checks and contact previous employers before hiring a caregiver; in the rare case that a caregiver does commit an illegal act, the agency will take responsibility and deal with law enforcement.
- Termination.
What if the caregiver isn’t meeting your expectations, or your loved one does not like the caregiver, or the arrangement just isn’t working? Firing an employee is seldom pleasant…and there may be unemployment claims to deal with.
When your caregiver is employed by a professional home care agency, the agency will be able to provide you with a different caregiver and deal with wrapping up the relationship.
- Cost.
When you’re first comparing prices, it might seem cheaper to hire from a registry. But don’t forget the hidden costs—and potential costs—of serving as the caregiver’s employer. You may need to pay an accountant, elder law attorney or aging life care professional (geriatric care manager) to help with payroll and other human resources tasks. You may lose income if the caregiver doesn’t show up or there’s a problem that forces you to take off work. Don’t ignore the fact that there’s the possibility of hefty tax evasion penalties or even a personal injury lawsuit which can occur.
Remember: You pay a professional in-home care provider not only for the services of the caregiver, but also for an array of legal and human resources support tasks and protections. The peace of mind? Priceless
If you are interested in exploring how my team can help your loved one stave off social isolation decline and live their best life possible wherever they call home…please call or text me.
I am eager to help.
727-641-5483
As a child of a father with advanced dementia who lives at home I know how important this decision is. I am with you every step of the journey!