You visited mom over the holidays, and you see that she just is not able to do what she could do for herself over the last year. She agrees she needs someone to help with the housework and prepare meals for her. But, you think she should not be driving, so she needs a driver too. You also have some concerns about her remembering to take medications as directed. Is it time think about hiring a caregiver?
Where and how do you start to look for help? The majority of families now go to Google to start their search. Isn’t it wonderful we have this resource? But the choices all sound alike and you have no idea how to evaluate any of the agencies. How do you choose one over the other when the number of options is overwhelming? Some individuals will ask their physicians, attorneys or other professionals for suggestions and some families try to private hire not knowing the risks, oversight, and skills needed to secure good care.
Let’s look at the different care choices for hiring in-home care:
- Private hire – means you will need to run a background check, follow local and state laws in regards to taxes, hours worked, and overtime laws. You will need to write a contract for employment, supervise the caregiver, have adequate liability and worker compensation insurance, and pay for legal expenses – Do you have the skills to do this? What about on-going training for the caregiver?
- Registry hires – these look like companion home care agencies, but you have all the same legal responsibilities as a private hire. You might even have more if the caregiver you hire is paid as a 1099 employee (independent contractor). Check with your accountant and attorney. You should always ask who the caregiver is working for when you call any agency.
- Companion Home Care Agency hires – these are caregivers that have been screened, background checked, bonding or liability insurance is covered. All taxes, labor laws and insurances are included in the cost of your service. Caregivers in many agencies receive paid medical insurance, paid vacation, and paid training. You will want to know if the agency has the needed state or local licenses, and do they have certification from the Joint Commission (this is the same certification that major hospitals have). You want to know there is supervision and on-going training requirements. Who owns the company – it should be someone in the health and human services profession. Always use an agency that has been in business for at least five years when hiring a caregiver for mom.
- Home Health Agencies – this is for skilled workers such as registered nurses, physical therapists and is most often only used after a severe illness or hospitalization because it is paid for by Medicare. They sometimes offer private pay services but rarely for day to day care because of their highly trained and skilled staff.
Hiring a caregiver for mom is more work than you thought. The next step after you have found the right agency for your family member, the professional staff of that agency should do a home visit and put together a plan of care that meets mom’s needs and does not overwhelm her. You want to start slowly and build a safe relationship. Then increase the time and services as mom becomes more comfortable with her new “friend” the caregiver.
Some agencies such as Eldercare Services have the added option of adding a Professional Care Manager to be your eyes and ears and make sure the home care is successful by giving the caregiver tips on dealing with resistance, dementia behaviors and other issues like medication reminder systems or technology for those that wander.