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Adult home care: independent
contractors vs. home care companies
It's not unusual for family
members to provide some or all of the non-medical home care needs of an elderly
parent today. In fact, according to one recent survey, more than half of all
caregivers are family members, usually daughters taking care of their mothers.
However, if they don't already have outside professional help, many
family caregivers expect to secure some kind of full- or part-time assistance
in the near future. Because, according to this same survey, as many as 80
percent of these family caregivers are juggling full-time jobs, in addition to
their care giving responsibilities.
Once the decision is made that the
elderly parent will remain at home, the issue for many of their children
inevitably becomes, What kind of help is best suited to my parent's needs: an
individual private duty caregiver or a home care services company?
But
the issue becomes even more complex, when you consider you're going to allow a
complete stranger into your home - or that of your loved one - to perform some
of the most personal services imaginable (bathing, dressing, etc.), often
without direct supervision.
The ultimate solution depends greatly on
the nature and scope of care you or your parent needs. But it also depends on
how much responsibility you are willing take on when it comes to the hiring
(and potential firing) of an individual private caregiver.
For one
thing, that caregiver may be viewed by the Internal Revenue Service as your
employee, which can have significant financial implications, as outlined below.
For another, engaging the services of home care providers requires recruiting
people who are not just qualified from a care giving standpoint, but people who
can be trusted to be there every day for the contracted time, trusted not to
steal anything and trusted to be compassionate - issues of particular
importance for relatives who may not live in the same town with their parents.
And finally, there's the issue of compatibility: you have to find
someone who will get along with you or your parent on a very intimate level.
Individual Private Caregiver
If you decide to engage the
services of an independent or private duty caregiver, you may pay less on an
hourly basis, won't have to agree to a minimum number of visits or hours per
day, or even sign a formal agreement.
But consider these facts:
 You'll have to do a job search, just as any hiring manager
would.
You'll probably be responsible for paying all payroll taxes
(federal income tax withholding, social security, Medicare, state income tax
withholding)
Private caregivers typically do not carry
personal liability insurance to protect against damage in the household.
Likewise, they may not be bonded against theft of valuables.
Individuals often do not have workers compensation or disability insurance to
cover on-the-job injuries. They typically do not have anyone to fill in if they
are sick or otherwise can't make it to work on short notice, leaving you in a
bind.
You become the sole supervisor, responsible for
the individual's job performance and any problems that arise on the job. If the
person doesn't work out for any reason, you'll have to terminate employment and
begin the process of finding someone else to match the needs of your loved one
- no easy task.
Because most caregivers are family members, those
receiving care most often form emotional attachments with them (as opposed to
outsiders), making it difficult to sever those ties should anything go wrong,
or the family simply wish to make a change. On the other hand, the newspapers
periodically recount stories of relatives bilking the elderly out of thousands
while ostensibly in their care.
Home Care Services Company
On the other hand, utilizing a home care services company may cost
a little more initially, require a minimum number of hours or days and a
contract, but it can alleviate much of the risk and burdens described above.
For example:
An adult home care company knows what kind of
people to recruit, the level of training they should have (sometimes providing
the training) and how much to pay them.
A home care company has the
resources to do thorough background checks before hiring people who will be
allowed into the privacy of your home or that of your parents. A home care
company pays all taxes and insurance premiums, including those for liability
and workers compensation, and fully bonds its employees.
A home care company is responsible for supervising its caregivers, monitoring
their performance, keeping their training up-to-date and making sure clients
and their families are satisfied with the quality of service provided.
With a full staff of caregivers available, you never have to
worry if yours calls in sick; there will always be someone to fill in.
And, if for any reason, your caregiver doesn't work out, you
may be able to ask for another one better suited to your needs.
Reputable adult home care services companies recruit and train
individuals who are compassionate about what they do and provide the kind of
care they would their own family members. More than a third of the family
caregivers in the survey mentioned earlier felt that caring for a loved one was
affecting their (other) job performance negatively. With so many time pressures
on today's families, it certainly makes sense to find a company that can
provide the kind of care they provide, if possible, even better.
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