Before getting into the industry, I was unaware of the issues that come with finding an in-home caregiver. As it turns out, I wasn't alone. A lot of people think that you just open the phonebook, pick up the phone, say what you want, and the senior homecare provider just shows up. If you're unhappy, the company replaces the person. That scenario doesn't necessarily work all the time. Figuring out who is actually on the other end of that phone is trickier than most people think. And what muddies the water even more is that you can unknowingly open yourself up to certain liabilities and responsibilities, depending on how you choose to find a senior care provider.
I have learned the ins and outs of finding senior care and I want to simplify the process for you, because had I begun the process on my own, I would have encountered a great deal of frustration--much of which is avoidable and entirely unnecessary. Although I was surprised by the subtle nuances, there are some key differences that I can point out that will make you a more astute searcher when it comes time to find a senior care provider.
Years of corresponding with National Private Duty Association members and speaking with the average consumer have helped prepare me for discussions on the primary issues that you will encounter when searching for, hiring, and working with the right senior home care agency. Use the following senior home care options as you would any road map to ensure that you find a senior care provider that's right for you and your loved one.
Find a Senior Care Provider from Many Options
There are three types of senior home care options: full-service agencies, referral agencies, and private-hire caregivers. While the first two include necessary services such as pre-screening and reference checking, the third option leaves the door wide open when you want to find a senior care provider, meaning you are responsible for most, if not all, of the required duties of being an employer.
Full-service agencies cover many of the important aspects in hiring a caregiver, such as pre-screening, checking references, providing worker's compensation, handling payroll taxes, and carefully monitoring and supervising caregivers that are placed in a home.
Referral agencies take care of the initial aspects of the in-home care process, but once you find a senior care provider through the agency, your business relationship ends there and you are responsible for the rest. The referral agency will pre-screen and check references but does not supervise a caregiver in the home. However, you will be required to insure and supervise the caregiver--as well as handle payroll, worker's compensation, and all applicable taxes.
Private-hire caregivers are found through alternate channels like personal recommendations, online listings, and health care organizations. You will be required to perform the background check and interview the caregiver yourself. Much like referral agencies, you will be responsible for insurance and supervision of the caregiver, worker's compensation, payroll, and other taxes. Should you decide to find a senior care provider on your own by hiring a private-hire caregiver, ElderCarePay and PayCycle both manufacture payroll software that you can use to ensure proper payment of taxes during each pay cycle (1).
Bringing anyone into your home necessitates a bit of protection, and senior home care providers are no different. Protect yourself and your property (or your loved one's belongings) by securing records and valuables in a lock box, collecting the mail yourself, and reviewing credit statements carefully each month.
Remain Proactive Throughout the Process
When looking for the right senior home care agency, find out whether they are a full-service home care agency, a referral agency, or an independent contractor. Before calling a senior home care agency, evaluate the following questions with the individual in mind. When will you need a caregiver in the home? What duties will the caregiver be required to perform? And, most importantly, what sort of specialized care will the patient need (2)? Now, it's your turn to ask the agency a few questions, such as:
How long has the senior home care agency been providing home care services?
What is the agency's screening process? Are references and criminal background checks required for each caregiver?
How are emergencies handled by the caregiver during and after working hours?
What is the supervision situation for caregivers in a home?
What is the agency's policy on payroll and other applicable taxes for its employees?
After you find a senior care provider but prior to hiring the individual, ask to meet with him or her for a brief introduction. At this point, you can interact with the caregiver to see if he or she would be a good fit (3).
Hiring Privately Requires a Level of Commitment
If you decide not to go through a full-service agency (or benefit from the basic screening method from a referral agency), you now have quite a few responsibilities on your plate in order to find a senior care provider that will prove reliable. You will have to conduct an interview, a criminal history background check, an elder abuse and sex offenders registry check, a reference check (request a minimum of three), a motor vehicle record check, communicable disease screening (it's recommended that caregivers receive a Hepatitis B vaccine prior to employment), as well as verify documentation of the caregiver's certification (4).
Ideally, once you find a senior care provider you're happy with, you should provide the newly-hired caregiver with a detailed job description outlining job title, purpose, duties and responsibilities, necessary qualifications of caregivers, Americans with Disabilities job specifications, supervision of caregiver designation, and initial training requirements (5). Have the caregiver sign and date this document and keep a file saved in a safe place. All caregivers in a home should receive proper training, with you demonstrating the details of each responsibility as well as tasks that must be carried out on a daily basis. Usually, not all family members or friends will be able to demonstrate all the necessary senior homecare requirements. Often, it is this inability to carry out some required tasks that prompt a family member to find a senior care provider and hire a professional. Ensuring that the family member or friend is the point-person needs to be done from the start, and what the family member or friend doesn't know the caregiver should. In the case of an agency hire, however, the supervisor will be able to determine what exactly the care recipient needs and who can help. At all points, the family member or friend needs to be in the loop and needs to coordinate with the senior homecare agency and/or caregiver on a regular basis.
Furthermore, do not neglect training on OSHA regulations for tasks such as rigorous hand washing, dealing with human waste, and personal hygiene as well as providing supplies in order to comply fully with these precautionary cleanliness measures (6). Choosing to find a senior care provider on your own comes with many responsibilities, but you ultimately have more control in the decision.
Paying for the High Cost of Senior Home care
One of the major issues concerning senior home care is affordability. Searching and interviewing to find a senior care provider or agency (regardless of the channel you use) is a costly expenditure. With the annual amount of senior home care costing an average of $52,560 (7), it's no wonder that few can afford this luxury. While home care is most frequently a private pay situation, there are options, such as paying with long-term care insurance policies or even finding a trusted family member or friend to watch over the elderly individual. Make sure you research your senior homecare options fully before making any decisions though. Become more informed, be proactive, and, above all, be firm and prepared when making decisions to find a senior care provider. This way you'll ensure that you've made the best choice!
Sources
1. Gilbert Guide
2. Gilbert Guide
3. privatedutyhomecare.org
4. Ibid.
5. Ibid.
6. Ibid.
7. christinedecorte.com
Jill Gilbert is the President and CEO of GilbertGuide.com Gilbert Guide, a senior care website that offers a comprehensive GilbertGuide.com senior housing guide along with valuable tools and resources on caring for aging loved ones. She authors the monthly "Leading by Example" column in McKnight's Long-Term Care News, the chief industry publication for long-term care providers and is currently working on a new book, Gilbert Guide to Senior Housing (Penguin/Alpha Books, 2009). Jill has been quoted in numerous publications, including The San Francisco Chronicle and The Dallas Morning News. Gilbert Guide, the leading source of senior care and aging information on the Internet, was founded on the concept that quality matters, and its primary goal is to educate consumers on a breadth of senior care issues. To learn more about finding the right senior care provider, please visit GilbertGuide.com.
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