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. 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.