Hiring a Home Care Worker: The Agency Advantage

Portrait of an elderly woman in a wheelchair and her caring nurse beside her

Is it becoming more difficult for Dad to take proper care of his yard or bend over to take the laundry out of the dryer? Does it seem like too much effort some days for him to cook or take care of basic housework? Does he bathe less often because he is worried about slipping and falling in the shower when alone?

Maybe your mom has experienced a small stroke. She is about to be discharged from the hospital and wants to return home. But she needs speech therapy, physical therapy and help with eating and transferring from bed to chair. She shouldn't be alone for the first few weeks.

These are familiar scenarios faced by thousands of American families every day. If you're not familiar with eldercare options and how to help an aging loved one, chances are you will be in the future! Today, 40 percent of Americans are already involved to some degree in the care of an elderly person. And when older adults prefer to stay in their own homes rather than move to a nursing home or other senior living facility, home care can be a real life saver for the older adult and family caregivers alike.

The home care field is growing every year, and many specialized services can be provided in the home. Here are some categories of professionals who can help:

Personal care attendants and home health aides are trained to provide custodial and personal care, such as helping with activities of daily living (e.g., dressing, bathing, getting in and out of bed, and assistance with using the bathroom). They can also provide medication reminders, run errands, prepare meals for the patient, and do light housekeeping tasks.

Certified Home Health Aides/Certified Nursing Aides (HHAs, CNAs or NACs) are health aides who have received more specialized training. The training requirement varies from state to state. In addition to personal care, CNAs can perform simple medical procedures such as taking temperatures, changing dressings, and in some states can administer medications under a nurses oversight.

Registered Nurses (RNs) and Licensed Practical Nurses (LPNs) provide skilled medical services beyond those that home health aides offer. Nurses can conduct an assessment to determine the care needed and monitor the patient's condition. They perform hands-on procedures such as changing wound dressings, inserting catheters and IV lines, and giving injections.

Rehabilitation Services provide care in the home to help maximize the patient's quality of life, independence, and safety, and to restore the patient to the highest level of function possible.

Durable medical equipment companies provide home care equipment that will be used over an extended period of time, such as oxygen delivery systems, wheelchairs, walkers, and hospital beds. They can also furnish wound care dressings, incontinence aids, and other products and supplies like grab bars, shower heads, and shower chairs to ensure safety in the home.

Finding the Right Home Care Services

The first step is to assess the person's needs. Make a realistic list of home and personal care tasks the person needs help with. Work with the person's health care provider to get an accurate picture of the person’s medical requirements.

The second step is to locate the right home care provider. A reputable home care agency is the safest choice—both for your loved one's well-being and your own peace of mind.

Some families have gone through the informal network or "gray market," hiring a home helper through a classified ad, Craigslist, a nurse registry or through word of mouth. But before you go this route, ask yourself whether you really want to become the person's employer, with all the risks and responsibilities that the role entails? Think about these factors:

  • You would be responsible for withholding and reporting income taxes and paying Social Security taxes. This can be very complicated and could also leave you open to having to pay back taxes and penalties.
  • If the caregiver were to be injured while working, you could end up paying the medical bills. The caregiver could file a workman's compensation claim or even file a lawsuit against you or your family.
  • It would be up to you to check certificates, licenses, references and criminal background…and to protect against elder abuse and financial exploitation.
  • You would be responsible for determining whether the care provider knows how to safely care for your loved one. For example, if your family member needs to be transferred from a wheelchair, you would need to be sure that the care provider knows how to do this safely.
  • You cannot try to hire someone on a seven-day-per-week basis. No employee can be a good employee for long without having time for personal needs and interests. So, you would need to plan for days off, vacation time and other times when the caregiver cannot be available.
  • If problems arise, you would be on your own in working things out as an employer. This includes discipline and termination.

Given the burden of finding, hiring, training and functioning as an employer, going to an agency instead provides numerous advantages. An experienced caregiver arrives pre-screened, trained and under the supervision of the agency. You don't have to worry about tax withholding, or liability. If the caregiver doesn't arrive, it's the agency's responsibility to provide a backup.

Hiring qualified, reputable home care aides can help meet your family’s needs and greatly extend the ability of seniors to live safely and comfortably at home.


Source: Assisting Hands Home Care in association with IlluminAge. Copyright © IlluminAge, 2013