When caring for aging parents, many adult children are unsure where to turn for in-home care. The myriad of choices can be overwhelming. When broken down, there are three key options: private hire, domestic referral agencies and full-service companies.

Private hire caregiver

When it comes to hiring a private caregiver, family members are responsible for all steps of the hiring process. They must advertise, interview and conduct background checks.

Once a caregiver is selected, the older adult or family member must negotiate schedule, salary and benefits. A written contract, signed by both parties, clearly outlining all of the duties and expectations, is imperative. Liability normally falls on the client’s lap when it comes to payroll taxes, social security, unemployment taxes and workers compensation cost.

It is important to get a rider on your homeowner’s insurance policy to protect your assets if anything should happen to the private hire in your home. A private hire might be cost effective, but safety risks are greater, especially when an older adult lives alone or has impaired judgement. The risk is greatly reduced when a family member is able to supervise the caregiver. Professional geriatric care managers are also excellent supervisors when family is not available.

Domestic referral agencies

Domestic referral agencies are essentially registries. A client calls for service and a caregiver is placed in a home for a placement fee and sometimes an ongoing management fee. The referral agencies do not employ the caregiver. The client becomes the employer, and similar to a private hire, is responsible for payroll taxes, social security, and unemployment insurance and workers compensation.

Some referral agencies have trust accounts set up, in which the client pays the agency and the agency then pays the caregiver, and sometimes sets up a tax service for the client, but the client is still considered the employer.

Full service agencies

Full service agencies employ caregivers. They hire, screen, train and supervise the employees and place them in the older adult’s home. As the employer, the full service agency is responsible for all payroll taxes, social security, worker compensation, and unemployment insurance. A quality full service agency should be able to produce a copy of its liability insurance and carry some sort of bond.

Supervision is done by the agency, with some agencies providing care managers who directly oversee client cases, lowering the risk to the consumer. The cost of a full service agency is normally higher than a private duty hire or a domestic referral agency, but ultimately, the risks are lower.

When choosing homecare for yourself or an older adult, remember to take into consideration the risk level of the older adult and the familial involvement. Educate yourself on what service is best for your situation and then interview several potential individuals or agencies. Finally, think ahead, don’t wait for a crisis to begin searching for the best care for you or your loved one.

Dorothy Silvanic is a 25-year veteran of the U.S. Air Force, serving primarily as an Aircraft Maintenance Officer with one assignment at the USAF Academy as a Group AOC. She retired in 2011 as a Colonel and Commander of the 48th Maintenance Group, at RAF Lakenheath, England. In 2011, she returned with her family to the Colorado Springs area, attracted by the outstanding school systems, year-round sports and outdoor activities and beauty of the Front Range. Her interest in helping seniors is a natural extension of her service ethic, and a way to give back to her community. She has first-hand experience finding quality care for loved ones who faced a variety of specific in-home care needs, and looks forward to providing the best quality care to seniors in the Colorado Springs area.

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