Risky Business...Unlicensed Home Caregivers

By: Carolyn Casey

You're faced with a tough decision; your 78 year old mother insists on living alone in the home she shared for 35 years with your now deceased father, even though she's beginning to have problems coping with day-to-day activities such as housekeeping, meal preparation, and remembering to take her medications. And there's more; you've noticed some dents in her car and she can't seem to remember how they got there. You and your spouse work full-time and try to help out as much as possible in the evenings and on weekends, but you're worried that it's just not enough; not to mention the cumulative  effect the stress of being her primary caregiver is having on you and you spouse.

It's not time for the nursing home yet and you'd rather Mom stay in the comforting surroundings of her home than move to assisted living, so you've decided it's time to get some help.  You've done your homework, researched senior home care providers in your area and collected information on available services and hourly rates.  You and your spouse have good jobs but you're not wealthy; so you're a budget conscious shopper. You decide to check out the classified ads in your local newspaper to see if you've missed anything and sure enough, there are several ads for independent caregivers offering their services for what appears to be bargain rates.  Each caregiver claims years of experience and good references.

You want the best for your mother, but you also need to manage your finances.  So now you're wondering "What's the difference between using a licensed senior home care agency and just hiring an individual on your own and paying them directly?"

Well, the risks are BIG; both to your mother and to you and your spouse.

Community based agencies that provide in-home care to seniors are licensed by the State of Texas and regulated by the Texas Department of Aging and Disability Services.  The state licensing standards apply stringent guidelines on how agencies hire caregivers, perform criminal background and reference checks, and provide required training and follow-up competency evaluations, as well as requiring the agency to make sure their caregivers are bonded and insured.

Unlicensed independent caregivers on the other hand are operating outside of the system unmonitored by any standards or requirements to show competency.

What are the risks to your mom?  When you hire a caregiver from a licensed home care provider that caregiver's background has been carefully vetted, the caregiver has been provided with specialized training and the individual is bonded and insured by the provider agency.  Also, the agency has many caregivers in its employ, so if your regular caregiver is sick or has an emergency and can't work, the agency can quickly find a fill-in substitute who is equally well qualified.  When you hire an unlicensed independent caregiver you're rolling the dice and relying on the honesty of the caregiver and his or her references.  No guarantees and no back-up support.  And worse, every year thousands of seniors are abused or victimized by ill trained or unscrupulous caregivers.

What are the risks to you?  When you hire an independent unlicensed caregiver YOU have become an employer.  You are now responsible not only for paying the caregiver's wages but also bear the responsibilities of an employer such as making sure payroll taxes including income tax, social security, Medicare, unemployment compensation and workers compensation taxes are withheld and remitted to the proper state and federal agencies. And what do you do if the caregiver incurs an injury while working in your home? In such an event you could potentially become liable for financially devastating damages. When you use a licensed home care provider, the agency is the caregiver's employer and assumes the responsibilities and liabilities as the employer.

In the final analysis, the cost associated with the financial, legal and personal risks to you, your spouse and your mother when you hire an unlicensed independent caregiver far outweigh the additional cost of hiring a professional licensed home care provider; not to mention the peace of mind you'll get knowing you and your mother are protected.

Carolyn Casey is the owner of Home Instead Senior Care, a licensed provider of non-medical in- home senior care in New Braunfels and surrounding communities.