Home Instead Senior Care is actively involved in advocating for seniors at the national, state and local levels to try to keep non-medical home care available, safe and affordable.  From time to time, we will add articles we think will be of interest to seniors and their families.  Below is one such article:

Choosing the Right Caregiver

What You Should Know and Ask

Are you, or your mom, getting along in years and finding it harder to manage things around the house?  Are you thinking of bringing in someone to help so that dad can safely remain in his home?  You are not alone.   An AARP study found that 85% of seniors want to "age in place" in their own homes or in independent senior living communities for as long as possible.  Having a caregiver come in for a few hours or days per week can help make staying at home more enjoyable and safe by doing household chores such as housekeeping, laundry or errands that become more difficult with age.

But how do you find the right caregiver?  Bringing a stranger into the home of a vulnerable adult to care for him or her is an important decision that can lead to a lasting, compassionate relationship or to a horror story of abuse.  Sandy Boughner, owner of the Home Instead Senior Care office serving the North Olympic Peninsula, suggests the following things to think about and ask about when looking for in-home care for seniors:

Agency vs. Private 

The first and most important decision is whether to hire a caregiver privately or go through an agency.  You can probably find a private caregiver who charges less than an agency, but like most things, you get what you pay for.  The risks with going the private route are many.  Ask yourself these questions:

·         Is the caregiver trustworthy?  If you are considering a private caregiver, be sure to get lots of references and check them all.  An agency will always check references of new hires (Home Instead Senior Care checks six), and will also do a criminal background check and a driving record check.  These checks are not easy for private individuals to do.  Never advertise for a caregiver in the newspaper or on line.  That is an invitation to con artists looking for an easy target!

·         Is the caregiver supervised?  An agency will follow up to be sure you are happy with your caregiver(s), and will make a change if you are not.  An agency will watch for signs of the caregiver taking advantage of his or her clients, and will terminate any caregiver who does not meet the agency's standards for client care.  With a private caregiver, you can fire your caregiver if you are not happy, but then you have to start over finding someone you like and trust.  Private pay home care agencies are regulated by the Washington Department of Health.  DOH regulations require agencies to properly supervise their caregivers.

·         Is the caregiver trained?  Private caregivers may or may not have been trained through prior employment or schooling.  Agency caregivers must receive training when they are hired, and on a continuing basis.  Home Instead Senior Care devotes a new CAREGiver's first two days to training on the non-medical needs of seniors, and adds to that training throughout the CAREGiver's employment.

·         Who is the caregiver's employer?  If the caregiver works for an agency and you pay the agency for his or her services, the agency is clearly the employer.  But if you hire the caregiver privately and pay her or him directly, most likely you are the employer.    That makes you responsible for withholding federal income tax; paying Social Security and Medicare taxes, including the employer's share; and paying worker's compensation and unemployment insurance premiums.  And there are many other employment laws you need to follow, such as overtime rules and eligibility to work in the US.  Many people who hire private caregivers ignore these laws -- remember nannygate?  Consider the risks:  You could face stiff charges, interest and penalties if you are caught.  If your caregiver gets injured on the job and you have not paid worker's comp premiums, you are responsible for the cost of her medical bills and disability pay.  Your homeowner's insurance may exclude this type of coverage.   And ask yourself this:  if my caregiver is unconcerned about working outside the law when it comes to employment, can I trust her when it comes to my care?

·         Is the caregiver insured and bonded?  Suppose you are injured due to the caregiver's negligence?  Suppose the caregiver steals from you?  Could you ever hope to recover your costs from a private caregiver with no insurance or bonding?  Agencies carry insurance for such eventualities, and their caregivers are bonded.

·         What if my caregiver gets sick or needs time off?  Is there a backup to provide my care while he or she is gone?  An agency will assign another caregiver, but a private caregiver usually has no backup.

Picking the Right Agency

Assuming you have by now decided to go with an agency, the next question is which one?  All agencies are licensed by the state and must meet the state's minimum standards.  A representative from a licensed agency should be happy to show you a copy of their license.  They can also show you a certificate of insurance coverage. 

Differences among agencies are more a matter of degree and emphasis, with each having their own style and niche.  For example, some cater to those who qualify for state assistance while others serve clients who pay for their own care or use long-term care insurance.  Some offer "home health care" (i.e., medical services) while others do "home care" (non-medical services such as companionship, household chores, meal preparation, transportation and errands, and personal care).  Some do both.   Said Boughner, "I would much rather lose a potential client to another agency than to a private caregiver, because then I know they will receive care meeting state standards.  At Home Instead Senior Care, we serve private pay clients with non-medical home care.  We focus on making good client/caregiver matches to foster a compatible relationship, being responsive to client and family member wishes, and following up with clients to be sure they are happy with our services."