Know the Basics To Hire An In-Home Caregiver

By Gabriella Ambrosi
President, CEO Sequoia Senior Solutions, Inc.

Today we are all aware that we are living longer, that the baby boomer generation has reached the age of retirement, and that as we age, Alzheimer's disease and dementia are becoming more and more prevalent. We are also witnessing the existence of a growing new phenomenon, dubbed the "sandwich generation", those families caught between taking care of children and aging parents at the same time.

Financial advisors along with legal and medical professionals are quite familiar with this growing situation, as many of their clients or patients take on the responsibility of caring for elderly parents. In order to maintain an independent life, more people are turning to in-home care solutions rather than institutional care for their elderly loved ones. However they often unknowingly incur legal liabilities and unforeseen tax implications as they unwittingly enter into an employer-employee situation when hiring private help.

In most cases members of the general public do not realize that hiring an in-home caregiver is not something as casual as the common practice of hiring a neighborhood teenager for babysitting. By hiring an individual to come into the home and personally take care of an elder parent or relative, one is effectively entering into an "employer-employee" agreement, thereby becoming liable for employee taxes and expenses such as Social Security, Medicare, federal and state unemployment and payroll taxes, and workers' compensation.

Such a complicated situation is easily avoided by utilizing the services of a competent, trustworthy, in-home caregiver agency. Such an agency should be bonded and insured thus guaranteeing a selection of good, qualified caregivers. By serving as a full-service umbrella, the agency also takes full responsibility as an employer for all legal aspects of the caregiver as an employee: employer and employee state and federal payroll taxes, Social Security, Medicare, state and federal unemployment taxes, etc.

It is also important to understand the differences between a simple referral agency, temporary worker placement agency, an independent contractor company, and a nursing/caregiver registry, compared to a fully insured and bonded in-home caregiver service or agency.

A referral agency does simply that: only refers names from a master list, minus any guarantee of quality or experience. Such individuals are not employed nor supervised by these agencies—a situation comparable to a day labor company. On the other hand, a full employment in-home agency ensures the quality and experience of its caregivers through a rigorous selection process, including in-depth interviewing, background checks, on-site supervision, and strict requirements for capable, competent, knowledgeable, and trustworthy caregivers.

There is also peace of mind that comes with contracting the services of a caregiver through an agency, knowing that if a caregiver should fall ill, the agency will supply a competent substitute. The issue of elder abuse is also a major concern today when hiring caregivers, and again, by contracting help through a legitimate agency, a client can be assured of the quality of the in-home caregiver personnel or have viable recourse should something go awry.

In the event that there is some personal conflict, or questionable working habits and methods, or even to avoid such situations, the agency acts in a preventive capacity, or as a conflict resolution mediator by establishing clear and regular communication channels and attendance rules, performance reviews, as well as establishing a conduit for discussing problems as they may arise. However, first and foremost, the agency will strive to find a good fit between the in-home caregiver and the potential client or household by instituting a detailed interview process and taking into consideration such details as the exact location; daily, weekly, and monthly routines and activities; house rules; individual and/or family preferences, personalities, skills, etc. A reputable agency also provides ongoing training and educational programs for its caregivers so they are aware of the most recent legislation affecting their profession, as well as medical breakthroughs and warnings that could affect their service.

Perhaps one of the largest overlooked liabilities is that of an on-site, on-the-job injury, which could be devastating to a private household should an in-home caregiver be illegally employed. Private homeowner's insurance will most likely not cover such medical expenses or disability payments if the injured person is found to have actually been working as an employee, while not legally hired as such. Again, by hiring an in-home caregiver through a legitimate insured and bonded agency, worker's compensation would cover such costs.

How to pay for a caregiver contracted through an agency is also important to consider. Depending on the personal and/or family situation, and the income level, there are several options ranging from private long-term care insurance, funding that may be available to low-income disabled In Home Supportive Services (IHSS) recipients, or that of simple private payment.

Finding a caregiver through a professional agency not only offers peace of mind for the host of aforementioned reasons, but it also offers personal ease and assurance by not having to call upon "do-it-yourself" methods such as searching through classified ads, following up on recommendations from friends and acquaintances, seeking out registries or lists, interviewing with temporary placement agencies, independent contractors, etc.

In short, hiring an in-home caregiver through a full-employment agency saves time, assures quality care, legal compliance, avoids risks, and most importantly, allows our elderly loved ones to stay at home. Aging today can, and should be, dignified, and today's in-home care solutions provided by an insured and bonded full-employment agency offers this possibility.

© 2009 by Gabriella Ambrosi. All rights reserved