1. Choose between hiring a Private Caregiver or an AgencySeniors can easily fall victim to financial, physical, and psychological abuse by their care provider. In fact, statistics show that they often do. Much thought and research should go into the hiring of an in-home care provider. The choices are many and the consequences of making the wrong choice can be serious. The first thing to consider is whether to hire a private caregiver or an agency. Private vs. Agency
While hiring a private caregiver may seem the most economical choice, the legal implications are often overlooked. According to IRS and Labor Law rules, a private caregiver falls under the category of “household employee” and the person hiring the caregiver is, by law, an “employer”. This means that they assume all of the obligations that a normal employer assumes.Full-Employment Agency vs. Independent Contractors
In order to pass on a lower cost to their clients, some agencies hire “Independent Contractors”, thereby seemingly bypassing those “employer obligations” cited earlier. However, while this may appear to be a simple way to keep costs low, it does nothing more than to shift the employer obligations from the agency to the person receiving care.Agency
Choosing a professional Home Care Agency is often the best choice, particularly for those who are new to this issue. The Agency should be bonded and insured, be experienced, and should work with you as your needs change. They should be able to provide you with the security that their caregivers are properly background checked, trained, and reliable. You should feel that the most important service you are receiving is the “Peace of Mind” knowing that you or your loved one is being properly cared for.
2. Begin the processStart your search by researching lists of Home Cars Agencies. Sources of information include your local hospital, senior center, or Area Agency on Aging. There are several publications offering listings of Home Care Agencies, including Born to Age, which prints separate publications for Alameda, Contra Costa, Napa, Solano, and Sonoma and Marin Counties. You can also visit their website at www.borntoage.com to find a listing of Home Care Agencies and a brief comparison of the prices and services they offer.
3. Conduct a Telephone InterviewAlways conduct a formal telephone interview before setting a date for an assessment. This will reduce the amount of time it will take you to decide on a provider and will eliminate wasted time in talking to providers that are unqualified to care for you or your loved one. We recommend asking these three questions (at least):
- Is your agency certified by CAHSAH (California Association of Health Services at Home)?
- What is your Better Business Bureau rating?
- How long have you been providing In-Home Care?
4. Conduct a Personal InterviewThe next step is the Personal Interview, where you get to meet a representative of the agency. Take your time and ask a lot of questions. We recommend that you have a written list of questions ready before the Personal Interview starts. This really is your chance to get to know the people who will be caring for you or your loved one. It is vitally important that all your questions be answered to your satisfaction and that you feel comfortable with the provider you choose. You might want to give a value (1-5) for each question and a score (also 1-5) for each answer. By multiplying the value and the score, you can come up with a total rating of each provider interviewed. This will help determine which provider you wish to hire.
5. Perform background checksIf you have chosen to hire a private caregiver, he/she should provide you with:
- Criminal history: due to California privacy laws, you cannot perform criminal background checks on private individuals unless you are a company and are considering them for employment. View http://oag.ca.gov/fingerprints/security for instructions on how the caregiver can request their own criminal history. The Caregiver can then make a copy for you.
- DMV history: if you expect the Caregiver to drive, either for errands or to transport your parents to their various appointments, the Caregiver should provide you with a printout of his/her driving record. This can be requested from the DMV.
- At least 5 Personal/Professional references: Why so many references? The more you have, the more secure your parents will be. Call every reference the Caregiver has provided. Make a list of questions to ask and keep record of the answers you receive.
6. Involve your ParentsIdeally, your parents have been involved in this process from the beginning, and by now are anxiously awaiting the help they so dearly need. In reality, most parents are reluctant to have a stranger in their home and try to put off this decision for as long as they possibly can. When do you begin to involve them in this process? We believe that they should be involved, if not from the beginning, at least at the time of the Personal Interview. Their considerations and preferences are extremely important to the outcome of this process. You should:
- Discuss with them the process and the steps you have taken up to now,
- Go over the criteria you have used to determine which providers to invite to the interview (CAHSAH certification, Better Business Bureau rating, years in business, etc.),
- Go over the list of questions to ask each provider candidate and ask them for their input,
- Discuss with them the timing for the interviews,
- Let them review any materials you have received from the providers,
- Continue to involve them in the decision-making process
7. Start small – ease into a long term relationshipNo matter how convinced we may be that our parents need the help, for them, having a stranger in their home is intimidating and awkward. From their point of view, it infringes upon their privacy and independence. They may feel that it is being force upon them by their children and this “role reversal” often creates friction in the family. Starting with relatively short visits allows the senior to get used to having the help. Over time, the frequency of the visits, as well as the length of the visits, can be increased as the senior becomes more accepting of the help.
8. Follow up to ensure you have made the right choiceOnce the service begins, continue to ask questions to ensure that the services you have requested are, in fact, being delivered. If your chosen provider uses a Customer Satisfaction Survey system, be sure to respond to their questions and make any comments you feel will help to improve the service. Speak often with the caregiver or the Agency’s Representative, usually called the Care Manager, to review ways to improve the care your parents are receiving. If the assigned caregiver turns out not to be a good fit, ask for a replacement. It is important to understand that sometimes the Caregiver and the Client simply don’t have “chemistry”. Generally, it is neither the fault of the Caregiver nor the Client and it is in everyone’s interest to make a change as quickly as possible. Your parents should have a Caregiver with whom they enjoy spending time. So should the Caregiver. The sooner the change can be made, the sooner everyone is happy. Continue to monitor the service and keep up a healthy conversation with your provider. Your parents will benefit greatly.
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