1. Choose between hiring a Private Caregiver or an AgencyWe know that seniors 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. In the end, you pay the Agency a fee while assuming all the responsibilities.Agency
Choosing a professional Home Care Agency is often the best choice, particularly for those who are new to dealing with In-Home Care issues. The Agency should be bonded and insured, 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 are 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 unqualified providers. 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 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. 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 on your list and a score (also 1-5) for each answer. By multiplying the value and the score, and then adding all those results together, you can come up with a total score 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 or that report for you to review.
- DMV history: if you expect the Caregiver to drive, either for errands or to transport you to your various appointments, the Caregiver should provide you with a printout of his/her 5 year driving record. This can be requested from the DMV and again, can only be requested by the Caregiver.
- At least 5 Personal/Professional references: Why so many references? The more you have, the safer you 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. Start small – ease into a long term relationshipHaving a stranger in your home takes time to get used to. Initially, you may feel that your privacy and independence are being limited. Starting with relatively short visits allows you 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 you become more accustomed to having a Caregiver in your home.
7. Communicate, communicate, communicateOnce the service begins, continue to ask questions to ensure that the provider you have chosen can adapt to your changing conditions. 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 service you 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. You should have a Caregiver with whom you enjoy spending time. The Caregiver should have a client who enjoys his/her company. The sooner the change can be made, the sooner everyone is happy.