At age 88, Flora had dementia and heart disease but still lived at home. As Flora’s care manager, I worked with her family to arrange for home care services when it became evident that she needed assistance with personal care. Initially Flora’s home health aide came daily for several hours, but as Flora’s dementia progressed and she became prone to wandering, it was not safe for her to be alone at night. The family considered the options: placing Flora in a memory care unit or hiring a live-in caregiver. They already had someone in mind: a woman named Jan who had taken care of a friend’s mother with dementia, who had recently passed away. Jan was not affiliated with an agency.
While the right home care services can make it possible for seniors to live safely and comfortably in their own homes, it’s important for families to weigh all factors when making a decision. In Flora’s case, her family considered circumventing an agency and hiring Jan privately. While this would save them money, it also presented risks that they hadn’t even thought about. For example, as the employer, they would be responsible for compliance with payroll taxes, social security withholding, and wage and overtime laws in their state. They would have to do their own screening, background and reference checks. There would be no back-up coverage, and they risked being sued if the care provider got hurt on the job.
For many families, this is simply too much to handle. Ultimately, Jan took another job and Flora’s family decided to hire a live-in caregiver through an agency. I assisted them in vetting the agency, and we asked key questions such as:
- How are staff screened? Are background checks done?
- How are agency staff trained? Does the care provider have any special certifications?
- Is the care provider current with immunizations and a TB test?
- Is the agency bonded and insured? Is the care provider an employee who is covered under the agency’s workers comp policy?
- Who will supervise the care provider?
- What is the back-up plan if the care provider gets sick or needs time off?
Often families who are navigating the senior care system for the first time are presented with a bewildering array of options when it comes to home care services. As an experienced care manager, I can assess the level of care that the senior needs, make recommendations, and monitor the services provided.