In-Home Care for Elderly Parents

When I was in college, my grandfather was no longer able to live by himself due to physical and mental decline. He was adamant about staying in his home, so my mother, the oldest child, took on the task of trying to find help for him so he could remain living at home. Unfortunately, my grandfather lived in Pennsylvania and we lived in Texas, so finding and managing help was a challenge. I still remember my mother’s increasing frustration every time he fired one of his caregivers, which he would do because he was in denial about needing help. This would have been in the late 80’s, and home care companies were practically non-existent. My last column gave tips on finding the right home care company, but many families go the route of hiring private caregivers instead of a company, so I thought I would explore the pros and cons of hiring a company versus private caregivers.

When hiring a private caregiver, one pro is being in complete control of the selection process, and you can decide what type of experience is most important. But along with more control comes more responsibility. Conducting personal interviews, checking references, and performing background checks are time consuming tasks. Also, management and supervision of the caregiver(s) requires a good deal of time, and increases legal and financial exposure. You are responsible for managing employee payroll and tax records, as well as social security, Medicare, and unemployment taxes. If you choose not to withhold and pay taxes, you run the risk of incurring tax liabilities and penalties. A lot of people don’t realize that overtime laws include private caregiving, and caregivers must be paid time and a half once they’ve worked 40 hours in a week. The greatest exposure occurs when a caregiver is separated from employment and files a complaint with the Texas Workforce Commission stating that overtime was never compensated. You are also liable for job related accidents in the home if you don’t carry worker’s compensation.

Hiring a home care company is usually more expensive than hiring a private caregiver. Also, you don’t have as much control over the choosing of the caregivers. The pros for hiring a company, however, include having a variety of caregivers to choose from if one doesn’t work out. Also, back up caregivers are available when the regular caregiver is not available. Caregivers are managed, supervised, and disciplined by the company’s staff. The task and cost of recruiting and background checking is handled by the company, as are taxes and insurance, including liability and worker’s compensation. Another pro is that you can easily change the level of care. You may need to move from housekeeping and meal prep to bathing and dressing after a hospitalization, and a company can provide the appropriate skill level of caregiving as needed.

Source: “In-Home Care for Elderly Parents”, Clare Absher, RN, BSB, www.carepathways.com