Finding the right care for a loved one isn’t always easy. But, understanding the differences between your options will help make your search a little easier.
Agency In-Home Care
In-home care agencies provide you with choices, like a registry would, but the process is guided. When you meet with an agency Care Manager during the initial assessment, you may detail what duties you wish your caregiver to perform, the hours you would like assistance, and all other details. You will be asked to describe the level of care your loved one needs and you will put together a Plan of Care outlining the specific needs. Agencies provide hourly care up to around-the-clock, or 24-hour care, as well as respite care for family caregivers.
After describing your ideal caregiver, an agency can match you with a caregiver and help you decide on a good fit. If you’re unhappy with the caregiver you picked, you can report the problem to a manager who can reassign another caregiver.
What agencies do that registries do not:
- Payroll – Agencies are responsible for hiring and paying the caregiver as well as scheduling.
- Bonding and insurance – Agencies carry insurance that protects you from liability if the caregiver is inquired in your home.
- Background checks – Agencies conduct thorough background checks as well as multiple reference checks on all employees.
- Licensing – Home care agencies are state licensed and provide supervisory visits to enforce standards and remain compliant.
- Taxes – The agency is responsible for withholding social security, unemployment, and other taxes.
- Ongoing training and supervision – You can expect a licensed agency to provide ongoing training as well as supervision of caregivers.
- Back-up Care – Agencies provide a substitute caregiver if your caregiver is sick, inquired or on vacation.
Some agencies are small and locally based, and others are larger national agencies. It is important to read comments or reviews from other families and to speak with the owner of the agency. Services may vary from agency to agency as well as the areas served.
Home Health Care
Understanding the difference between home care and home health care may be confusing. It is usually the child of an aging parent that determines their elderly parent may need some assistance in their home and it may be troublesome trying to decide which type of assistance is appropriate and when. Extended Family Home Care provides in home senior care services in metro Denver, Colorado and is available to discuss your elder challenges and concerns.
If your loved one requires an injected medication or nursing care while recovering from a surgery, than home healthcare is needed. If the elderly family member requires assistance with bathing, cooking or housekeeping, then home care services are needed.
Home care and home healthcare differ in several ways:
- Home care offers non-medical services and is not paid for by Medicare, although home care agencies are required to be licensed by the state of Colorado. Home care services are private pay services in which the patient or the patient’s family will pay directly for home care. A long-term care insurance policy may also pay for home care services.
- Home health care is medical care that is covered by health insurance or Medicare. To receive home health care, a senior (or patient) must always be homebound and be in need of medical care as ordered by a physician. Medicare could additionally cover non-medical services executed by a home health aide, but these services are only covered when medical care at home is warranted. Generally these non-medical services occur at the same time as the medical care visits.
- Home care delivers non-medical services to seniors and patients recovering from a surgery. Assistance with bathing and dressing are standard home care services. Other home care services include medication reminders, light housekeeping, meal preparation, running errands and transportation. Assistance with all activities of daily living help make life easier and are offered by home care professionals. Home care agencies assist the elderly who prefer to reside in their homes, but who might require help to do so.
- Home healthcare is doctor-prescribed and has skilled medical personnel such as nurses who can dispense medication. Physical and occupational therapists may also be part of the health care plan. Home health aides may be assigned to assist with activities such as bathing, however, this will only be covered by Medicare as long as other medical care is also demanded.
In-home Care Registry
An independent caregiver can be found through a registry, which is much like a staffing agency. An in-home care registry generally doesn’t employ the caregiver. Instead, it acts as a referral service. Registries help connect people with caregivers and will collect a referral fee for the assignment of a caregiver. The process that registries use to screen applicants varies tremendously from one to another. Some do very little beyond verifying a caregiver’s identity. It is important to understand how much screening a registry does do if you do consider going through a registry.
Registries generally don’t handle taxes. As the employer of record, this would be your responsibility. You would also be liable for any accident or injury your caregiver suffers on the job because they are your employee, unless the caregiver carries their own insurance. It is very important to discuss this issue right away with the registry. Because the caregiver is your employee, you will be responsible for dealing with any problems or issues that arise as well as the supervision and scheduling.
Independent In-home Care
Legitimate businesses warn consumers of the dangers of hiring independent contractors to do household work all of the time. You’ve probably heard of nightmare scenarios where a homeowner gets a great deal on a home improvement project and then the contractor injures themselves on the job. A week later, the homeowner receives a court subpoena. They are being sued.
The same thing happens in caregiving. People who hire independent caregivers will often pay them under the table, without proper insurance and then they unwittingly end up paying for
attorney fees, medical expenses, lost wages, long-term disability AND back taxes that include interest and penalties.
Not everyone ends up in dire straights due to litigation from an independent caregiver, but other stressful scenarios are all too common. When someone hires an independent caregiver, they become the boss. That means managing your employee if they are late or cancel at the last minute. Also, how do you know if the caregiver is providing good care, and if they aren’t providing good care, what can you do to correct it? Managing all of the details of a home caregiver can take just as much time as providing the care yourself. The worst part is that with independent caregivers, there is no replacement. You would have to hire someone else if you need someone else.
Due to all of the ways hiring an independent caregiver can go wrong, most people find that hiring an agency is a much better and a less stressful alternative. Although Home Care Agencies are going to be a little more expensive, you have a few built-in guarantees, such as having caregivers that are prescreened, insured and bonded. Licensed agencies are also responsible for payroll, benefits and taxes and will provide a backup in the case your primary caregiver is sick or on vacation.
Due to the higher cost of hiring a caregiver through an agency, or even a registry, many people choose to hire a caregiver independently through local job listings, such as Craigslist, or through personal referrals. If this is the route you choose, you want to be prepared to take care of the tasks that an agency or registry would perform for you. The includes researching the potential caregiver’s background including reference checks, determining the duties to be performed, setting the pay rate, and handling all supervision and responsibilities as the employer of the caregiver.
As your caregiver’s employer, you’re required to set up a tax withholding system. It is best not to pay a caregiver under the table as the IRS would hold you responsible for back taxes, with interest, and potentially penalties, if the relationship was discovered. You could be liable to pay medical costs and disability if your caregiver suffers an accident or injury on the job. Discuss the possibilities with the potential hire. They rarely carry their own insurance. Another piece to consider is the arrangements that will have to be made if the private caregiver is out sick or needs a day off.’
Exploring Finances for Home Care
According to an article on caring.com, if you’ve decided it’s time for assistance, you may find that Medicare, Medicaid, VA health benefits and/or private insurance may not cover the program you need; however, there are still options open for you. This can help:
- Check insurance and know your options. First of all, call the insurance company/companies to find out exactly what they cover. Sometimes writing doesn’t explicitly state what you need to know.
- Out of pocket. If you find that their insurance doesn’t cover home health care, or isn’t covering it at this time, you can still pay out of pocket. Unfortunately, this can be very expensive.
- Decide exactly what type of assistance is needed. The type of assistance needed depends on the issues your parents are having. Perhaps they don’t need a nurse. Why would you hire a nurse when something simpler is needed? For example, maybe a caregiver is needed to assist with a bath, take them to an appointment, or run errands with them. Our company has professionals who can check in on your parents, provide companionship, assist with personal care, housekeeping services, etc.
- Family contribution. If money is tight or if your parents aren’t quite ready for other options, talk to their friends and your family to see who is available to contribute time. Perhaps everyone can work together and take turns helping your parents with their daily activities.
You don’t have to care for your parents alone; there is help out there for you. Discuss the situation with the insurance companies, your parents and extended family. If you still need assistance, Extended Family Home Care is available for free consultations.
If you need help deciding what type of care is right for your situation, we’d be glad to help navigate to the best solutions for you. We’ve also put together a Guide to Finding the Right Home Care in Denver if you’d like to know more about what home care can do for you and your family.
Are Home Care Agencies Worth It?
Of course we think Home Care Agencies are worth it, but we also have to face the facts. Many home care agencies don’t deliver enough value for what they charge. If you’ve had a bad experience with a home care agency, there are thousands of other people just like you with similar experiences.
You’ve probably worked with someone who wasn’t as good of an employee as they should have been, or much worse. Like any job, there are professional home caregivers that are amazing and others who are duds, but most caregivers probably fall somewhere in the middle. We put serious effort into selecting amazing caregivers and we are proud of them on a daily basis. Unfortunately, that isn’t the case for many other home care agencies who simply staff enough caregivers to meet demand. Anyone can find someone who is willing to provide care, but that doesn’t mean they will be good. If an agency doesn’t ensure the quality of their caregivers, you will end up managing and overseeing the caregivers.
A large number of seniors are reluctant to accept any outside help. Many simply don’t know what they can’t do; they don’t think they need assistance in their home. They have been cooking, taking care of the house and driving for many years. Others wish to continue to rely on family members to assist them with their activities of daily living. It is usually the child of the aging parent that hires an in home care agency such as Extended Family Home Care of metro Denver, Colorado, and obtains in home care services for mom or dad. The son or daughter may live out of state, have a full-time career, children of their own and/or commitments that don’t allow them to be a caregiver for mom or dad. Many family caregivers are exhausted.
Loved ones enjoy the comfort and confidence in living at home, control over their own schedule and more fulfilling visits from family and friends. This puts the son or daughter at ease having a caregiver with mom or dad when they can’t always be there. The problem we face as a family owned, local home care provider is how we to educate people who are researching care options so that they understand that we aren’t like the other agencies. We find ourselves trying to rise above classic economic forces: supply and demand.
What People Want
On the demand side of the equation, people are limited by their budgets. Since they want to get as many hours of care as possible at the most affordable rate, they might only compare agencies by hourly price. When consumers only look at price, they don’t consider things like caregiver matching, consistent caregivers, dependability and a caregiver’s ability to communicate. These variables have a major impact on the quality of care someone receives. If people demand the cheapest care, they shouldn’t expect the highest quality to come along with it. From our experience, people can get less hours with better care and get the care they need.
What Businesses Supply
Since there is a strong demand for the cheapest care, some home care agencies accommodate the demand by sacrificing in other areas. This means that they have to be willing to hire people who are less dependable and lack the communication skills you might expect of a caregiver. They also pay the caregivers at the lowest market rate. Not only does this lend to low quality candidates, but high turnover. Getting the same caregiver on a daily or weekly basis isn’t a guarantee. No shows are a common occurrence.
Supply and Demand
At Extended Family Home Care, we aren’t trying to compete with the national franchise chains who provide the lowest rates in the market. Of course, price is still a major consideration for everyone, so we provide competitive rates among non-franchise home care agencies that have a good reputation.
We are very serious about our caregiver selection process and ask, “Would we trust this person with our loved ones?” If the answer is “no”, there is no chance that they will be a caregiver for Extended Family Home Care. Since we look for high quality caregivers, we also pay better than the other chains. We have lower turnover and you can choose your caregiver according to your preferences. We supply the people in Denver with caregivers that they can trust and depend on. Lucky for us, many of our neighbors seem to want the best caregivers possible for their loved ones and we are glad to help them.