Article Posted: 10/23/2009
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Hiring Caregivers in Your Home
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Hiring Caregivers in Your Home
Five Tips to Success

By Cheryl Mathieu, Ph.D., M.S.W.
The Eldercare Expert

Most of us want to remain in our own home for the rest of our lives. When people struggle with everyday tasks, or become so confused that they are no longer safe to be alone all day, hiring a caregiving in the home can allow them to stay at home. 

The following 5 tips are areas to consider so you get the best results from your caregiving experience.

1. What Type of Care is Provided by Caregivers?

• Home Health Aides (HHA) and Certified Nurses Assistants (CAN) are trained to provide custodial care, or help with activities of daily living – such as bathing, cooking, dressing, toileting, and light housekeeping.
• Medication reminders
• Companionship
• Driving

2. Hiring an Agency vs. Independent Caregiver

You have the option to either hire a caregiver through an agency or hire privately. There are pros and cons to each.  The following are some things to consider before hiring a caregiver.

Hiring an Independent Caregiver – Private Hire
Pros
    Usually costs less ($10-15/hour) than hiring through an agency
    More individual choice in worker
Cons
     No back-up replacement
     You need to pay taxes and insurance
     You take on liability in case of injury
     High turnover rate
     Not background checked
     No supervision or oversight

Hiring Caregivers from an Agency
Cons
    More expensive ($18-25/hour) than hiring privately
     Less individual choice in workers
Pros
     Can provide backup caregiver when needed
     Insured, licensed
     Background checked and screened
     Usually has been trained
     Usually abide by company ethics and policies
    Agency will supervise workers and develop a “care plan”
 

3. Who Pays for Care?

There is often misconceptions on WHO will pay for caregiver in the home. 
• Bottom-Line … YOU pay.  Almost exclusively, caregivers are paid for privately.
• Sometimes insurance will provide a certain number of caregiving hours ,     depending on need (Medicare pays for skilled care, licensed nurses and therapists) - if custodial care is an essential part of your care, and on a short-term basis. Check with your insurance company for coverage options.
• Low-income individuals may qualify for In-Home Supportive Services – intermittent care.  These have similar qualifications as Mediciad/Medi-Cal.

4.  What to Ask The Agency When Hiring

These are some of the questions you want to ask when interviewing different caregiving agencies.
     • What type of criminal background checks are performed?
     • How long has the caregiver been with the agency?
     • Do you check references from previous employers?
     • Do you check drivers licenses and insurance if they will be driving the client?
     • Are your caregivers employees or independent contractors?
     • What type of training do you provide caregivers?
     • What type of supervision to you provide?
     • What type of service agreement do you require?
     • Do you have references I can contact?
     • How do you bill and what form of payment?

5. What to Ask After You Decide on An Agency

Try to make the best match between the client and caregiver.
     • Are there any preferences in gender, personality, specific interests?
     • Set up clear expectations – a job description - what will this caregiver be doing?

Employers Responsibilities When Hiring Privately

When hiring a caregiver privately, the family may be responsible for the following:

•  Federal requirements:  The Internal Revenue (IRS) Publication 926 http://www.irs.gov/publications/p926/index.html  is the household employer’s tax guide.
•  A W2 form: must be provided by January 31st of the year following the year of employment.
•  Employment Eligibility Verification:  When you hire a household employee to work for you on a regular basis (hired after 11/06/1966), you and the employee must complete the U.S. Citizenship and Immigration Services (USCIS)  Form I-9,  Employment Eligibility Verification. Call the USCIS at 1-800-870-3676 to order the Handbook for Employers.
• Employment taxes:
Social Security (FICA) and Medicare taxes: If you pay your household employee cash wages of $1,600 or more in 2008, all cash wages you pay to that employee in 2008 (regardless of when the wages were earned) are social security and Medicare wages.
Federal Unemployment Taxes (FUTA):   This is paid by the employer and filed with the Internal Revenue Service annually or quarterly, when an employee is paid $1,000 or more per quarter.  FUTA is not deducted from the employee’s wages.  For information on paying federal taxes for household employees, call 800-TAX-FORM or view it online at    http://www.irs.gov/formspubs/index.html
• State Requirements:  Seek advice from your individual state employment department listed in the government section of the local phone book.  State Disability Tax (SDI) and other state taxes may be required.  You may also need to fill out State Form DEI to establish a person as an employer of domestic help, and get a State ID number.
•  Workers Compensation Insurance:  Contact your homeowners insurance policy to see if additional coverage needs to be purchased for accidents or injuries that occur while on the job.
There are often local services to help seniors, or you can contact your Certified Public Accountant for assistance.

Dr. Cheryl Mathieu is a Certified Geriatric Care Manager, founder of www.AgingPro.com and owner of Ultimate Senior Solutions care management in Southern California.  Her tips have helped thousands of stressed caregivers find valuable solutions and peace of mind.  Find everything you need about eldercare, caregiving and planning your own aging at AgingPro

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