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Understanding the Different Models of Home Care

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Understanding the Models of Home Care

There are many choices for in-home care. To help assure you are making the best choice, you must consider three important variables: WHAT? WHO? and HOW MUCH?

  • WHAT:   What level of care and what services does your older adult require?
  • WHO:  Who is going to provide the care, hire, manage and pay the worker?
  • HOW MUCH WILL IT COST: What is the full cost of providing the care?

 Home Care Agency – Hire, Employ, Manage and Train Workers

Home care agencies provide certified nursing assistants, companions and a wide range of other homemaking services in the home setting.  Home care agencies employee the workers and provide management and supervision.  Since the worker is not an employee of the family, the family does not have to worry about managing payroll, training or employee issues.  In fact, the family may ask the agency to remove the worker and have him/her replaced at any time.

Before choosing an agency you need to make sure the workers are employees not independent contractors.  This is important, if the agency uses independent contractors the family may be considered the employer of the caregiver.

Private Duty Home Care – Recruiting and Hiring Worker Yourself

Private duty services are privately hired by the family and can provide any supportive services someone needs to stay at home. Private duty/private pay services are hired directly by the older adult his/her family members.  Private duty caregivers are generally found through word of mouth, newspaper advertisements, or through the Internet.

Registry or Referral Service – Assist with Hiring Private Duty Workers

Registries can provide a wide range of services from basic homemaker services to skilled nursing care. This model of agency acts as a “matchmaker” service, assigning workers to clients who need home care.

Important Note When Hiring a Private Caregiver:  When a private duty caregiver is in a private home, supervision, monitoring, payment, government-mandated taxes and workers’ compensation coverage, fall on the consumer.   If the caregiver is to use the client’s car, be sure the client’s auto insurance will cover the caregiver. Also, there are NO  training requirements for private pay or registry caregivers.

Overview of Responsibilities 

 Things to Consider and Question When Hiring a Caregiver or Agency

  • Experience of agency and/or caregiver – Find out longevity of agency, who manages the agency who owns it and their involvement in the community.  Find out the amount of experience the workers have and any certifications the workers have.
  • Get references about the agency and/or caregiver – Ask for at least three references for the worker or the agency.  Ask references about their experiences, if they would hire the agency or worker again, what worked and did not work.
  • Make sure that the worker is covered by insurance and bonded – Ask the agency for a copy of it’s coverage.  If you are private hiring call your insurance agent and find out what coverage is needed for workmen’s compensation and on your home and auto.
  • Make sure that background checks are done – Ask the agency what type of background checks they do.  If you hire privately, use a private investigator or background check service to verify employment, police records, debts and any other items recommended.
  • Find out what support is provided by the agency – Do they do an assessment? How often do they come and check on their workers?  Experience of management? What do they do if the assigned worker is sick or does not show up for work?

© Copyright Reserved, Eldercare Specialists, LLC, May 2009 Version 1.0