Private vs. Company-Backed Caregivers

caregiverOnce a family has reached the conclusion that it’s time to bring in at-home assistance for their elderly loved one, they must decide whether to go with either an independent caregiver or a home care agency. As might be expected, there are pros and cons to both options, which are presented below.

What Does an Independent Caregiver Offer?

Private caregivers are individuals hired directly by the family. There is no intermediary between the caregiver and the recipient. Some independent caregivers offer (and are trained in) medical care, such as wound care, injections, and monitoring of vital signs. Others assist with activities of daily living, such as helping with eating, bathing, dressing, and grooming; or provide oversight and assistance with shopping, housework, or running errands. Still others strictly offer companionship.

If no medical care is needed by the recipient, then virtually anyone can decide to be an independent caregiver. That leaves the burden of finding appropriate applicants, determining qualifications, and checking references firmly on the shoulders of the hiring family. Additionally, it is critical that the family make sure that any potential caregiver is fully insured; otherwise, the family will be liable for any medical bills resulting from injuries incurred on the job (which could easily happen when a caregiver performs a task such as lifting an elderly person).

Nationally, the average hourly rate for independent caregivers is about 20%-30% less than going through a home care agency, which is attractive to many families faced with the costs of home care for their loved one. However, hiring a private caregiver means the family is in charge of paying the caregiver and taking care of taxes. One option would be to hire a payroll company to take care of this, but in many cases, it can save time and hassle to go through an agency instead.

What Does a Home Care Agency Offer?

A home care agency does all the vetting and reference checking for qualified caregivers. They take care of scheduling, payroll, and taxes, and are bonded and insured. Because they handle the tax end of the transactions, the family receives full tax benefits for all caregiving costs.

An agency also takes on the task of customizing a home care plan that is specific to the individual and family. With the extensive experience and level of expertise that home care agencies bring to the table, they are able to foresee changing care needs and can accommodate them. During the selection process, a family can work with care coordinators to determine which caregiver is the best possible match for the loved one in need. Some agencies (such as Cahoon Care) specifically train their caregivers to provide personalized care for those suffering from conditions such as Alzheimer’s or dementia.

Which Choice is Right for You?

The answer will vary according to particular circumstances, but factors that can weigh in heavily are where the extended family doing the hiring lives, how much time they have to interview candidates, and how available they will be on an ongoing (daily or weekly) basis to oversee the home care process and make adjustments as needed.

If a personal caregiver calls in sick or takes a day off, the family is responsible to find a replacement. If a family member lives nearby and can assist with caregiving when needed, this kind of scenario might not be a big deal; but for families who live at a distance or who don’t have flexibility in their daily schedules, it can become quite challenging. If the family goes through a home care agency instead, the agency handles all such logistics. If a caregiver calls in sick, the agency finds a replacement for that shift.

When working with an independent caregiver, the family is also in charge of managing the care schedule and making sure the care is adequate for the loved one’s needs. If the family lives out of state, it will be difficult for them to check in on a regular basis; they will need to rely on feedback from their loved one. If the family is unhappy with the level of care being provided and decides to find a replacement, they will have to start the search, interview, and hiring process all over again. In contrast, a home care agency has strict regulations as to whom is hired, and if the first match with a care recipient isn’t satisfactory for whatever reason (temperament, scheduling, etc.), they can easily find a replacement for the family.

In terms of affordability, it may be tempting to consider the option of paying an independent caregiver under the table; however, this is not only illegal but is also not in the family’s best interest, since in doing so they would lose out on the tax benefits caregiving expenses can provide. In the past, families had the option of hiring private caregivers as independent contractors, sparing themselves the responsibility of payroll taxes and withholdings. With a recent IRS ruling, however, this classification is no longer an option; caregivers must now be classified as employees.

While a private caregiver may provide some cost savings, the family ends up with much greater responsibility. In contrast, a home care agency takes on the task of finding qualified caregivers, creating a customized care plan with the family, and reviewing/adjusting that plan over time as needed.

Cahoon Care is a boutique, family-owned home care agency that has been providing customized non-medical, at-home senior care services since 2010. We’d love the opportunity to speak with you about your home care needs. Contact us today.