How to Manage In-Home Caregivers

Congratulations on taking a big step toward providing care for your loved one by hiring in-home caregivers. Most older adults state they want to age at home, but many require assistance to function safely. However, once you hire in-home caregivers, your work is not done. To ensure quality care, you must supervise and monitor an in-home caregiver situation, even with an agency.

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Types of In-Home Caregivers

There are several ways to hire in-home caregivers, each with pros and cons. Which method you choose will dictate the level of involvement and management required. Let’s review the different caregiver situations.

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Private Hire

A private hire is someone you know or who is referred to you but is not licensed and does not work for a company. 

Pros

• You will usually pay less per hour since you can negotiate rates.
• You may know the caregiver and have confidence in their abilities.
• You have direct communication with the caregiver and can have more control.

Cons

• You have no liability protection against lawsuits or caregiver-perpetrated fraud or abuse. 
• You will have to require background and drug screenings.
• You will want backup coverage in case your caregiver is sick or a no-show.
• You won’t know if the caregiver’s skills will meet your loved one’s needs.

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How to Manage Private Hires

A private hire situation can be successful if you put protections in place and accept that you have several responsibilities.

• Investigate liability protection insurance.
• Require a background check and drug screening.
• Talk to an attorney about drawing up a contract for services.
• Talk with a tax accountant about payroll taxes. According to the IRS, if a private caregiver is paid more than a certain amount per year, they are considered a household employee. Therefore, you are responsible for payroll and taxes. 
• Put a communication system in place so you know what the caregiver is doing daily, and talk with your loved one to ensure the situation is going well.

On-Line Caregiving Companies

Online caregiving companies, like Care.com and Carelinx,  allow caregivers to post resumes and sometimes videos on their sites. You pay the company a monthly fee to gain access to caregivers whom you can then interview and negotiate pay.

Pros

• Some companies will do background checks and payroll services for an additional fee.
• You have control over the hiring process.
• You can match a caregiver’s skills to what your loved one needs. 
• You will likely pay less per hour than using an agency.

Cons

• If the caregiver you hire gets sick or quits suddenly, you have no backup.
• You are open to lawsuits without the additional legal protections some companies offer.
• You have to rely on the accuracy of caregiver resumes unless you require references.

How to Manage Online Caregivers

Manage an online caregiver just as you would any other type of hire. 

• Have a contract for services that outlines responsibilities and hours.
• Request proof of any certifications and training.
• Arrange for a communication system about services, problems, and concerns. 
• Talk with your loved one to ensure that the situation is a good fit and that the caregiver provides the agreed-upon care.

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Agency

An agency certainly can alleviate much of the worry of managing in-home caregivers, but even with an agency, there are concerns.

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Pros

• An agency that is licensed, bonded, and insured will handle all payroll responsibilities. Ensure that they also do background checks and drug screenings.
• An agency will have backup caregivers if yours misses a shift.
• An agency will provide training for all caregivers. Ask about state-required training and any additional skills education that the agency offers.

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Cons

• Home care agencies are plagued by high turnover. Once you choose a caregiver you like, that person may leave, and you must start over again.
• Due to staff shortages, you may have little choice of which caregiver works with your loved one.
• You can expect to pay higher hourly rates than private or online hires. 

How to Manage

Managing an agency caregiver is the agency’s responsibility, but you should still be involved. Here are some steps to take to ensure the best care possible.

• Communication is vital to managing caregivers, but an agency may require you to go through the company rather than communicating any changes directly to the caregiver. If that is the case, ask who is the contact person at the agency to report any concerns.
• Talk with your loved one about the caregiving situation, and take any reported problems seriously. 
• Review the care plan regularly and make any suggested changes.

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In-home caregivers can provide significant support and relief to family caregivers. However, your involvement is necessary to ensure consistent quality care. 

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