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In Home Care for Elderly Parents
Private Caregiver vs. Home Care Agency

By: Clare Absher RN, BSN

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If your elderly parents want to stay at home, then at some point, it will be necessary to hire in home care. Explain to your parents that hiring help is not a sign of weakness or "giving up", but instead a sign of good common sense and realizing limitations. Most elderly parents need some type of home care assistant to help with personal care and activities of daily living. This might include assistance with bathing, grooming, dressing, meal preparation, feeding, medication assistance, walking and exercising, shopping and running errands, housekeeping, and laundry. Perhaps your parents can't be left alone and need supervision, or perhaps you are the primary caregiver and need time to yourself. All of these are reasons to hire in home care.

In most situations, a nurse aide will be able to provide this type of care. Hiring a licensed nurse such as an RN or LPN is not necessary for custodial home care but rather only when skilled care is required. The question now becomes whether to hire this nurse aide through a local home care agency or hire a private caregiver directly. There is no right answer to this question. Let's consider the pros and cons of both choices.

Private Caregiver

PROS

  1. You are in charge of the selection process and making the final decision.
  2. You can overlook formal training or certification and instead consider valuable experience.
  3. Private caregivers are always an option, especially when home care agencies are limited.
  4. Hiring a private caregiver is cheaper than hiring through a home care agency.
  5. You are giving caregivers an opportunity to work independently and for better wages.

CONS

  1. It may be difficult to find caregivers.
  2. You must have a back-up plan when your caregiver is not available.
  3. Conducting personal interviews, checking references, and performing background checks are time consuming tasks.
  4. You are responsible for managing employee payroll and tax records, as well as withholding social security, medicare, and unemployment taxes.
  5. You are liable for job related accidents in your home.

Home Care Agency

PROS

  1. You have the possibility of several caregivers to choose from.
  2. Most agencies offer back-up caregivers when your regular caregiver is not available.
  3. Nurse assistants have formal training and certification that is verified upon hire.
  4. Caregiver references and background checks are reviewed at the time of hire.
  5. Home care agencies are required to supervise their aides and evaluate performance.
  6. Caregivers participate in ongoing training.
  7. Licensed home care agencies carry liability insurance, and many have worker's compensation.
  8. Employees are insured or bonded to protect you against theft and damages.

CONS

  1. Different caregivers may be sent causing a disruption in the care of your parents.
  2. Having less input in the selection of your parent's caregiver may cause stress and frustration.
  3. Home care agencies cost more than private caregivers because they have expenses related to recruitment, hiring, orienting, payroll deductions, and ongoing supervision and training of employees.

Regardless of whether you choose to hire a private caregiver or employ a home care agency, hopefully you will be fortunate enough to find a devoted caregiver. Becoming comfortable with a caregiver in your home may take a little while, however their immense value will be quickly realized. Good communication, clearly outlining work expectations and requirements, with an emphasis on positive feedback, will create a sound relationship and warm bond with your caregiver. Caregivers, as is the case with many of us, need to hear praise for good work and appreciation frequently expressed. This effort will in turn encourage your caregiver to develop a sense of loyalty and devotion to your parents and family.