Should I use an agency or hire privately to provide care for a loved one in their home?

I am asked this question often, probably because my company, BrightStar Care, provides in-home care. While we offer what I feel is great solution for people facing the problem of finding quality care for a loved in their home, I also realize that there is not one solution that will work for everyone.

So, you might consider hiring privately, but be aware of the risks involved.

Why would you choose an agency over hiring privately? If you use an agency, I believe the biggest advantage is accountability. There is someone other than you to whom the caregiver answers and to whom you can speak about issues. There is also a formal vetting process for the caregivers that agencies hire. What are things to ask when hiring an agency to provide care? You should always ask what kind of background check the caregivers go through. Georgia only requires a state-wide background check. Some companies go beyond the state licensing requirement and run a nationwide background check. Does the agency really drug test its applicants? Is there nurse supervision of care? Are the caregivers W-2 employees of the agency or contractors?

If you use a reputable agency to provide care for your loved one, the care-givers in your home should be covered by Workmen’s compensation insurance, they should be bonded, they should be covered by liability insurance, and the caregiver’s payroll taxes should be taken care of. What is a disadvantage of using an agency licensed by The State of Georgia? You will likely pay more than by hiring private caregivers.

What about hiring privately? The disadvantage of hiring privately is that you usually don’t really know who is coming into your house or what their background might be. Also, caregivers have lives too and things happen that sometimes prevent them from working. Whether it’s a sick child or car trouble or anything else, it would be important to have a backup plan for those instances where your private caregiver can’t make it. If you use an agency, the agency is responsible for getting a replacement there if the regular caregiver can’t make it. Also, there is a question of whether someone working for you privately is your employee or a contractor. Most people hiring privately believe they are using contractors. However, if you understand the definition of contractors versus employees, I believe families using private caregivers in their home are employing those caregivers and the caregivers are not independent contractors. Probably the biggest issue with hiring private caregivers is dealing with injuries. If the caregiver is injured in your home it will be your responsibility to pay for medical treatment for the care-giver. Given the nature of in-home care, lots of bending and lifting, workplace in-juries are common amongst caregivers.

You may think you are using an agency when in fact you may be using a registry. A registry simply puts care-givers together with families needing care. If you use a registry, the caregiver works for you, not the registry. There has been a surge in the growth of registries in recent years and if you use one, you need to know the ramifications.

These are some of the things to think about when searching for in-home care. Again, no one solution works for everyone. 

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