Agency or Private Caregiver--Helping Families Make the Choice

When a family hires a private caregiver, there are many benefits for the family and for the caregiver. The family can interview multiple people and decide who best suits their loved one. They have the option of controlling the entire scenario, and can switch caregivers with no notice if they feel that the caregiver is not working out. Oftentimes the right caregiver comes to feel like part of the family. But as with any employment arrangement, there are a number of ways that issues can arise, and families should be aware of their responsibilities and risks should they choose to pursue hiring an independent caregiver.

When a family hires a private caregiver, they become the employer. This means that they are responsible for withholding taxes from the caregiver and paying into the unemployment insurance and FICA (social security). While the care is going on, this is not usually a problem—it can seem like a benefit for the caregiver since their pay is more because tax is not being withheld. After the care is completed, however, the flaws become apparent. 

Consider this scenario: A family has hired a private caregiver to care for their mother. She provides fantastic care, is reliable, and the caregiver feels like part of the family. Then the mother passes away, and suddenly the caregiver is without employment. If she files for unemployment, as many unemployed persons would do, and the family has not been paying into the unemployment insurance, the family as the employer is held accountable and may be penalized. With an agency, the agency is the employer and takes care of the unemployment insurance. If the same private caregiver reaches retirement age and no money has been contributed to FICA, she will not receive social security benefits. In this case, if the caregiver reports it, again the family will be held accountable for the situation. Most families hiring caregivers directly are not aware that paying the taxes is their responsibility, and so may fall victim to this type of situation. If the family is not prepared, they could be responsible for fines and the contributions, and it could severely impact them financially all because of a simple mistake or misunderstanding. Working with a home care agency protects the family from these additional burdens and responsibilities and ensures that caregivers are covered in case of unemployment or retirement.

If a private caregiver is injured while working at a family’s home, the family is responsible for their injury. The family may find themselves in the position of being without a caregiver and with the additional burden of medical expenses and penalties. Injuries are very common for caregivers due to the physical nature of their work, so this type of situation could easily become reality for families. If the family hires a home care agency and the caregiver is injured while on the job, the family is not held accountable for the medical costs since the agency will have worker’s compensation insurance. 

Absenteeism is also an issue because a large majority of professional caregivers are also caregivers in their personal lives. They may care for their children, their parents or grandparents, or may otherwise have responsibilities that come up suddenly and require that they miss work or quit altogether. Here is an example: A caregiver named Andrea cares for a client five days a week. Her son, for whom she is solely responsible, gets sick and cannot go to school. Andrea has no choice but to miss work, leaving the client without a caregiver. With an agency, there are many caregivers on staff, so if a caregiver is ill or otherwise unable to come to work, the shift will still be covered and the client will still receive the care that they need.

Another potential issue with hiring private caregivers is the lack of background checks. People who are employed by home care agencies, retirement facilities, and other entities charged with caring for people must pass a background check that verifies that they have never been convicted of abuse, theft, or neglect. If a family hires a private caregiver and is not aware that they should check the caregiver’s background or if they do not have the means to do so, they are putting themselves and their loved one at risk. This is not to demonize private caregivers; most people who choose the caregiving profession are genuinely loving, caring, wonderful individuals, but as with anything, there are always the few who have ill intentions. A background check serves as a way to preserve the family’s peace of mind. Similarly, reputable home care agencies test their caregivers for drug use and intoxication on a regular basis, and if the family is again unaware or without the means to perform this safeguard, they run the risk of having a caregiver who is impaired by drugs or alcohol solely in charge of their loved one.

There are many benefits to hiring a home care agency to provide caregivers rather than to hire caregivers directly. Agencies verify employment and references, provide drug and background testing, and pay the applicable taxes for their employees. If a family hires an agency, the agency is accountable for the caregiver since the caregiver is an agency employee, and therefore if an incident occurs, the agency will be liable rather than the family. For the caregiver, the benefits are that their unemployment insurance is paid so they will be taken care of should they lose their client, they have a greater likelihood of being assigned to a new client and having steady work, they are insured in case of injury, and they have support from the office staff if an issue arises with their client. 

There are many wonderful caregivers out there, whether employed by an agency or working independently. As a family makes this important choice regarding finding care for their loved ones, it is important to weigh the pros and cons of going with an individual caregiver or with an agency.