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7 in-home care mistakes to avoid

by Doresa Banning

In-home care is a valuable service for people who need help at home that can't be provided by themselves, family or friends. This may be individuals who are elderly, disabled, recovering from an illness or even new moms. Home caregivers provide a range of non-medical services, from homemaker tasks, like preparing meals and light housekeeping, to hands-on care, such as bathing and grooming.

Because the caregiver spends time with the person needing assistance and in their home, for the arrangement to work, it's vital to find a good, safe match. Whether you're looking for an in-home care provider for yourself or for a loved one, don't make the mistakes many people in your shoes do when searching for and hiring someone.

Avoid these common in-home care mistakes

Here are some typical in-home care mistakes, with ideas on how you can steer around them:

1. Not determining needs and preferences first

Initially, write down the specific care needed and what exactly those tasks entail. Does bathing mean a bath or shower? What does housekeeping entail? Determine how often those should be done, and on what days, if there's a preference. For every task, specify when, how and where (as it relates to errands, for example) it should be done.

Document any preferences. Do you prefer a male or female caregiver, or not have a preference? What are preferred times for meals? Are there house rules about shoes and smoking? Capture anything that's important to the care recipient's routine and desires.

2. Not creating a care plan

Using the needs and preferences you've noted, develop a care plan with checklists that details what the caregiver is going to do each day they work. For instance, if the caregiver is to grocery shop, explain what store to go to, how to find out what to buy, where to get the money for purchases and other pertinent information. The care plan also should contain emergency contacts.

"Be very clear about what the job is, what the expectations are," said Claudia Fine, chief professional officer and executive vice president at SeniorBridge, a national elder care provider headquartered in New York.

3. Assuming one home care provider fits all

Don't assume if a home care provider worked out well for someone else, the same would be true in your situation.

"That's not necessarily the case because each person's needs are so unique," Fine said.

Referrals from friends are helpful, but still do your due diligence on them (see Nos. 5 and 6) as you would for a stranger.

4. Not understanding agency vs. private hiring options

There are two ways to find and hire an in-home care provider: do it yourself or go through an agency. It's essential you understand the differences up front.

Doing it yourself involves getting referrals from friends, family or a registry, or placing an ad. You can consult with a private care manager for help (look on the National Association of Professional Geriatric Care Managers website). You're in control, and there is no middleman such as an agency.

On the positive side, the cost of care typically is less than with an agency, said Vicki Schmall, executive director and gerontology and training specialist at Aging Concerns, an Oregon nonprofit organization.

On the negative side, you alone must handle all aspects of hiring, oversight and potentially employment requirements (see No. 7). In addition, there is no backup caregiver.

Agencies, typically with numerous caregivers in their employ, find you one or more possible caregivers. They investigate potential workers and manage employment requirements. They provide backup care, oversight and availability in case of emergencies, and they can adapt to changing needs. Many agencies have care managers on staff who can meet and help you with Nos. 1 and 2.

With agencies, the downsides are the cost is higher and not negotiable, Schmall said, you relinquish control and additional individuals are involved.

5. Dismissing interviews

Always interview the caregiver candidates to determine if they're a good match in terms of skills, experience and personality. Is there chemistry between the caregiver and recipient? Does the care provider have a good attitude? Do they fully understand the person's needs? Ask open-ended, rather than yes or no, questions.

"The interview is extremely important," Schmall said.

6. Taking potential candidates at their word

If you opt to hire a home care provider privately, investigate them. Do a criminal background check, talk with their references and, if necessary, obtain their driving record.

"You really want to make sure that [the person needing care] is protected," Fine said.

7. Not learning the financial, insurance and tax requirements

If you hire someone on your own who only works for you, they're considered an employee. You're required to withhold payroll taxes, have workers compensation insurance and meet all state requirements concerning employees. You also need insurance (beyond homeowner's insurance) in case a caregiver is injured in your home.

If your caregiver has several clients and determines their own schedule, they qualify as an independent contractor. You could treat them as such, avoiding payroll withholdings, etc. If, however, you go through an agency, it takes care of all employment requirements. You simply pay the agency for services.

Avoid these in-home care mistakes, and you can look for a positive experience with an in-home caregiver.