In the past few months, Family Caregivers of BC received numerous calls from individuals asking about how to hire private care, through an agency or an independent care provider. Most cases we come across involve care for the elderly. Hiring private care is sometimes an option in other cases involving other disease specific illnesses or conditions. The three most common forms of hiring private care are through a home care agency, hiring a private home care provider, and employing a live-in caregiver.
This article is most relevant for hiring private care for a senior. We’ll be tackling hiring a private live-in caregiver in a subsequent piece.
Mrs. Robson is a 92-year-old widow with Alzheimer’s disease. In her younger years, she was a schoolteacher and raised three children. She and her husband married at 20 years old and enjoyed a 60-year marriage. She was an avid hiker, gardener, and enjoyed reading. She loves her home, which overlooks a nearby park, and she has lived in the same neighbourhood for the past 40 years.
Although very independent, Mrs. Robson needs some care and supervision; she can no longer make meals, isn’t consistently taking her medications, is unable to drive and is unsteady to shower by herself. Some of her children’s concerns include Mom getting lost on one of her walks or having a fall in her home.
Before her diagnosis, Mrs. Robson and her children discussed her future and she expressed her desire to stay in her home for as long as possible. Although Mrs. Robson was assessed by a health authority case manager and she was eligible to receive home support services publicly, her current income and her need for consistency in who provides care and support are the main reasons her family want to explore private care.
For consideration: it is very important for families to engage with the public health system. Don’t bypass this step. Circumstances, care needs, and caregiver abilities can change quickly. Health authorities have specific and specialized programs and services to support seniors to remain independent and in the community. For example, Mrs. Robson had an in-home assessment done by a case manager through Home and Community Care as well as she was seen by a geriatric team through a program called Seniors Outreach Response Team. Mrs. Robson is very social and only one of her children lives nearby. Part of her care plan includes going to an Adult Day Program once a week.
There are several important decisions seniors and their families face when more help is needed to allow an aging loved one to stay in their home. Hiring a private caregiver to provide home support services and other household management tasks are often at the forefront. There are different options for hiring private care depending on the needs of the person being care and we’ll cover each option below.
Before jumping in with two feet, it’s important to ask, “What assistance is needed and how much?” Consider personal care, household tasks, transportation, meal preparation, medication management, companionship and cultural compatibility.
In Mrs. Robson’s case, the family decides that their Mom needs a care provider every afternoon, Monday to Friday, for two hours to help with meal preparation, housekeeping/laundry, transportation to appointments and some companionship. The family will rotate and assist in the evenings and weekends.
Using a local home health care agency is often a first choice for families and seniors. A well run reputable private home care agency will run criminal record checks, screen and train employees, and require them to abide by a strict code of conduct. Talking to friends and colleagues who’ve used private care agencies is a good place to start. The other option of hiring a private caregiver through the newspaper or online is a riskier and often requires more up front time on the behalf of the family. One Canadian online database of for hire caregivers is www.caregiverjobs.ca.
Regardless of which option you choose, there are some key due diligence activities to consider with using private care providers.
Some families or seniors are fortunate enough to receive a direct referral from a trusted source. Even so, it is still important to ask key questions about an agency or individual’s care services:
Once you know what you need, write down a job description. It doesn’t need to be fancy (but it can be!) and it helps to lay the foundation for a service contract between you and your in-home provider.
It’s best to be as specific as possible and list expectations, duties, and responsibilities. Typical duties include personal care (bath/shower assist, getting dressed), companionship, housekeeping, meal preparation, grocery shopping and other errands, transportation to appointments, etc).
When dealing with an agency, they should provide a contract detailing the terms of the servicer relationship. When hiring an individual care provider, it’s ideal to hire them as an “independent contractor”. An independent contractor deals directly with Canada Revenue Agency (CRA) to pay their own income tax, etc.
It is still vital to have a service contract with an individual private caregiver with a detailed section outlining the rate of pay, number of hours and termination of contract, etc. Some independent care providers may have a sample contract to use as a template.
If the private caregiver wants to be hired as a legal employee, the employer (the person paying for the services) are required to follow all the necessary rules on having an employee on payroll. This includes submitting payroll records, paying employee deductions (EI and CPP) to CRA, covering holidays and abiding the regulations on overtime and statutory holidays. This can be a very laborious and time consuming process.
If an individual is providing care, the following areas of coverage are important to understand.
WorkSafe BC: You may need to provide WorkSafe coverage to a private caregiver providing ongoing services in your home or the care recipient’s home. Start here.
Home Insurance: Inquire with home insurance agent to make sure that adequate coverage is in place to protect from theft, injuries not covered by WCB, or damage to the home or contents caused by the caregiver providing care.
Vehicle and Passenger Insurance: Call ICBC to find out what insurance is required:
Ask the right questions. Interviewing potential applicants and doing reference checks is key. Standard questions can give you insight into a person’s skills and their reasons for working with seniors. It’s also helpful to give hypothetical scenarios and how a care provider would handle the situation.
Here are some areas and questions for consideration:
Getting permission and checking references are next steps. Acquire copies of documentation such as education certificates, first aid training, etc.
Sound daunting? Have a friend or family help you or have a professional assist you in setting up the paperwork and assist with hiring the right person.
Everyone’s caregiving situation is a bit different, but hopefully this will be useful for you as a starting-off point. If you have any questions, you can always contact us.
You can find this article here on the Family Caregivers of BC blog.
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