Janet’s father Bill was 86, diabetic and frail, but he wanted to live at home. As Bill’s care manager, I worked with a professional Home Care Agency to arrange services to assist him with personal care, shopping, and household chores several times a week. However, as time passed and Bill’s health worsened, it became evident that he needed more care and it wasn’t safe for him to be alone.

“My father doesn’t want to go into a nursing home and I think I have the answer,” Janet told me, as we discussed the options. “I know a woman who took care of my neighbor’s dad before he passed away. She was a nurse in the Ukraine and she’s available for a live-in position. I think I’d like to hire her. It would be a lot cheaper too.” The woman Janet had in mind was not affiliated with an agency.

“Let’s talk about the pros and cons,” I said. This was certainly not the first time that families I worked with wanted to hire privately. And while a private duty caregiver is usually more affordable and can make it possible for seniors to live safely and comfortably in their own homes, it’s important for families to weigh all factors when making a decision.

For example, Janet would become the employer and would be responsible for compliance with payroll taxes, social security withholding, workers compensation taxes, and wage and overtime laws in her state. She would need to regularly prepare payroll, submit taxes, and issue a W-2 at the end of the year. This would require accurate records. She would also need to maintain specialized insurance to protect the home in the case of an accident and to protect the caregiver. Second, there would be no back-up coverage if the caregiver became sick, wanted time off, or decided to leave. Third, the family risked being sued if the caregiver got hurt on the job.

For most families, this is not something we would advise. Janet was an accountant and payroll specialist who had worked in the family business managing employees for years and she felt that she knew and understood the employment rules and laws. The reality was that the reputable home care agencies I usually recommended were experiencing severe staffing shortages and they were having difficulty finding staff who could provide the long hours of care they needed for Bill.

Ultimately Janet decided to hire the live-in private duty caregiver, who bonded well with her father. Janet asked me to visit Bill every couple of weeks and to continue monitoring his care, both in the home and through the medical system. I made it clear to all parties involved that I would not provide direction to the caregiver employee or manage her work in any way as I would not be the employer. This is a very rare case where this option worked. Each family’s situation is different. A care manager can help families make the best decision for their senior and keep eyes on how things go.

If you or someone in your family are facing aging challenges, please give us a call at (920) 740-8441 or email us at sue@coylecaremanagement.com. We’ll be happy to assist!