In-Home Senior Care Choices: How to Do it Right

For many families faced with caring for an elderly parent, sibling, spouse, relative, or friend, the choices in senior care can be overwhelming.

The term “senior care” covers a range of care options but commonly refers to extended services for seniors who need help with activities of daily living (ADLs). Care can be provided in a senior’s home, as well as the home of a family member (such as a son or daughter), in the community, or in various facilities like adult daycare centers, fixed communities, assisted living facilities, and skilled nursing homes.

The National Aging in Place Council reports that more than 90 percent of older adults prefer to “age in place,” meaning they stay in their homes for as long as possible. By aging in place, your elderly loved one feels in control, maintains a sense of dignity and independence, and are usually closer to family.

However, to “age in place,” some seniors may need help with basic tasks that have become difficult as they grow older.

In-home senior care often includes medical and nonmedical services such as financial planning and management, companionship, home safety, meal preparation, personal care, and transportation. Job titles include chore worker, companion, cook, driver, homemaker, personal attendant, and senior caregiver.

Some families choose to take on the caregiver responsibilities themselves, which can place a tremendous toll on balancing work and life commitments around attending to the needs of an elderly loved one. This also requires family members to be close by, which is not always the case.

Families may try to save money by caring for their seniors on their own. However, the logistics of being the senior caregiver, time demands, and elevated stress often times becomes too much for a family to handle.

For families that wish to hire a caregiver, there are typically three ways to obtain in-home senior care.

Home Health Care Agency

The agency employs the senior care provider to work in the family’s home and maintains control over the worker’s duties. The agency also takes care of payroll, taxes, insurance, and human resources.

Referral or Placement Agency

In this case, the agency charges a fee and then finds and recruits the in-home senior care provider on behalf of the family. Control over employment duties lies with the family who will manage payroll, taxes, and compliance with wage and labor laws.

Hiring Independently

When hiring on their own, the family finds, hires, and employs the in-home senior care provider. They control employment and handle the responsibilities of being a household employer.

Hiring through a home health care agency is typical when the senior has specific medical care needs that require a trained and licensed caregiver to perform medical treatment.

When nonmedical care is required, many families choose to hire independently or through a placement agency. However, in these cases, the family becomes a household employer in the eyes of the IRS and other government agencies.

Three Benefits of Hiring Independently or Through a Referral/Placement Agency

1. More control

The family has more control over the employment arrangement and can choose how care is managed.

2. Cost-effectiveness

It’s typically more cost-effective, especially if the senior needs less specialized care or only needs help for certain hours or days a week. The family saves money by taking on the management and supervision of the caregiver themselves.

3. Less “red tape”

There is far less “red tape” compared to hiring through a home health care agency. However, the family still needs to comply with all applicable tax, wage, and labor laws.

8 Questions to Ask About Your Senior’s Care Needs

However you (or your family) decide to hire an in-home senior caregiver, you’ll want to understand your objectives for bringing an employee into the home to look after your senior.

1. How much and what kind of care does the senior need?

2. How is each one of us able to help physically or contribute financially?

3. Are there services in our community for older adults and their families?

4. What specific duties will the caregiver perform?

5. Which days and for how many hours do we need a hired caregiver?

6. Can we, as a family, provide backup help if the hired caregiver is unavailable due to time off or illness?

7. Who will be in charge of the hire and employment of the caregiver? This includes recruiting, background screening, managing payroll and taxes, and supervision of work.

8. Who will act as the liaison with the senior care provider?

Talking about the financial and emotional issues surrounding senior care can be difficult for a family. It may be beneficial for an impartial person to help guide the discussions around these questions. A social worker, religious official, or an objective family friend can help calm tensions and find solutions for your senior’s care.

A family may also benefit from consulting with a senior care coordinator or geriatric care manager. They can assess the situation and needs and offer guidance on the medical, personal, socio-interactive, financial, estate planning and environmental issues surrounding your senior’s care. A care manager may also formulate a plan of care for the senior’s remaining years.

For more guidance on how to hire in-home senior care for your elderly loved one, read How to Hire a Caregiver for Your Senior: Your Complete Guide to Finding, Employing, and Retaining In-Home Help. The book is available as an e-book or paperback on Amazon.

Also, call GTM Payroll Services at (800) 929-9213 for a free, no-obligation consultation about hiring in-home senior care and how to manage the responsibilities of being a household employer.

Hiring a Senior Caregiver?

Download our complimentary Senior Care Payroll and Tax Guide. In this new guide, we lay out the steps on how to comply with tax, wage, and labor laws when you hire an in-home senior caregiver.