Caretaker13 Asked January 2011

Should you hire an individual or a care service for help at home for a dementia parent?


We have several local area businesses that provide in-home care, but my friend had a bad experience w/ one during her father's illness before he died. Now she desperately needs help at home caring for her mother w/ Alzheimer's, but she won't consider calling a professional service. What do you or your readers think/suggest/advise?

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I wouldn't hire an individual to stay with mom for a million dollars and free services. Too much liability. A paid caregiver (paid individually and not thru a service) is NOT covered for accidents on your property. That's #1. Number 2, you are breaking the law if you don't withhold (and pay your portion of) Social Security for a caregiver. Filing those forms is a pain in the backside. Number 3, an individual caregiver will not be bonded and insured. Don't think that's important? Wait until they clean out your jewelry box. ;) Or steal medications. Or whatever.

You'll pay more through a service. Why? Because it's worth more. Way too much exposure in too many ways to hire someone individually. Are you capable of running background checks? Checking references? Work history? Are you sure this person won't move into your home (if it's a live-in position) and squat? Believe me, that happens.

Tell you friend to hire professionals through a professional service. Think she had a bad experience before? Maybe, just maybe, she ain't seen nothin' yet.

A hint that's worked for us: We put locks on two of our bedroom doors where we keep all of our personal papers, our checkbooks, our account statements, mom's medication, anything we wouldn't want a stranger alone in the house to have access to. Tell your friend that's a reeeealy good thing to do no matter who she hires.
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Bunnyo Aug 2014
When I was very sick before, the doctor ordered Home Health Care. We were fortunate to get a great agency. We had a RN, a CNA, and a aide that gave me showers and put lotion all over me. After awhile everybody was done except the shower aide. I had asked for her, and she came every time.
Now I am ill again, and am wondering if I can just ask this wonderful aide back, or must I go through the Home Health Care Agency?
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JulieWI Jan 2011
The agency I use for my mom is similar to what PirateQueen described. We haven't had any really bad caregivers, but some are better than others. The one we have now has been with mom for almost a year and mom LOVES her.

Tell your friend that there is another risk of hiring your own person. If they get hurt while working for you, they can sue for medical costs, disability, etc. It can end up costing a LOT more money in the long run.
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becayce Jan 2011
There are some great caregivers out there however as with any hiring process if you hire the caregiver privately you are on the hook for worker's compensation and taxes. Also when they are sick, have a flat tire etc then you have no backup. Additionally you need to check their criminal background. If you are okay with the risks, then proceed. There are many good service providers who do all this plus train their caregivers. It is unfortunate that you had a bad experience. But you can also be like many I have had and be with your own revolving door of caregivers who are well meaning but have their own issues leaving you uncovered some days.
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PirateQueen Jan 2011
Okay my homecare giving services that I hire DOES take my mom in the car to anything no extra charge. The service is 20 bucks an hour and 3 hour minimum even if that's all you want is 3 hours. They are not nurses but bonded caregivers. They cannot put meds in your parents mouth but can set it out for them and remind them to take it. They wash and bathe them, wipe their dirty buns, they wash dishes and laundry and vacumn, I had one that even swept the leaves up, even bring in the garbage can from the street after pick up. My service I have used for 11/2 years already. Have gone through several gals over that timeframe, have not had any serious issues yet. You have to screen them yourself as well I feel, so you can feel good about them. Have a sit down talk with them before they start or be around the entire first day or call them alot and just find out more about them. You can tell who is not a good candidate on your own and usually the agency will remove them right away if you do not like them. There's my 2 pennies on the issue.
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LME Jan 2011
I have had caregivers both ways. When we used private caregivers, the one wanted to be paid cash and the other wanted to be paid six weeks in advance, then something would come up and she would be overpaid. Also, some private caregivers are CNA's and some are not. When the weekend caregiver(s) quit, I had to find one myself. The good thing is that they were able to take mom to doctor appointments in their own car. On the other hand, agency caregivers must be CNA's, you do not pay an individual caregiver, the agency provides their own replacements. In my current experience, the aides are not permitted to take the person in their car. Agencies usually charge more than do individual caregivers, because of taxes. However, it is my current choice to have an agency caregiver because they are CNA's and the agency can fire them if they are no good, and can replace anyone who quits or is sick. Whichever way you decide to go, make sure a background check is done, and that you are the overseer of the caregivers. If you decide to go with an agency, if the caregiver doesn't show up, or doesn't do her job, etc, you can report them to her supervisors. Make sure that the caregiver is familiar with dementia. If you get a private caregiver, you will need to pay taxes and cover them under worker's compensation.
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