I'm hoping to talk with some folks who have or are currently using an independent caregiver.
Would really appreciate some insight and advice on what the hurdles are, how your experience was, and whether there were any issues in working directly with an independent caregiver (as opposed to an agency caregiver).
I'd have to say the pro's of hiring independent is that you will get better quality people. Most homecare agencies will hire anything standing upright. With hiring privately, you can be picky. You can check their references yourself and their backrounds. You set the care plan too which is nice. I went independent because it paid usually twice what an agency pays its caregivers and then some. Yet the clients who hire privately still save money. The pay is so good for us because there's no agency middleman taking their cut. So you're going to get quality people who will work a lot harder and will go the extra mile for your loved one. Hiring privately also means you can cut through all the red tape on what the aide is "allowed" to do and what they aren't. Like giving a person their medication. Or changing a dressing. Independent aides won't complain about housekeeping and cooking either.
The downside of going independent is additional coverage when needed if the caregiver is not available. Then again most homecare agencies fail at getting a fill-in aide on short notice too.
You need a plan for that. A plan for who will be covering for the regular caregivers on their days off, when they get sick, when they want to take a vacation, or holidays, or if they cannot get to work because of weather or some other disaster or emergency.
If you have a good back-up plan for this, you can do great with hiring independent caregivers.
If you're looking to hire live-ins, NEVER hire just one person to do this and don't hire several because the more caregivers coming in and out of a home the more chaotic it will become. Caregivers will also start fighting over the hours when you have several too. So don't do that.
I would recommend hiring two caregivers who will split the week staying at your LO's house. Three days on, three days off and alternate Sundays. Or one caregiver who does Monday through Friday and then a weekend person. This way the caregivers do not establish residency at the client's home. Never let a caregiver ake your LO's house their address because this can be a problem.
If you have a good coverage plan in place if the caregivers aren't available, don't let anyone establish residency, and you treat them right hiring independent works great for keeping a person in their home.
Transportation was a big problem for her, and she really wanted the live in opportunity (come once, leave once). This was happening at the same time we needed to say goodbye to our daytime person. Right from the beginning I felt that the hours she was asking for were too many for one person. She does 5 nights and 4 days. But she literally begged me for the hours as she is the sole breadwinner for a family of 4.
My mother is on hospice and very demanding. I ask very little in terms of housekeeping. Mom has a paid housekeeper come in every other week. We really didn’t discuss this too much ahead of time, but I would suggest you do.
The caregiver only loads mom’s dishes into the dishwasher, and washes mom’s clothes & sheets as far as housework goes. Otherwise we expect her to help remind mom to take her meds, bring her food (we get meals on wheels and have a lot of easy prep food there), and the biggest thing is helping mom to the commode, recovering from using the commode, and cleaning the commode.
Our contract specifies that we are not an employer and offer no benefits. However, I did give her a paid day off for Thanksgiving, Christmas and New Years. I also allowed her to take some unpaid days, which was very difficult for me personally, as I had to cover. Btw, she gets over $20/hour, and I wouldn’t expect someone to do a job this demanding for less.
The biggest bone of contention is that I have to pay her by check to keep everything above board. She states that it takes 7+ days for her to get the money. I asked my bank about this because I can see that the funds leave mom’s account the next day. But my bank said it’s entirely possible that her bank waits 7 days to release the funds.
I think my caregiver is getting burnt out. Plus my mother has said unkind things to and about her. Even though I and the family know it’s my mom being difficult and we have assured the caregiver that she has our full support, it’s taking a toll on her.
In the meantime I started giving the caregiver the check earlier in the week (so before all the hours had been worked). It was inevitable, and the day finally came when she had to be absent, so now she owes me money back. This is my own fault.
Agencies are more expensive, but less stressful in terms of everything above, especially payment and covering for absences. However, many people I have spoken to have been through a dozen or more unacceptable caregivers from agencies, and even if you find someone your LO likes, they can send substitutes.
I hope you find something helpful in all of this.
Edit: Also on the advice of the attorney we raised mom’s personal injury on her homeowners to $1,000,000.
Don't expect them to work more than 40 hrs per week, even if they are live-ins.
Think about what you will do if this person calls in sick the morning they are supposed to work. Agencies provide subs. Agencies also do background checks.
Know what your state's labor laws are. If you are the only client for that "independent" caregiver, the state most likely will view you as an employer, and therefore you will need to do withholding, quarterly reporting and a W2.
Do you have the right (or enough) insurance for liability for this person as they are in that house every day?
Make sure all your LOs private and sensitive info and paperwork are secured, as well as any prescription medications.
FYI my cousin experienced caregiver financial abuse when she was the PoA for her half-brother (elderly, bedridden from a stroke). The caregiver took everything from him, even though she came with recommendations. At first she was very kind and sweet and seemed above reproach. But she was a predator.
They paid their caregivers a generous wage, checked references carefully, had a contract in place and they were good to go. They used their parents’ money to pay for their care.
Please don’t expect one person to fulfill a full time position. Hire more than one caregiver. It’s not only fair but necessary for this arrangement to work properly.
Best wishes to you and your family.