Some Thoughts on Hiring Home Care for Seniors: Finding the Just-Right Fit

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Donna Mae Scheib

Some Thoughts on Hiring Home Care for Seniors: Finding the Just-Right Fit

Posted by Donna Mae Scheib on November 17, 2017

Some Thoughts on Hiring Home Care for Seniors: Finding the Just-Right Fit

There is increasing demand for home care providers as more and more seniors choose to live independently and maintain their existing lifestyles. The responsibilities of the providers include household and personal care services like making meals, cleaning and helping with bathing and dressing. Some care providers also provide medical and therapy treatment for those who have chronic conditions, injury or an illness. Although qualifications, licensure and compensation vary from state to state, there are some general factors to consider when hiring a home care provider for seniors.

Considerations in Hiring Home Care

  • Interview in Person—You can ask questions and see firsthand if the provider will be a good match for the senior based on their personality, background, interests, etc.
  • Training—Verify their education and training certifications, especially as they relate to home care.
  • References—It’s important to gather references before determining your decision. Contact several to inquire about overall abilities of the potential employee.
  • Criminal Background Check—This is necessary, easy to do, and will give you peace of mind about the safety of the senior, home and property.
  • Availability—Establish in advance the amount of care needed per day/week/month and make plans for if the home care provider requires time off and/or is ill.
  • Transportation—Will the caregiver be assigned transportation duties to help the senior with errands, appointments, community activities, emergency trips, etc.? Will a vehicle, gas money and insurance be provided? Does the caregiver have a valid driver’s license? Will the senior need any equipment for transport?
  • Rates and Billing—Keeping accurate records is mandatory. There are many ways to pay for services: private pay, Medicare, Medicaid, long term care insurance, etc. Research what will work for your situation.
  • Insurance—Does the senior have updated homeowners insurance? What is covered? Will you be providing workers’ compensation to the hired individual?
  • Taxes—Wages must be reported if you hire an independent home care provider; additionally, local, state and federal payroll taxes need to be paid to the independent provider.
  • Contract or Service Agreement—In writing, develop a contract that outlines the services/responsibilities of the care provider. Get input from the provider. Outline a minimum time commitment and the pay agreement. Does the provider have an initial deposit requirement? Through what system will you provide money for transportation and outside activities for the senior? Once both parties agree, secure signatures. Update the document as needs change.
  • Documentation—Consider keeping a daily log of activities the senior is involved in and have the provider update it throughout the day. Provide a list of important contact information (medical, POA health, police, ambulance, fire, your own number, etc.) and secure a list from the provider of their contact details in case something comes up.
  • Back-Up Plan—If there is a change in the contract or service agreement, have a back-up plan in place. See if an alternative provider can be available on short notice, whether it be a family member, a friend, another independent provider, or someone available through a trusted agency.

Comparing an Agency Provider to an Independent Provider

Advantages of Agencies

  • Screens and hires qualified employees
  • Able to provide help quickly
  • Sends replacements if needed
  • Offers their employees training, supervision and liability insurance
  • Handles employee payroll
  • Takes care of potential conflicts (between provider/senior or provider/hirer)

Disadvantages of Agency Provider

  • Typically costs more than independent providers
  • Schedules may be less flexible than needed/desired
  • May allow for less say over selected caregiver
  • Continuity of care may be disrupted if agency sends different workers throughout the caregiving period

Advantages of Independent Provider

  • Typically less expensive than an agency
  • No middleman inefficiency; has control over tasks, hours and pay
  • Maintains continuity and consistency of service

Disadvantages of Independent Provider

  • Often more time and labor intensive during hiring process—hiring party must schedule interviews, screen candidates, develop the contract, etc.
  • Responsibility for securing substitute providers falls on the hiring party
  • Hiring party must complete and manage more paperwork (as for payments, insurance, etc.)
  • Hiring party may require added insurance (for example, liability insurance) in case provider has an accident on the job


Finding that “just right” caregiver for a senior is an important job—after all, their provider will play a crucial role in their day-to-day life. The considerations noted above need to be weighed carefully for you to make the best decision possible for your loved one.