You have decided on getting elderly home care services for your elderly mom. However hiring a home care worker can be a difficult task. Where do you start from?  Should you ask her physician? Or maybe her neighbor? Or a friend? Maybe placing an ad on Craigslist or any online site will yield the desired results? You are also scared of leaving your dear one at the mercy of devious caregivers taking advantage of defenseless clients. When you realize that only a reliable and consistent caregiver can do, what you need is the expertise and support of a home care company.

However not all these companies are actually home care agencies. Some are registries. Though there are similarities, these two types of businesses are different. They both match families with home care workers. But that’s the only similarity; take a closer look at the differences.

Professional in-home care agencies offer a variety of health or non health care services in the home. These agencies are licensed and regulated by their states where required. They are involved in the recruitment, screening, hiring, training and supervision of their caregivers. These caregivers are bonded and insured by the agency. The cost of caregiving is paid directly to the agency, and the agency sort out all payroll taxes and other human resources tasks.

A registry (also known as a private duty registry, staffing service or independent contractor agency) is like a clearing house for home care workers. Registries refer, but do not hire home care workers. They behave as a middleman, matching families with a list of possible candidates for the job. You pay them a finder’s fee; once the caregiver is hired, the relationship is usually terminated.

The key difference is that when you hire from a registry, you become the caregiver’s employer and you have to assume some certain responsibilities, risks and liabilities.

If you decide on a registry, these are some of the tasks you should anticipate

1. Hiring: The agency gives you a list of potential candidates to interview. It is up to you to carry out background checks, cross-check references and licenses, and talk about duties, expectations, salary and experience and then to decide on the caregiver you would employ to care for your loved one’s needs and preferences.

However a reputable home care agency will take care of this responsibility and send you a bonded, insured and rightly licensed caregiver suitable to cater for your loved one’s needs, from their own well trained staff.

2. Training: One disadvantage of hiring a caregiver from a home care registry is that the caregiver may not be experienced enough. You have to be patient as they learn on the job. You are probably not qualified to provide that training. A professional home care agency, on the other hand, will match with a caregiver who has received adequate professional training and who knows your loved one’s care needs, be it physical or cognitive or a combination of both.

3. Supervision: if you hire a caregiver from the registry, it’s your responsible to supervise the person. However, home care agencies supervise and evaluate caregiver employees on a regular basis. The agency also will find out if the caregiver shows up at the right time for their shift and carry out their assigned tasks. This is an added advantage when the family leaves in a faraway place.

4. Payroll taxes. A registry has no responsibility to handle payroll taxes when you hire through them. If you are found guilty of evading taxes you may have to pay civil fines or face civil penalties. Home agencies; on the other hand, takes care of payroll, including federal and state taxes, Social Security, Medicare and unemployment.

5. Work-related injuries. Caregiving is a daunting task, and senior care workers are at risk of injuries, such as automobile injuries, falls and sprains and strains from lifting clients. If you hire a caregiver from a registry and the caregiver gets injured in your home, you will be responsible for the caregiver’s medical bills and disability. Your home insurance may not cover this type of situation. Why not hire from a professional home care agency and let them take care of the liabilities for you?

6. Backup: If your usual caregiver couldn’t make it to your place due to an emergency or illness, a professional home care agency will provide a backup caregiver even if it’s at the last minute. 

 7. Performance: If the caregiver is missing shifts, arriving late or slacking up on duties, you have to have the talk and put in place consequences for not improving if you hired them from a registry which may not be comfortable. However, if they hired from an agency, you can report to them and they handle the situation much better even if it means providing you with another caregiver.

8. Ensuring your loved one’s safety: Since very few registries perform background checks, there is a high possibility of hiring a dubious caregiver. There are caregivers who abuse their position of trust to take advantage of helpless elders by stealing from, exploiting or even physically abusing them. You will have to assume the responsibilities of taking up the issues with law enforcement officers. In the case of a reputable home care agency, background checks are carried out on every employee and if the caregiver commits any crime, the agency is responsible to taking it up to the appropriate authorities.

9. Cost: At a superficial glance, it may look cheaper to hire a caregiver from a registry compared to hiring from a professional home care agency. However, remember all the hidden costs and potential costs of being the caregiver’s employer. You have to hire an accountant, elder law attorney or aging life care professional (geriatric care manager) to help with payroll and other human resources tasks. There’s also a high likelihood of hefty tax evasion penalties or even a personal injury lawsuit.

Don’t forget the cost of a professional in-home care provider is not only for the services of the caregiver, but also for the various legal and human resources support tasks and protections. So make the best choice based on these facts. Choose a professional home care agency now!