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Hiring Home Care: Options for those Impacted by Alzheimer’s

Alzheimer’s Disease impacts each patient in different ways – from the onset of each symptom to the progression and duration of each disease stage.  This unpredictably makes it difficult for loved ones trying to balance their own health and wellness with the physical, emotional and financial challenges of caring for their loved one diagnosed with Alzheimer’s.

Often, family members rely on home care as the preferred solution for managing day-to-day activities of daily living for their loved one while getting a break from the demands of providing twenty four hour-a-day care and supervision.

But selecting a home care provider can be challenging as California only requires private duty home care companies to obtain a business license.  There is no governing body to enhance the quality of in-home care by enforcing standards for providers.  Not all agencies are the same!

In California, a prospective home care client has 3 options.  First, hire a caregiver directly.  The benefit is cost.  In this instance, the client will pay the lowest fees.  The risk can be great.  The caregivers are not screened by clients to include identity verification and criminal background check.  Additionally, the caregiver is NOT covered on the client’s homeowner’s policy in case of theft or injury. Often, caregivers are paid under the table and this becomes a risk for the client as well.

Second, a home care client can use a Home Care Registry.  In this model, the Agency is not the employer but acts as a placement service.  They screen applicants, but do not pay payroll taxes, cover Workers’ Compensation, and they cannot train or supervise their workers.  The cost is slightly more than hiring a caregiver directly.

Finally, a home care client can use an Employer-Model Home Care Agency.  In this instance, the cost is more but the agency minimizes risk and enhances its quality of service by conducting thorough background checks, performing new employee orientation programs, handling all payroll tax liabilities, covering the employee via Workers’ Compensation, offering caregiver benefits (such as health insurance), providers ongoing training to staff, having relief staff availability, being on-call 24/7, making supervisory visits in a client’s home, and much more.

Three years ago, the California Association for Health Services at Home (CAHSAH) recognized the predicament for families purchasing home care services and created a program for identifying quality in-home care providers.  CAHSAH created its Certified Home Care Aide Organization Program to identify agencies that meet the minimum standards as proposed in state legislative efforts to regulate the in­-home care service industry.  To learn more about CAHSAH, its Certification Program, and to find Certified Agencies in your community, visit www.cahsah.org.

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