A Need for Care
Home care can be provided for all ages, but the primary consumer is those older than 65. By 2020, 56 million Americans will be 65 and older. By 2050, that number will reach 84 million, with individuals over 85 tripling by 2040. Nearly 70 percent of Americans who reach 65 will be unable to care for themselves at some point without assistance. Home care fills the needs for those who require help, as the majority of individuals wish to remain at home.
Home health nurses can assist with the medical side of remaining at home by providing nursing care. Types of services include illness prevention, by providing vaccinations, administration of medications, and coordination with outside physicians and other specialists. Home health nurses can also create care plans for maintenance of ability to complete activities of daily living, restoration for those recovering from illnesses or surgery, & palliation for those at the end stages of life. However, it is the caregivers that execute these care plans, which is why it is important to have skilled assistance.
While caregivers are not typically medically certified, they do receive professional training to enable them to assist in activities of daily living (ADLs). Assistance with ADLs such as such as bathing, meal preparation, running errands, and housework is essential to remaining at home. Caregivers also help seniors stay healthy by providing medication reminders. This is a critical job considering 40-75% of older people reportedly make some kind of error when taking their medications.
Caregivers also assist with maintaining healthy, balanced diets by preparing nutritious meals. More importantly, caregivers provide companionship and mental stimulation by engaging their clients in conversation and hobbies. They also act as an additional set of “eyes and ears” by recognizing potential signs of declining health and falls. (For more information about this, check out “Five Signs Care is Needed“).
Agency vs. Private Hires
When you seek assistance from a reputable agency, caregivers receive training in the above skills, have background checks and drug testing, and undergo assessments for proficiency on an ongoing basis. Some families turn to hiring individual caregivers or rely on neighbors to volunteer help. Not only can this cause more work for the family, it can also be more dangerous for several reasons. Agency caregivers have special coverage and carry disability insurance in case of injury. Under-the-table caregivers are unlikely to come with these safeguards. If they are not bonded and insured, you could be liable if they get hurt while working in your home. Typically homeowners insurance does not cover an “employee” in your home, so it is important to check your personal insurance coverage.
When you hire a private caregiver, the IRS considers that person your employee if you pay them more than $1,800 in a calendar year. This means the IRS holds you responsible for withholding and paying taxes, which include income tax, Social Security, Medicare, and other state and federal taxes and benefits. Some families try to get around this by labeling a caregiver a “contractor,”. In this case, you must file a W-9 recording the annual total of your caregiver’s wages. However, few situations meet the IRS’s contractor definition, and the government is cracking down on this issue.
These issues create a grey area for family members and their hired caregivers or volunteering friends and neighbors. If valuable items go missing, or your loved one has a fall, or your helper hurts their back, your relationship and finances can be put at risk by working out potential legal issues. This is why it is important to seek out skilled care through reputable agencies. Not only will this improve the quality of care for you, but it will also relieve you of the stresses of acting as an employer for a caregiver. And that is ultimately the point of home care – allowing you to be stress-free and comfortable in the comfort of your own home!