Eldercare Tips – How to Hire Help Your Parents Won't Hate Through an Agency

How can you find capable and honest people whose quirks won’t drive your parents nuts? How much will they be paid? For how many hours at a stretch? How many stretches per week or month? Will these people be employees of yours/your parents? Of an agency? Or independent contractors? Do you know how the IRS determines these things and what paperwork and record keeping are required? Have you thought about worker’s comp and withholding? Suppose the applicants don’t speak much English?

Finding Candidates
There are two common ways to find help. Your parents can hire workers through an agency or can hire privately using referrals from friends, neighbors, physicians, local groups, or advertisements. Do you and your parents know the pros and cons of each option?

Agency hires
What are the pros and cons?

If your parents hire through an agency, the helper is the employee of that agency. It will find candidates, select a helper, pay that person, withhold taxes, provide W-2 forms to the helper, and bill you/your parents at its hourly rate. Although your parents will not have to recruit, screen, or haggle over wages, they will have limited choice in whom the agency sends – but somebody will show up, including substitutes when your parents’ worker is ill or on vacation. Clients may ask about the agency’s hiring and screening policies but are expected to rely on the agency’s selection.

If your parents have a problem with the worker, they can call the agency and a supervisor will talk to the worker for them. This is a strong argument in favor of agency hires, as long as your parents are willing to ask for help. How likely are your parents to report dissatisfaction while problems are small and easily fixed? Will they have the moxie to call the supervisor? Will they let you know?

Your parents will probably be charged between $20.00 and $40.00 per hour and will have to agree to a minimum number of hours per visit, usually four. The worker receives about half of the agreed-on fee. If the worker is dissatisfied with the fee schedule or benefits, that dissatisfaction is with the agency, not with your parents. Most agencies have policies prohibiting clients from supplementing salaries or giving gifts to their helpers. This is to protect clients from pressure by rather poorly paid helpers. If a helper suggests ways to skirt this policy and bestow tokens or riches, the agency should be told immediately. This could lead to financial abuse. Will your parents tell you or the agency promptly if this happens?

Types of agencies:
If your parents need simple housekeeping, they should work with a housekeeping agency. If they need in-home help including personal assistance, they should use agencies that specialize in in-home helpers and non-medical personal care providers. If they need assistance with health problems, they’ll need to look into more skilled home health aides.

The first option, housekeeping agencies, provides people who clean homes. But even this apparently simple option should be influenced by the results of the check sheets.

• Some house cleaners sent by housekeeping agencies bring their own cleaning supplies. That’s a help if it saves you or your parents a shopping trip, especially one that involves hauling heavy containers. But it’s a problem if your parents want specific cleaning products used and not others.
• House cleaners from agencies probably are on a fairly tight schedule, will come in, clean, and move on to the next house and may work in pairs or teams. This is great if your parents want the house cleaned quickly because it reduces the time somebody is in their home. But it can be a problem for a parent who doesn’t like people in the house because it increases the number of people there at one time. And with a team cleaning, several rooms may be in upheaval at the same time.
• Agency house cleaners may also chat with each other, and not necessarily in English. This can be a problem if your parents don’t want the noise involved with several people cleaning and talking. If they want to work along with or supervise the helpers, they may hit trouble both because of the helpers’ time constraints and also because they may not speak much English. And, if your parents want sociability as well, they may want to avoid this option. These workers get paid for cleaning, not talking, and need to move quickly and get on to their next job.

The second option, agencies that provide personal assistance and light housekeeping, offers more services and more sociability. Even if your parents don’t need much assistance beyond light housekeeping at this point, choosing an agency that provides in-home health aides may make sense. As your parents’ needs increase, they won’t have to start fresh with a new agency. These agencies provide employees who can offer broader services including transportation, sociability, assistance with activities of daily living (ADLs), and other support. In essence, your parents make a list of things they’d like help with, how many hours a day/week they’d like assistance, and the agency does its best to match the request with their available staff. The agency bills an agreed hourly rate based on the level of difficulty of the services provided. It has policies about weekend, holiday, and overtime charges.

To get the best match through an agency that provides help beyond housekeeping, you and your parents should give the intake worker at the agency a detailed list of what your parents want help with and how they want to be helped. These checklists should be reviewed right away with any helper who shows up at the house to prevent the well meaning 19-year-old aide from driving your parents crazy by gabbing all day long about a fruitless search for a soul mate. Review the checklists and work regularly with the aide, and pass the feedback along to the aide’s supervisor at the agency. Attention to little details at the outset will make eldercare services more tolerable to your parents now and in the future.