ADIA provides answers to the most commonly asked questions to help you navigate through the selection of a Personal Care Assistant, senior care options, and financial planning for your future.
What is the difference between Home Health Care vs. Home Care?
Home Health Care refers to a skilled professional (Registered Nursed/Licensed Vocational Nurse), who provides medical care at home. A physician often prescribes the type of skilled care needed and the costs can be covered by Medicare or Medi-Cal, if the elder qualifies. Home Care involves a Personal Care Assistant, who provides assistance in the home and attends to the elder’s personal needs (bathing, dressing, eating, house cleaning, etc.). Since many elders require this type of care rather than home health care, finding the right home care provider that suits your needs and lifestyle is critical.
How do I find a Personal Care Assistant?
There are three principal ways to find an in-home Personal Care Assistant:
Relative: The elder may prefer care from a relative (child, grandmother, sibling) rather than that of someone unknown. A relative might care for an elder without receiving any compensation or in exchange for living in the residence rent free. Often this type of arrangement is understood by the parties, but is not in writing. At times, a written agreement may be preferable.
Private Agencies: There are many agencies that provide paid Personal Care Assistants. It is important to know whether the Personal Care Assistant provided by the agency is an employee of the agency or an independent contractor. Caution: avoid financial arrangements that may lock you into doing business with an agency (for example, an up-front deposit).
Other Sources: You can hire a Personal Care Assistant through a referral by a friend, professional (Geriatric Care Manager, Conservator), or service organization (senior center, church, etc.) A Personal Care Assistant can also be hired through a registry, which operates like a referral agency by maintaining a list of potential Personal Care Assistants.
What do I need to know when selecting a Personal Care Assistant?
Personal Care Assistant as Employee/Independent Contractor: Is the Personal Care Assistant your employee or an independent contractor? If the Personal Care Assistant is your employee, you are responsible to withhold and pay various payroll taxes (including unemployment compensation and social security) on behalf of the Personal Care Assistant. If an agency provides one of its employees, the agency bears the employer responsibilities. Check with an accounting professional for more information on employee/independent contractor issues.
Personalities: Work to match the personality of the Personal Care Assistant with that of the person receiving care. Can they get along? Have mutual respect? Work together? It may take several attempts before a good match is made.
Screening/References: Has the Personal Care Assistant been properly screened (personally interviewed, criminal background checked, credit checked, references contacted)? A Personal Care Assistant provided by an agency or registry is not a guarantee that screening has occurred. Be sure to obtain and check references of the proposed Personal Care Assistant.
Training: Has the Personal Care Assistant had any specialized training (familiarity with equipment/supplies, received training in a specific illness, etc.)?
Personal Care Assistant Duties: From the very start, a clear understanding of duties the Personal Care Assistant is to perform is an important part of the working relationship. Write down the duties the Personal Care Assistant is to perform (and not perform) and monitor performance as time goes by.
Plan for Care: There should be a plan for care that considers and responds to the elder’s specific needs (prepare special menus, provide needed transportation, etc.). How will the plan be developed, and by whom? How will the plan be reviewed and revised from time to time?
Reliability: Does the Personal Care Assistant have reliable transportation? Is there a backup plan in the event that the Personal Care Assistant doesn’t show up?
Supervision/Isolation: Who will independently supervise the Personal Care Assistant to ensure the quality of care? Who will make sure that the elder does not become isolated from others? Warning: isolation can increase the likelihood of physical and/or financial abuse.