You may not pay much attention to articles about home health care companies–unless you’re in the business, in need of these services or perhaps considering work as a home caregiver. But, for those of us who do work in this industry, the press can occassionally be quite disturbing, and often reflective of some of the widely held beliefs (misconceptions, we say) about the home health care industry.
To begin, most people don’t have much exposure to the industry (or even know there is one) to understand what is available (and not). We created our “Paying for Care” fact sheet because we often heard from families confused about what Medicare would and WOULD NOT cover in terms of in-home senior care. We also want to help clear up your confusions or questions and invite you to ask us anything! You can leave a comment below or fill out our contact form for private questions.
One of the most common themes in articles and related commentary is that home caregivers do not get paid much when working for an agency and that they could make more money working directly with families on their own (and therefore, families should choose this method as well). With developing technologies, more “matching services” are popping up using the internet, some of which include angles like offering sophisticated profiles, vetting of caregivers, reviews, etc. Prior to the technology advances, there has always been a word-of-mouth type network existing in which families throughout the community locate and hire home caregivers through friends and neighbors. In states such as Florida, we also have a type of agency which is akin to this matching type of service but with some additional requirements–known as a nursing registry. These are some of the options families can utilize when seeking a home caregiver, but we feel that too often families don’t understand the details of what they are getting (and not) with each option.
We’d like to share some “behind the scenes” information about home health companies to provide insight in to what really goes on, and why the dollars don’t always add up the way they are portrayed.
The basic premise we often hear is that, “the home caregiver at an agency makes $X, while the agency charges $Y…the family could save money and help the caregiver make more money by eliminating the agency”. Here are all the additional costs an agency like EasyLiving covers on behalf of our caregivers (these facts may not hold true for every home health agency, we can only speak for the way we do things):
- Continuing education – 8-10 hours per year which we develop and provide, as well as pay for that caregiver’s time to attend (time which of course is unbilled to any client).
- Workers compensation. Every family and caregiver knows when they start services that they are fully protected. Families should never ignore the possibility of injury, with caregivers working in homes and different environments, doing tasks like driving and lifting. At EasyLiving, we also provide the injured caregiver with light duty work so they can continue earning a wage while they are unable to work on a (billable) case.
- Mileage reimbursement for traveling with clients.
- Tools for the job such as gloves, hand sanitizer, communication tools for the caregiver and family, etc.
- We pay for a life-insurance policy for employees also.
- The support and development of employees (coaching opportunities, training, care planning-which includes both staff time/costs and costs of related tools), to better enable them to handle clients’ needs and rewards as they grow and improve (raises, our iCaRewards program).
- Our iCaRewards (TM) program: additional rewards (points which are redeemed for gift cards, technology prizes, etc.) caregivers can earn beyond their wage-for recruiting other caregivers, attending events, getting a “kudos” from a client, and more.
Here are a few things for clients and families to consider when digging “behind the scenes” of this issue:
You may be saving on an hourly rate, but are you really saving when you add in the additional costs as outlined above and the management issues? Who will be supervising this caregiver? Who completes the care plan and ensures that it is being executed properly? Is the care plan done by a registered nurse? Is there a R.N. available to ask questions and get advice for the family and caregiver? What happens when issues arise? What happens when the caregiver gets sick? What happens if Mom doesn’t like the caregiver? What happens if my caregiver doesn’t show up? What happens if my caregiver’s car breaks down? What if I need to change the shift time and my caregiver cannot work those hours? What happens if Dad refuses to take his meds? Who calls the police when something is believed to be stolen? Who does a drug test? Who gets background and employment screening/references/interviews? Who has provided this caregiver with their training? Why isn’t there any continuing training?
Who is doing all of this work??? Either no one is and you’re taking a lot of risks–or you, as the family member, are. For potentially a few dollars/hour more you have a full team of professionals answering all of these questions for you when you work with a home health agency.
As our healthcare system becomes more complex and diseases can be managed in the home, the patient/client needs to have a caregiver with the proper training, support, and oversight to ensure quality of care is being delivered. Many EasyLiving home care clients take more than eight medications/day. We work with many clients with Alzheimer’s disease, who need caregivers with an understanding of the disease and techniques to work with individuals with dementia. A properly trained caregiver supervised by a R.N. caring for a client under a plan of care can help to spot issues and avoid crises. For example, a plan of care might include monitoring sudden weight gain as a potential sign of fluid build up in cardiac patients.
Not only do some of these generalizations about home health agencies ignore all these costs and important professional issues, they undermine the value of what professional caregivers do. Similarly, a caregiver working privately may be able to make a bit more per hour but potentially undermines his or her future in other ways. When the job ends with your loved one, the caregiver has to find new jobs and may suffer gaps in employment. The caregiver may be sacrificing having coverage such as worker’s compensation and social security disability which can provide a safety net in case of injury or illness. The caregiver and family may also be running tax risks depending on how they are handling payroll.
In addition to the protections we provide as a home health agency, we believe there is real value for both the client and home caregiver in the training, education and support we provide. Our continuing education program boosts skills that can also help in future careers, since we teach things like general computer skills. We know that many of our caregivers hope to move on to careers in nursing or other fields. We’re proud if our training and employment support offers them the opportunities to grow and move forward.
There is a lot to consider from both the family perspective and the caregiver perspective regarding home health care options. The decisions you make are personal–we just aim to ensure everyone has the information to make informed decisions, taking in to account true costs and benefits.
Are you a caregiver who would like to work for a great home health agency like EasyLiving? Check out our Home Health Careers page!
Are you a potential home care client or family searching for a home caregiver for a loved one? Call us any time at 727-448-0900 or click below to:
