What Are My Home Care Options?

By September 30, 2018Home Care

As people grow older, their healthcare and day-to-day living pursuits become more and more complicated. In fact, maybe you have started to feel overwhelmed with your elderly loved one’s medical, legal, financial, and psycho-social challenges? Perhaps you have even begun to wonder how much longer they can continue to live independently in their own home?

Take heart. You can find the help your loved one needs, and it’s likely that their care can be provided where they are the happiest and most comfortable—at home.

Just remember to proceed with caution. Finding the best home care agency that meets your needs will take some research. A good place to begin is with a review of the different types of home care options for seniors.

When you’re looking for home care for an elderly loved one, your options include:

  1. Private caregivers
  2. Independent caregiver registries
  3. Home care agencies
  4. Care-managed home care agencies

Private caregivers are, by law, considered household employees. Thus, seniors and their families are required to handle all of the caregiver’s tax filings, liability insurance, workers’ compensation insurance, and other human resources aspects such as paid sick leave and overtime.

Home care agencies, such as LivHOME, provide a much more hassle-free approach to home care services because, in addition to offering logistical support in procuring the right in-home care provider, they also handle all employment-related paperwork for you, dramatically simplifying your legal and financial responsibilities and reducing your exposure.

1. Private Caregivers

Private caregivers are those in-home caregivers working directly with families, with no agency involvement. Private caregivers can be found using sites such as Craigslist and Care.com. A private caregiver is often the right avenue for families when cost is the primary criterion. However, though private caregivers offer a lower-cost alternative, there are also some risks involved to be aware of before choosing this option.


  • Costs are lower.
  • Families can be more selective about the caregiver.
  • Hiring private caregivers may be sufficient for seniors with very limited needs, such as those who are seeking light help with shopping or cleaning.


  • Families must learn how to find caregivers and perform background checks.
  • After finding a caregiver for elderly parents, families must screen and manage the caregiver.
  • Seniors and their families are the caregiver’s direct employer and are therefore responsible for the caregivers’ payroll, workers’ compensation insurance, liability insurance, employment taxes and payroll reports, unemployment insurance, behavioral issues and complaints, sick days, vacations, and other human resources issues.
  • No backup caregivers in case a private caregiver is sick, unavailable, or away.

Things to Consider:

Of all the types of in-home senior care options, hiring private caregivers poses the greatest risk to the client and their family. Private caregivers are the direct employees of seniors and their families. As such, the relationship places more responsibility on families and carries more risk for them. This can add a considerable burden to an already stressful situation.

2. Independent Caregiver Registries

An independent caregiver registry is similar to an employment agency. It refers caregivers to families for a fee but does not employ the caregivers directly: The senior receiving care and his or her family do. This option makes sense for those who are cost sensitive, but again, there are some “hidden costs” present. Here’s a closer look at the pros and cons of going with a caregiver registry.


  • Unlike hiring a caregiver on your own, a caregiver registry provides screening, insurance, access to a variety of professionals, and it helps to determine duties.
  • It is less expensive than a home care agency.
  • It is better suited for clients who are higher functioning, who can manage to have an employee, and who can advocate for themselves.
  • A caregiver registry provides candidates to interview. If a candidate doesn’t work out, you can interview others within their caregiver pool.


  • Caregivers are not the registry’s employees; they are employees of the family and client. The family and client, therefore, bear all employment-related responsibilities.
  • The family and client, as the legal employer, are responsible for the caregivers’ payroll, workers’ compensation insurance, liability insurance, employment taxes and payroll reports, unemployment insurance, behavioral issues and complaints, sick days and vacations.
  • An independent caregiver registry only handles referrals, not scheduling or other logistical matters.
  • Caregiver registries don’t play a role in sorting out conflicts or other contentious issues with caregivers.

 Things to Consider:

When working through an independent caregiver registry, seniors and their families are still exposed to risks. A caregiver registry is a bit like a temporary middleman; they are there to pair seniors and their families with a screened worker. But, ultimately, using a caregiver registry means seniors and their families end up as the employer, which means they face the same work and liabilities that are entailed when hiring a private caregiver directly.

3. Home Care Agencies

When you hire a home care agency, it will match you with a caregiver and coordinate all aspects of in-home care and ongoing support. Like selecting any caregiver service, there are pros and cons to consider before partnering with a home care agency.


  • It is easy to find caregivers who are already on staff.
  • The care agency is the official employer, handling all payroll, employment paperwork, and government requirements.
  • The home care agency provides legal protections against theft, wrongful termination, caregiver injury, and professional liability.
  • The agency has replacement workers who can cover in case caregivers call in sick or are otherwise unable to work on a given day.
  • They provide on-call support 24/7 in case of emergency.


  • Costs are higher when working with a home care agency.
  • Caregivers are limited to those the agency has on staff.
  • Limited range of support services beyond caregiving.

Things to Consider:

Using a home care agency prevents you from having to deal with the significant drawbacks of hiring a caregiver directly, which requires you to become the employer.

Keep in mind that if you choose to not use a home care agency and hire a private caregiver directly, you become the employer, and you will be responsible for that caregiver’s payroll, workers’ compensation insurance, liability insurance, employment taxes and payroll reports, unemployment insurance, background checks, supervision, and management.

Many people will not be able to provide all of this without the assistance of financial or legal professionals (CPAs, Attorneys, etc.) and will need to spend a considerable amount of time and money to ensure they’re following all of these additional requirements, so be sure to factor those costs into the calculations when comparing pricing between private caregivers and home care agencies.

4. Care-Managed Home Care Agencies

The last option is a type of home care agency that provides additional geriatric care management support and guidance for its clients and their family members. Having a professional geriatric care manager involved to assess, develop a plan, and manage based on the plan results in the most “hassle-free” service.

Like the home care agency, the care-managed home care agency provides a concierge level of senior care services for not that much more in cost. Clients can choose how much professional care management services they would like, tailored to their needs and preferences.


  • In this model, the care-managed home care agency is the employer of the caregiver.
  • An experienced professional is involved in the ongoing oversight, training, and coaching of caregiving staff.
  • Geriatric care managers offer recommendations on a whole range of eldercare services beyond home care. They make it their business to know about all of the available, applicable community resources.
  • Geriatric care managers provide ongoing decision support to help families make great, educated decisions.
  • Geriatric care managers not only ensure quality home care services, but they also pay close attention to the quality-of-life issues and risk factors which affect a senior’s sense of well-being.


  • Costs are higher when working with a care-managed home care agency, but not much higher in cost compared to most home care agencies.

Things to Consider:

Aging can be complicated, so it’s important to get the best support you can. Engaging with a geriatric care manager can be affordable compared to the time required to personally perform the agreed-upon tasks. Some clients use home care professionals for as little as one-half hour per month, while others may choose weekly visits with a geriatric care manager.

Finding a caregiver who best meets your elderly loved one’s needs and preferences will take some time. But the effort is worth it. The right caregiver will become a trusted part of your family, helping you all enjoy a better quality of life.

Sharing is caring!


Author LivHOME

More posts by LivHOME

Leave a Reply