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Pros and Cons of Home Care Agency vs A Private Caregiver

If you’re considering home care services for yourself or an aging parent, you may be torn between hiring a private individual as a caregiver or working with a home care agency. Understanding the key differences between the two is important. After all, the caregiver you hire is going to be inside your loved one’s home and will be entrusted with their care.

Here we outline the benefits of a home care agency versus a private caregiver:

1. Legality and tax deductions

To hire a private caregiver as a legal employee, the employer (who is the person paying for the service) is responsible for Canada Revenue Agency (CRA) ongoing remittances. This includes submitting payroll records and calculating and paying the necessary income tax, Canada Pension Plan (CPP), Workers Compensation premiums, Employment Insurance (EI) deductions, as well as following provincial labour laws and regulations related to statutory holidays, overtime pay, and vacation pay.  Private employers are also responsible for, and should be concerned about, any discrimination and sexual and other harassment claims, wrongful/constructive dismissal actions, “notice” and severance pay issues. Agencies manage all of these tasks in addition to disciplining or replacing the caregiver if he/she is not satisfactory, replacing caregivers if sick, on vacation, on maternity leave or taking personal time off.

A caregiver who is employed by a home care agency is paid directly by the agency thus eliminating most of the risks and responsibilities and saving the client from having to undertake a multitude of mandatory reporting responsibilities.

2. WSIB coverage in the event the caregiver is injured on the job

If a “private” caregiver is injured on the job, the employer is liable for compensation which can be long term depending on the severity and nature of the injury. Caregivers employed by a home care agency are covered under WSIB (Workers Safety and Insurance Board) and any claims are between the WSIB and the home care agency, not the client.

If hiring private staff, employers need to register (and remit) with WSIB as an employer and ensure that their home insurance policy covers any injuries not covered by WSIB.

3. Insurance against theft and damage

Reputable home care agencies have an extensive screening process for potential employees which includes a thorough interview process, reference checks, and criminal background check. This helps ensure they hire honest, dependable, and professional staff.  Home care agencies also fully insure their staff for liability and dishonesty for your protection and theirs.

When you hire a private caregiver, you are responsible for having adequate home insurance coverage in place to protect from theft or damage to the home or contents caused by the individual providing care.

4. Quality of care

The quality of care really comes down to the individual providing care, regardless of whether they work privately or for a senior care agency. One key difference between hiring a home health care agency versus a private caregiver is that if you are unhappy with the quality of care, you can immediately request a replacement worker. Agencies also undertake a due diligence process to ensure they are hiring experienced and qualified caregivers who take pride in offering excellent care. Many caregivers work with their agencies for years and have a verifiable and proven track record.

If you’re unhappy with or dismiss your private caregiver, you will have to start the entire advertising, interviewing and hiring process and employee registration all over again possibly leaving you or your loved one in the lurch.

5. A Change in Care Needs

Most reputable home care agencies maintain an extensive call list and have the staff needed to accommodate a client’s changing or increasing needs. This also means coverage is available if the caregiver calls in sick.

Along with other caregivers, an agency has PSWs and nurses available to handle more advanced home healthcare needs if and when they arise. Most reputable agencies also employ a Registered Nurse as a supervisor to their PSW and RPN field staff.

A private caregiver works alone, making it difficult to manage changes in schedule, unanticipated absences, vacations or more complex care recipient challenges.

8. Types of Care

The types of care offered by home care agencies range from companionship and help with daily activities, such as shopping and errands, to advanced home health care, such as injections and wound care.

While some private caregivers are able to provide different types of care, it’s not easy to find one which is professionally trained and licenced to provide medical care. This speaks to an agency’s ability to accommodate change when and if it is required. Privately hiring and paying for private licensed nurse for a care recipient who may not always require medical care at home is rarely financially prudent. A home care agency offers the flexibility of choosing as much or as little care as needed with the ability to adjust the schedule at any time.

There is much greater risk and responsibility involved when hiring privately and assuming the role of employer. A home care agency handles the screening and legalities, thereby providing peace of mind for the care recipient and their family.

David Porter, CPCA

Living Assistance Services – Senior Home Care

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