In-home care, also known as domiciliary care, provides a caregiver to work in your home and help with activities of daily living (ADLs), instrumental activities of daily living (IADLs), and household chores. Some home care aides accept clients who live in assisted living or skilled nursing facilities, and in those cases, they work with their clients at the facility rather than in the client’s home.

There are three basic ways to hire a professional sitter. First, you need to decide whether to hire a private caregiver or go through an agency. There are two types of home care agencies: referral and full service. This article addresses the differences between the three options.

Full Service Agencies

Full-service home care agencies take care of the main aspects of hiring a caregiver for you. It is in the best interest of these agencies to ensure that their caregivers are experienced, competent, and a good fit for you, the client. Services normally include:

* Preselection of criminal records of employees

* Checking multiple references

* Provide workers’ compensation insurance

* Maintenance of professional liability insurance or bond

* Cover all payroll taxes

* Provision of a sitter when a hired one will be absent

* Replacing a caregiver who is not a good fit

* Supervision of caregivers

Before you begin your search, read the important questions to ask before signing a contract with an agency.

referral agencies

Referral agencies provide some initial screening and screening services, but once you hire a caregiver from a referral agency, your relationship with the agency ends. Referral agencies do not supervise caregivers. Referral agency services generally include:

* Preselection of criminal records of employees

* Checking multiple references

Your responsibilities, after finding a caregiver through a referral agency, will include:

* Pay the caregiver directly and cover any related taxes

* Insure the caregiver and/or their personal items (contact a local insurance agent to ask what protection an existing homeowners policy offers. Ask for information on dishonesty bonds and workers’ compensation).

* Supervise the caregiver

* Find a replacement caregiver if necessary

Privately hired caregivers

Privately hired caregivers are often hired by word of mouth. To get started, read tips on finding, background checking, and interviewing a privately hired caregiver, review a downloadable caregiver job sheet, and learn how to avoid fraud and abuse by home care employees.

Taxes and Private Caregivers

Privately hired caregivers may work as independent contractors or as your employees. Tax laws change every year; however, in 2006, any household employee earning less than $1,500 per year is considered a contractor. Therefore, a caregiver in this situation would use IRS form 1099, which means that he is responsible for his own taxes at the end of the year. There is one exception: home care workers acting as their own business with, for example, business cards, clients, or a business license; even if you earned more than $1,500, a person in this scenario would be considered a contractor. All other workers would be considered your employees and you would be responsible for withholding the appropriate amount of tax from each paycheck. There is also a fixed amount for transportation costs ($105/month in 2006) and lodging costs, which are not calculated in the annual sum.