DIMENSIONS Spring 1999


by Julie Cleveland

There are three general types of in-home help: home health care agencies, house cleaning services, or private individuals. Home health care agencies provide personal care, live-in or companion help, and may assist with light housework or transportation. House cleaning services perform basic cleaning services, which may include laundry, vacuuming, and washing windows. Private individuals may provide both housekeeping tasks and personal care.

Hiring in-home help through an agency can save you time and paperwork. Agencies provide supervision and check references of their employees. They may also provide a backup person if your primary helper is ill or on vacation. Hiring in-home help yourself may save you money, but may be more time consuming. Agencies usually provide benefits, workers compensation, and social security for their employees; if you hire someone yourself, you will be responsible for these benefits.

One way to decide what type of in-home help would work best for you is to assess the needs of yourself and the person you are caring for. Record what tasks need to be done, and how often. Ask yourself what tasks you or other family members are able to do, and what tasks you need to hire help for.

Home Health Care Agencies

Home health care agencies provide assistance for those who need companion, live-in, or personal care (bathing, dressing, etc.) help. To know what type of help the person you are caring for needs, assess his or her care needs by addressing the following points:

Once you decide what specific tasks you and the patient need assistance with, ask the home health care agency if they provide those tasks. For example, not all home health care agencies provide companion, or live-in help; some agencies may provide only light personal care, while others employ registered nurses and people who can provide extensive personal care.

Generally, home health care agencies will charge by the hour, with varying rates depending on the types of needs you have. Agencies each have their own fee schedule, and will provide it for you upon request.

House Cleaning Services

House cleaning services provide basic cleaning and household help. Some questions to ask include:

Once you do hire a company, be sure to: have a payment agreement at the beginning; be present for the first visit to show the house cleaner what to clean; make a list of cleaning priorities; make arrangements for the key; have all needed supplies available and in working order; and contact the company if you are not satisfied with the services you received. You should not expect a house cleaner to provide supervision for your patient, and you may find it works best to arrange an outing for your patient while your house is being cleaned.

Private Individuals

The type of help that private individuals provide may include home care, housekeeping, or transportation. When you hire individuals, they are usually not licensed with the Washington State Health Department as Home Health Agencies. Remember it is your responsibility to screen, check references, and specify responsibilities, and establish a rate of pay.

Before hiring, consider liability - talk to your insurance company about your coverage against potential problems such as employee injury, theft, or using your vehicle to transport the patient. Some Home Health Care Agencies use bonding services, which will reimburse you if the employee steals or breaks an item. If income tax and social security are not withheld by an agency you will need to contact the Internal Revenue Service about your responsibilities for these taxes.. Also - know your emergency procedures, and have them written down and posted in a conspicuous place. Discuss them with the home help you are hiring.

Once you have decided who you want to hire and what they will do, develop a written contract. A good contract should include: names of the employer and employee; salary; terms of payment; hours of work; employee's social security number; duties to be performed; unacceptable behavior and conditions for termination. This contract should be signed and dated by both the employer and the employee.

For more information on home help issues, contact Senior Services Information & Assistance at (800) 972-9990; the Alzheimer's Association Western and Central Washington chapter at (800) 848-7097, or Eastern Washington chapter at (800) 256-6659.

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