Buyers, Please Beware of Private Duty Care!

What You Must Know!

Most Sundays, you will see a long list of classified ads very similar to the one above in your local paper. Close your eyes. You can almost see the person in the ad. Middle-aged, wise, gentle…Mrs. Doubtfire! And if you are looking for help, the price seems right…less than half what the home care agencies are charging. Almost sounds too good to be true. Well, unfortunately, like most things that sound too good to be true, it usually is, especially when you consider the following:

Employment Implications

Like it or not, when you hire private duty care, you become the owner of your own home health agency! You are responsible for payroll, benefits, taxes, social security, workman’s compensation, and all related insurance needs. You will have to deduct from the caregiver’s salary both FICA and Federal withholding taxes and provide Unemployment and Workman’s Compensation insurance. If you pay them on a cash basis and do not withhold any taxes or social security, the government may come after you, not the employee, for back taxes, including penalties and interest!

Who Is In Your House?

Bottom line, you don’t know who this person really is or where they have been, even if they are known to you. Sure, you can request references, but most people can find someone to put in a good word for them. Only an extensive criminal background and reference check can determine whether or not this person is who they say they are. Have they been tested for TB? Have drug or alcohol issues? How can you be sure? Home care agencies and senior communities are always looking for good people, and they typically pay well. Why doesn’t the private duty caregiver work for one of them?


Okay, so you have called a couple of references and heard some nice things, but how do you know this person has the training or certification to meet your needs or those of your loved one? Do they know CPR? Wound care? Alzheimer’s? Medication management? Can they cook? Can they prove their certification? Is it up to date?


Most people who hire private duty care mistakenly believe they will have the time and ability to monitor and manage the person they have hired. Their misperceptions stem from having forgotten the main reason they hired a caregiver in the first place: to reclaim the time needed to do the things their caregiving responsibilities required them to neglect. And unless you have a background in some form of healthcare, knowing what “quality care” looks like and how to get it for your loved one can be extremely difficult. For example, have you implemented a documentation system to record and monitor the services your caregiver provides?


If your private duty caregiver hurts his or her back when assisting your loved one get out of bed, transfer, toilet, walk, or prevent a fall, does your insurance protect you? Liability? Workman’s Compensation? Disability? If you don’t know, it is critical that you find out!

“Live In” Private Duty Care

Most people who hire a private duty live-in have no idea that if they want to terminate employment, it may not be so easy to do. In some states, the private duty caregiver may be deemed a tenant, have tenant rights, and require legal action to be evicted!


Medicare, Medicaid, and health insurance do not pay for long-term or non-medical care. In-home care is either paid privately (i.e. private pay) or through long term care insurance. Can you or your loved one afford to remain at home?

The Difference Between Counting the Years and Living Them

No matter how or whom you ultimately decide to hire, remember, if you were looking for a new car, you would shop, visit different dealerships, and do your research to find the model that most appeals to you and has the features you desire. You would also test drive it before buying it. The same steps should be taken when seeking in-home care.

Evaluating all your options and choosing what will work best for you is one of the most important decisions with far-reaching implications that will determine the quality of life for you or someone you love. Don’t wait until a crisis! Plan now and make your wishes known. Only then will you and your family truly have peace of mind and be able to live life to the fullest! The choice is yours.