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Assessing Home Care Options

All home care is not the same.

In-home care is an option that can aid in making seniors be able to live safely and comfortably. However, choosing and assessing what options are best can be a very imposing task. There are many home care options, and knowing the difference between the various services and providers can aid you in making the correct decision. Before making the ultimate selection or individual that will provide care for you or a loved one, make sure that you do your due diligence and research all services and providers, and ask the right questions.

Common Home Care Services

Caregivers who provide in-home senior care have a range of services and assistance that they offer to seniors and other adults who wish to remain in their own homes. The majority of providers typically offer a combination of the following services:

  • Homemaking and companion care: This commonly includes meal preparation, incidental transportation, errands, a little housekeeping, medication reminders, and most importantly companionship.
  • Personal care: These services generally include bathing, grooming and hygiene, incontinence and toileting, while also providing another level of meal preparation with specific considerations.
  • Specialized services: Around-the-clock emergency response, live-in care, and oftentimes care for clients who have Alzheimer’s or other dementia issues are what we mean by specialized services. These are for patients who need very specific care that can’t be handled by a standard caregiver.

Home Care Providers’ Business Structures

There are three types of structures that common in-home care providers operate under: employment-based agencies, registries, or independent providers. The critical difference between all of these models is the determination of who is considered the employer of the caregiver, and therefore, who is held responsible for all costs. What this means for you is who is responsible for the insurance coverage of the caregiver, liability insurance, and employment taxes and deductions, which can affect your cost for care.

Employment-Based Agencies

An employment-based agency has the ability to be a corporation, a subsidiary, or a franchise. The greatest benefit to hiring a caregiver that belongs to one of these organizations is that the behind-the-scenes details are all handled by the organization. They handle interviews for prospective caregivers, conduct rigorous background checks, verify employee information and reference, and takes care of all associated costs. This has huge benefits for you and your family:

  • Clients are not burdened with employer laws and requirements
  • Clients are not required to interview, perform background checks, or reference checks
  • Organizations provide compensation to the caregiver, not you
  • Caregivers are given the proper training before coming to you
  • The organization and its caregivers comply with all certifications and regulations
  • There is typically a large roster of caregivers available in case there is an emergency and one is not available
  • There is ongoing oversight and caregiver training so that you can rest easy


Registries build and manage entire databases of caregivers, but do not handle actually employing them. This is typically handled by contract labor, and the employment arrangements can vary dramatically. Clients who decide to use registries can find that they are considered the employer of the caregiver, and therefore are responsible for tax withholdings and insurance coverage. Some registries do provide worker’s compensation coverage, but clients need to understand that the coverage isn’t always covered while the caregiver works.

Quality registries typically perform their own background checks, and only provide quality caregivers. However, they cannot provide training, nor do they ensure a level of proficiency before placing them in your home. They instead function like “matchmakers” and provide applicable personnel to clients to consider. In the even that a caregiver cannot perform the duties, the registry will provide an alternative. Clients who hire through a registry should understand:

  • Who employs the caregiver and is responsible for employment tax withholdings
  • What background checks have been performed and the outcome of them
  • What manner of insurance coverage, if any, apply to the caregiver
  • What level of training and certification the caregiver has
  • How the caregiver is paid
  • If there is any type of caregiver oversight


Independents are typically found in cases where the client knows the individual personally, someone from the community, or someone who advertises in-home services in a classified ad; ultimately someone who is not part of a larger organizational structure. No matter what the source is, there are implications that surround hiring an independent that should be taken into account.

Clients who choose an independent are legally considered to be the caregiver’s employer. They are responsible for all taxes and deductions. They must also secure the appropriate insurance coverage in case there is an injury during care in the home, and general liability insurance in the event there is property damage. Most homeowner policies do not cover these expenses, and therefore attention must be paid. The client will need to also perform all background checks, experience checks, references, and licensure. In these cases the client is entirely responsible for all elements of employment and hiring, so the decision must be a completely sure one. There is also less opportunity for contingencies in case the caregiver cannot perform the duties.


If you would like to learn more about your home care options, contact the Fort Lauderdale Comfort Keepers’ office for information. Comfort Keepers’ caregivers are fully employed by the Fort Lauderdale location and are bonded and insured.

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