Do You Need to Hire a Senior Care Worker?

need to hire a senior care workerIt’s never easy to realize a senior loved one can no longer live completely independently and needs some assistance. But in order to provide the best quality of life possible, some seniors will need a companion or other caregiver to help them stay in their own home. Seniors may also require help with maintaining their home, especially if they are aging in place in their own house. Here are some possible signs that you need to hire a senior care worker.

Signs Your Senior Needs Help at Home

  • Spoiled food that does not get thrown away
  • Missing important appointments
  • Unexplained bruising
  • Difficulty getting up from a seated position
  • Difficulty with walking, balance, and mobility
  • Uncertainty and confusion when performing once familiar tasks
  • Forgetfulness
  • Unpleasant body odor
  • Infrequent showering or bathing
  • A strong smell of urine in the house
  • Noticeable decline in grooming habits and personal care
  • Dirty house, extreme clutter, and dirty laundry piling up
  • Stacks of unopened mail or an overflowing mailbox
  • Late payment notices, bounced checks, and calls from bill collectors
  • Poor diet or weight loss
  • Loss of interest in hobbies and activities
  • Changes in mood or extreme mood swings
  • Forgetting to take medications, or taking incorrect dosages
  • Unexplained dents and scratches on a car

Whatever type of help your senior needs, family caregivers cannot do it alone. That’s where we come in. Our senior care companion services are available 24 hours a day, 7 days a week. We offer on-call, temporary, part-time, or full-time options to meet your specific needs.

Contact us at (518) 348-0400 and let us know how we can make your life easier.

Hiring Senior Care: Options and Questions

hiring senior careFor families that wish to hire a caregiver for their senior loved one, there are many options available. It’s important to understand these options and to know what questions to ask.

There are typically three options for obtaining in-home senior care.

1. Home Health Care Agency: The agency employs the senior care provider to work in the family’s home and maintains control over the worker’s duties. The agency also takes care of payroll, taxes, insurance, and human resources.

2. Referral or Placement Agency: In this case, the agency charges a fee and then finds and recruits the in-home senior care provider on behalf of the family. Control over employment duties lies with the family who will manage payroll, taxes, and compliance with wage and labor laws.

3. Hiring Independently: When hiring on their own, the family finds, hires, and employs the in-home senior care provider. They control employment and handle the responsibilities of being a household employer.

Hiring through a home health care agency is typical when the senior has specific medical care needs that require a trained and licensed caregiver to perform medical treatment.

When nonmedical care is required, many families choose to hire independently or through a placement agency like ours. However, in these cases, the family becomes a household employer in the eyes of the IRS and other government agencies.

Three Benefits of Hiring Independently or Through a Referral/Placement Agency

1. More control
The family has more control over the employment arrangement and can choose how the care is managed.

2. Cost-effectiveness
It’s typically more cost effective especially if the senior needs less specialized care or only needs help for certain hours or days a week. The family saves money by taking on the management and supervision of the caregiver themselves.

3. Less “red tape”
There is far less “red tape” compared to hiring through a home health care agency. However, the family still needs to comply with all applicable tax, wage, and labor laws.

8 Questions to Ask About Your Senior’s Care Needs

However you (or your family) decide to hire an in-home senior caregiver, you’ll want to understand your objectives for bringing an employee into the home to look after your senior.

  1. How much and what kind of care does the senior need?
  2. How is each one of us able to help physically or contribute financially?
  3. Are there services in our community for older adults and their families?
  4. What specific duties will the caregiver perform?
  5. Which days and for how many hours do we need a hired caregiver?
  6. Can we, as a family, provide backup help if the hired caregiver is unavailable due to time off or illness?
  7. Who will be in charge of the hire and employment of the caregiver? This includes recruiting, background screening, managing payroll and taxes, and supervision of work.
  8. Who will act as the liaison with the senior care provider?

 

Learn more about our senior care services, and contact us at (518) 348-0400 with any questions.

Meeting the Growing Senior Care Demand

meeting the growing senior care demandAccording to the U.S. Administration on Aging (AOA), in 2015, 14.1 percent of the U.S. population was aged 65 or older, or one in every seven Americans. By 2020, 54 million people in the U.S. will be over the age of 65; by 2040, that number will top 82 million. People reaching age 65 today have an average life expectancy of 85.8 years (male) to 87.8 years (female), according to the Society of Actuaries MP-2016; which will result in a staggering number of seniors over the age of 80 in the next 20 years, many of whom will need some kind of care. Already, we can see the growing demand for senior care is critical in our lives and so it will continue.

Senior care is essential to our expanding elderly population. Some senior care is short-term, following an accident or injury that generally resolves itself. Most, however, is long-term care which involves a variety of services which help meet both the medical and non-medical needs of seniors with chronic illness, disability, or advanced age who have difficulty caring for themselves. Long-term care can be assistance with activities of daily living (ADLs) like dressing, bathing, meal preparation, and using the bathroom, or medical care that requires the expertise of skilled practitioners to address chronic conditions.

Senior care relates to a wide range of care but commonly refers to extended services for seniors who need help with ADLs. Senior care can be provided in a senior’s home, as well as the home of a family member (such as a son or daughter), in the community, or in various facilities like adult day care centers, fixed communities, assisted living facilities, and skilled nursing homes.

In-home senior care is usually provided in three ways:

  1. By a home health care agency that employs the worker to work in the family’s home, and sees to payroll, taxes, and human resources. (The agency employs the senior care provider in the home and maintains control of the worker’s job duties.)
  2. By a referral or placement agency (like A New England Nanny) that finds and recruits the senior care worker on behalf of the family, charging a fee to do so, but then withdraws direct responsibility and transfers control for the employment over to the family. This type of agency may provide advice, support, and replacement services, if needed.
  3. By hiring independently, whereby the family or friend finds, hires, and employs the senior care worker according to all federal, state, and local requirements as a household employer, on behalf of the senior needing care (sometimes the senior is also the one employing the caregiver directly).

To achieve an effective and practical balance between your career and your family—making your private and professional lives enjoyable, fulfilling, and manageable—you decided to hire an in-home caregiver for your parent or elderly relative and, therefore, to have your senior or yourself become a household employer. And we’re here to help! In addition to companion caregivers, we can also provide personal care aides and Certified Nursing Assistants. Caregivers in those fields can assist seniors with bathing and toileting, tasks that companion caregivers don’t generally perform.

Contact us at (518) 348-0400 and let us know how we can meet your senior care needs.

Guide to Employing Home Care Workers

guide to employing home care workersThe Department of Labor (DOL) recently released a new publication to help families that employ home care workers deal with the very strict wage and hour requirements of the federal Fair Labor Standards Act (FLSA), the federal minimum wage and overtime law that applies to most home care workers. The Guide for Employing Home Care Workers was created to help individuals and households determine their responsibilities under the FLSA.

The guide explains several things about who must follow the FLSA rules, with examples showing how it applies when:

  • You hire a home care worker directly
  • You use a home care agency
  • You arrange care through a self-directed program

The guide describes what to do when your paid home care worker is a family member, and if you have a live-in home care worker. Also included are instructions to comply with the FLSA rules, such as minimum wage and overtime rules, tracking employee hours, and record keeping.

It’s very important to understand the rules about whether your home care worker is an employee or an independent contractor. If you hired the worker yourself, if you set the worker’s hours and dictate what tasks are to be done, then the worker is most likely an employee, and therefore you are subject to the FLSA rules on proper wage payment.

Download the guide here, and contact us at (518) 348-0400 if you have any questions.

Open Interviews for Nannies, Babysitters, and More!

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Hiring a Nanny: the Family Interaction Test

family interaction testThere are many concerns to consider when you are involved in hiring a nanny or other household employee, as well as many legalities to abide by to ensure equitable and fair employment opportunities. By taking the hiring process one step at a time, you can proceed with well-planned and well-researched employment offers.

After you have conducted phone and/or in-person interviews, and you have finally decided in your own mind which are the best candidates, make sure you let them meet the family members they will be looking after. If this is a nanny, you can tell a lot from how she interacts with your child. You should be there to watch and to facilitate the interaction, but you should also move to another room and eavesdrop on the conversation and actions of the nanny and the child. You want there to be warmth between the caregiver and the child, you want them to have fun, you want the candidate to be polite, caring, and professional. The child should feel safe and happy in their care. If you are comfortable with the idea, you can also arrange another interview time to give a trial run of the nanny on their own and then gently ask the child their opinion and whether they enjoyed being with the nanny and liked her.

The same process can apply to hiring a senior care worker. Observe how the candidate and the senior get along, see if they carry on friendly conversations, and determine, as with a nanny, if they are caring, professional, and sincere. Ask your elderly loved one later how comfortable they felt with the caregiver, and see if they would enjoy spending time with him/her.

You could choose not to pay for this as part of the interview process, but you need to make sure the caregiver is aware that this is unpaid interview time before you make arrangements. Or you could choose to pay the candidate for this time as a goodwill gesture to keep them interested and to set up an employment relationship of trust from the beginning.

Listen to your instincts and back that up with the background checks that A New England Nanny takes care of. This will be well worth the effort in your overall work to hire an employee that makes everyone in your household feel comfortable and safe—and happy. You are hiring a nanny or senior care worker to help you not worry about what is going on at home. Take time now to check out the person you are bringing into your home and who you are entrusting with your loved ones, your property, and your memories.

For more information about how GTM helps families with household employment issues like this, contact us at (518) 348-0400.

Senior Care Tips: Estate Planning

senior care tipsThere are many issues that arise when it comes to senior care – one of the senior care tips to keep in mind regards estate planning. You’ve likely been repeatedly advised to ensure for your own estate planning, but as you take on caring for your elderly loved ones, you may also need to become familiar with their estate plan.

If your elderly loved one has not put his or her affairs in order, it should be done immediately, so you can be sure about his or her wishes before he or she becomes too incapacitated to communicate those wishes to you. Wills need to specify not only wishes for “handing on” precious keepsakes and possessions but also written directives as to how your elderly loved one wishes his or her remains disposed of, funeral and burial plans, and so on. Advance directives include the senior’s living will, which states his or her wishes in case he or she is near death and wants no life-saving, artificial measures taken to restore or preserve life, and medical power of attorney, also known as a health care proxy, enables the senior to designate a loved one as the decision maker for medical concerns in case he or she is unable to do so. A power of attorney allows the senior to give another the power to act on his or her behalf if he or she is in unable.

Be sure your senior caregiver is aware of where these important papers are kept (or has copies of them) and can access them in order to provide medical professionals with these critically important instructions during medical emergencies . For instance, emergency medical professionals in an ambulance or at a hospital emergency room will request copies of a patient’s  do not resuscitate order (DNR) or medical power of attorney.

Advance directive

This is a legal document that specifies that you do not want to be kept alive on artificial life support and can direct other aspects of health care if the elder is unable to speak for him- or herself. As with most legal documents, this needs to be as specific as possible, providing instructions regarding respirators, feeding tubes, and pain medication, among other things. Advance directives usually include a DNR, a living will, and a durable power of attorney.

  • Do Not Resuscitate: known as a DNR, is a written order directing health care professionals to not resuscitate a patient in case of cardiac or respiratory arrest. DNRs are generally given when resuscitation would only delay the inevitable and leave the patient severely and permanently incapacitated.
  • Durable power of attorney: enables a senior to authorize a specific person to make financial or health care decisions for him or her. Durable powers of attorney are most often effective when a doctor certifies that the patient is incapacitated; however, a durable power of attorney could begin upon signing the document. It will depend on the document’s wording as to when the powers begin.
  • Living will: a document that states in detail acceptable medical procedures and life-sustaining measures. It does not name someone to act on a senior’s behalf like a health care proxy, or medical or durable power of attorney. Living wills should be made available upon admission to any health care facility and to doctors, as well as kept on hand in the elder’s home. (A living will is not necessarily legally binding—state laws vary widely. Some hospitals and physicians may refuse to honor a living will in an attempt to keep the senior patient alive.)

Legal guardianship

A guardian is appointed by the court to have custody of another. Legal guardians may be appointed on a temporary basis (for a fixed period, i.e., one year) and for a senior’s medical consent. In short, a guardian may make medical decisions for the senior and work directly with medical professionals.

Living trust

According to AARP, a revocable living trust is a written agreement designating someone to be responsible for managing the senior’s property. It is called a living trust because it is established while the senior is alive. It is “revocable” because, as long as you are mentally competent, the senior can change or dissolve the trust at any time at his or her own discretion for any reason. Typically, a living trust becomes irrevocable (cannot be changed) when the person dies. As a trustee, you (as the senior’s designated relative or friend) can manage the assets, including selling or investing them.  You may also name your spouse as your co-trustee. If every asset is transferred into the living trust while the senior is alive, a living trust may substitute for a will. A pour-over will can be written to ensure that at the time of death any property not in the living trust is poured over into the trust.

Will

This is a legal document in which the senior declares who will manage his or her estate after he or she dies. The estate can consist of anything he or she owns—it may be as big as the senior’s home and as small as the deceased’s grandmother’s cameo pin or even a photograph.

There are professionals, namely attorneys and financial advisors, who specialize in elder law and estate planning. Since laws vary by state and are often subject to change, it is advisable to contact one. New York State’s legal services department may offer help at its Division of Elder Law, or you may access AARP’s prescreened list of attorneys.

For more information about how we help families with senior care issues, contact us at (518) 348-0400.

Mileage Reimbursement Rules for Household Employers

mileage reimbursement rulesBefore a family hires a nanny, the nanny’s compensation should be discussed and detailed fully, including any mileage reimbursement that may occur.

Mileage reimbursement rules apply to household employers who choose to let their nanny or other household employee use their personal car for performing their job duties. This includes running errands, picking up and dropping off children from school or other locations, taking a senior citizen to an event, shopping, or any other task that the employer asks the nanny to do which requires the use of his or her own car. Commuting to and from the family’s home is usually not considered reimbursable mileage.

In January, the IRS issued a new standard mileage rate for the year. This rate is used to calculate the deductible costs of driving a vehicle for business. The standard mileage rate for 2015 is 57.5 cents per mile for business miles driven, an increase of 1.5 cents from 2014. Most families use this IRS rate as the standard for reimbursing their nanny for mileage.

Some families may opt to reimburse their employee for gas expenses or provide them with a gas card, rather than compensation for mileage.

Any arrangements made between the employer and employee should be detailed in the Employee Handbook; it may be also useful to include a copy of an expense report to help both parties keep track of any mileage or gas used.

For more information about this or any other household employment issues, contact us at (518) 348-0400.

Try it Before You Buy it!

ANENpostcard---try-itDo you know someone who needs child care, senior care, housekeeping, or any other service we offer? Are they a little hesitant about spending money with a company they aren’t yet familiar with? We have a brand new promotion that may provide the solution!

The first time that they use us for any of our temporary services, we will waive both the membership and agency fees (a $122 value). They can just pay the caregiver directly* and then enjoy the peace of mind we provide!

To book a trial day or for more information on rates, please have them call (518) 348-0400 or email us.

* 4-hour minimum per shift. Hourly cost based on the service requested. After trial day is completed, annual membership fee will apply to future use of services. One trial per family.

Is My Nanny an Independent Contractor?

is my nanny an independent contractor“Worker classification” refers to whether a worker is classified as an employee or an independent contractor for federal and state employment tax purposes. Employers need to recognize the difference between these two classifications, because the employer’s tax requirements are contingent on whether the professional is working for the employer or is actually working for him or herself. It is therefore paramount that an employer knows the difference between the two, so that both parties’ taxes are filed properly. An employer can be penalized with having to pay 100% of associated payroll taxes of any payments made for services if the worker status is determined incorrectly. Additional fines, penalties, and interest may apply, and the effect on the family-nanny relationship could be devastating if it is determined the worker owes years of unpaid taxes.

Is my nanny an independent contractor?

When it comes to household employment, the vast majority of household workers are employees, not independent contractors. Families who try to avoid their tax obligations by attempting to define their nanny as an independent contractor may want to reconsider. The IRS is aggressively pursuing these cases and has been known to add penalties to tax and interest owed, along with civil penalties.

Whether an employer-employee relationship exists depends on specific facts including whether the employer controls the means and manner of an employee’s work performance. The Equal Employment Opportunity Commission (EEOC) lists 16 factors for distinguishing between an employee and an independent contractor. The status of an employee could be established even if only some criteria are met. The EEOC stresses that these factors are non-exhaustive and other circumstances might influence a given assessment.

Answering “Yes” to some or all of the following items generally indicates that the worker must be classified as an employee as opposed to an independent contractor:

  1. The employer has the right to control when, where, and how the worker performs the job.
  2. The work does not require a high level of skill or expertise.
  3. The employer furnishes the tools, materials, and equipment. (For household employment, this would refer to items owned by the employer that a nanny or housekeeper uses for their job.)
  4. The work is performed on the employer’s premises.
  5. There is a continuing relationship between the worker and the employer.
  6. The employer has the right to assign additional projects to the worker.
  7. The employer sets the hours of work and the duration of the job.
  8. The worker is paid by the hour, week, or month rather than the agreed cost of performing a particular job.
  9. The worker does not hire and pay assistants.
  10. The work performed by the worker is part of the regular business of the employer. (In the case of household employment, the “regular business” refers to being a household employer.)
  11. The employer is in business. (Again, “business” refers to being a household employer.)
  12. The worker is not engaged in his/her own distinct occupation or business.
  13. The employer provides the worker with benefits such as insurance, leave, or workers’ compensation.
  14. The worker is considered an employee of the employer for tax purposes (withholding federal, state, and Social Security taxes). (This applies to household employment if the worker is paid more than $1,900 a year.)
  15. The employer can discharge the worker.
  16. The worker and the employer believe that they are creating an employer-employee relationship.

For further guidance in determining a worker’s status, the IRS offers Form SS-8 (Determination of Worker Status for Purposes of Federal Employment Taxes and Income Tax Withholding). You can file this with the IRS if you are unclear about the status of your worker, the IRS will then review and officially determine the worker’s status for you.

For more information, please contact us at (518) 348-0400.