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I've been a private live in caregiver for a number of years now, working with a variety of clients with a wide range of needs. I have been looking to move on from my current client job but am finding it very difficult to find another family who wants to hire a private caregiver. This is confusing to me because as a caregiver who started out working through an agency, and who still works sometimes with employees of an agency for fill in purposes at my clients home, I have experienced firsthand how unreliable and problematic agencies are. The only two caregivers that my current clients family employed who have stuck around, and taken quality care of their mother are me and my coworker, both of whom who are private hire. Anytime we try to involve agencies in the mix it always brings drama, irresponsibility, and un-vetted caregivers into the home of my client. That being said, I know that my clients family is not unique in their experience with agencies as I have heard many horror stories from friends, and acquaintances with elderly loved ones. So why is it that people don't seem to look elsewhere for quality experienced caregivers?

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Sometimes It's the money part-Caregivers are expensive. Some insurances will not cover it, which I think stinks. Sometimes it's the fear of getting a bad one-Some caregivers are not true caregivers: They goof around, treat the patient badly, etc.
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We live in Arizona and I would love to find a good live in caregiver for my 75 year old husband with Parkinson's.

Suggestions are welcome.
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What Price do you charge per hour?

Do you have Insurance on yourself?

May be you just need to Advertise More.
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In our situation, there was not much money. But too much for her to qualify for state assistance. The only way we could swing it was to provide housing for the caregiver. And since we were located way out of town, it made it possible to get a caregiver to live on premises without them having to travel 30-45 minutes each way. We paid close to minimum wage, but factoring housing and utilities made it a generous arrangement for the caregiver. (especially since housing was difficult to find locally, and way expensive to boot.)
If that would work for you, best if you can offer some privacy / separation of space so that it doesn't feel like the caregiver is in the middle of the household. In our case, there was a separate entrance, a private bedroom and simple kitchen area (separate fridge & stove). Not the same as a full separate apartment, but as close to that as we could make it.
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Most families can not afford a private pay caregiver. Many seniors will only be able to afford it for a short time before the funds are gone. Every Long term insurance that pays in home caregivers require them to be certified by the State, or they will not pay.

BUT, here is the kicker. I investigated what/how/where to get this certification (checked it out in both Colorado and Florida). The answer is...they do NOT certify individuals, only agencies providing aides. Meaning, if the insurance company is paying....it must be an agency.
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We have a private caregiver for my 88 year old mother who lives with us who has Parkinson's with associated dementia and Alzheimer's - she was actually referred to me and we would be lost, lost, lost without her. She watches my mom for four hours, five days per week and that is all we have her do (no housework etc). We pay her an hourly rate, with paid holidays and such. She is a Godsend to us, she is good to us, we are good to her. It's a simple arrangement that works great!!!
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We used care.com to find caregivers and have been very blessed to find wonderful women there for mom. Generally we stick with our caregiver until they need to move on for marriage or visa expiring etc. Now they usually help find their replacement from their friends. So ask your caregiver friends to keep an ear out. Also advertise in 55+ community newsletters. Hope this helps!
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Racheld17 - you sound like a caring person who would be an asset to anyone needing care.
We had the opposite problem. We had a "in-law" apartment attached to the main house, with an interior door leading in. Our mother (who lived with us from age 90 to 94) had a room, the caregiver had a room, and there was a small kitchen and living space, and a bath. An ideal set-up.
However... we had a difficult time finding reliable live-in help. We paid at the lower end, but with the apartment and utilities factored in - it was a great combo. We asked for 5 days work, with the caregiver having 2 days off.

But we kept getting people who were unstable, or had inflexible attitudes about how the caregiving should be, or who only wanted to be on their cell phone or Facebook all day. We wanted someone who would actually pay attention to her, would keep her safe and clean. It took a lot of trial and error before we found a wonderful, reliable, kind and stable caregiver who wanted a good live-in situation.
For someone looking, they would be thrilled to find you. We advertised word-of-mouth, and on Craigslist. Don't know what would be best in your area.

As for reliability, as someone looking for help - I would rather have a good live-in person rather than an agency, even though it is more work in one way. The agency hires, schedules and pays the workman comp and insurance (usually). But the caregiver gets much less money after the agency takes their cut. And they don't always hire good people or have back-up available.

A friend of mine has also hired privately - but left the responsibility of taxes, insurance, etc. to the caregiver. I know that isn't the legal way to do it, but it worked for her and her family.
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Makeadifference Jun 2019
Hello,

That makes me so sad to hear. I am a private caregiver, of a mature age, and it makes it very hard for the reliable ones, who would never think to get out there cell phones unless it was for your mother's needs, and I am so sorry that happened.

Remember that in our world it takes all kinds, and I am one of the very dedicated caregivers that goes above and beyond with 26 five star reviews of Alzheimer's and Dementia care, because "I do really care"

Thank you and I am sorry for this.
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It's a scary thing; not knowing someone that is,
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I believe many don’t consider due to the cost or perceived cost of care. Others simply don’t know where to “look” for quality experienced caregivers.
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Racheld17 May 2019
That makes a lot of sense I think that’s probably the case for a vast majority of family’s in reality most private caregivers are less expensive then an agency
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Sorry, haven't read every post, so sorry if this has been said.

You can be self employed and as such be responsible for your own taxes. Do you all really think when a person hires a private care giver its done "by the book". As long as she pays her taxes, it should be OK. The only thing I would wonder about is Social Security. How do u cover that? Because its usually employer pays a %.

A 401k is a little out there. Homeowners may cover someone working in ur home.
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Isthisrealyreal May 2019
You pay 100% if your employer is not matching the 7.65% for SS and Medicare, then that portion is 100% deductible from your gross pay.
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The way you are handling your pay does seem like the simplest way, however, it is completely illegal and puts everyone involved at risk.

You, because you have no unemployment insurance for the in between times. No worker's compensation insurance in the event that you get injured.

Them, because they can be penalized by Medicaid and not be eligible for assistance for the length of time the money paid to you could have paid for facility care. If you get injured and can not work, now they get to go through a lawsuit because you will not just grin and bear it.

Those are only a couple of examples. If you are really interested in proving that you are a reliable honest caregiver then you need to have things required by law in place, that speaks volumes to a potential customer.

I for one see your situation as a disaster that is avoidable and I question your reliability because you are so willing to disregard the law for your profession.
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Shane1124 Jun 2019
Agree. Whatever state you are in, go to the website of the Department of Licensing for healthcare professionals and read state guidelines for the position you seek.
Why anyone would put themselves at risk regarding workers comp or short term disability is beyond me.
As makeadifference stated, you have to set yourself up as a legal entity to protect you and your client from harm.
There are already many state regulations in place it’s that these regs are not being enforced.
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https://seniorservicebusiness.com/4-things-you-must-know-before-starting-a-non-medical-home-care-business/

Non-medical is different that medical,


Please look at seniorservicebusiness.com

They have all the laws rules, and is a good way, if someone wants to do it right.

It is all about being real, honest, caring and reporting to the IRS.
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Care.com is a company that allows individuals to create their own information as far as what they specialize in:
Housecleaning
ElderCare/Senior Care -- Full Time - Part time
Child care
Pet Care
Housesitting
and much more.

They have a company called HomePay by Breedlove, that does all of the employee work for you. You just have to report online the hours, and your caregiver is paid.

Where I live in Washington State, most Agencies get 50% of the fee. Therefore if you are paying $30.00, the caregiver is getting 15.00.

I have been in caregiving for 15 years, and sure there are people on Care.com that have not and are not fully trained, and need assistance, but then there are people like me that at an older age, after mom has Alzheimer's this has become my passion.

There are very little Federal Regulations on Assisted Living Facilities, there are many state regulations. I have Insurance, I am bonded, and I am licensed.

I am saying, I believe that and know there are many fabulous caregivers that do this, and do this very well. I have several people private pay, and it has been the best of my life right now. For us caregivers, if you are hired by an Agency, you do not know who you are going to, and in Washington state they do not allow you to interview or meet people.

It needs to change, and I am not saying do not support Agencies, but there are a lot of good people, background checks extensive, that are excellent on Care.com, but there will always be the bad. Care.com just got a bad wrap about some safety concerns, it is common sense.

Are we really that paranoid, to see that anyone coming in our home we cannot trust. A true caregiver has the love of the job in her eyes, as I have been told that many times, and it is about the client, giving her the compassion, the companionship and the care that is needed. I am in the process of trying and am doing it methodically to find a way to allow private caregivers into assisted living facilities and nursing homes, just like in home health, (like hairdressers, nails, etc. they are services that are provided for the clients). I have checked out the laws and they vary state by state, but why not give some very good people a chance.
I met two woman on care.com and the reason was I am trying to get a group of very good people that are very committed to do this.

I have met alot of very nice families, doing this. It is not easy work, but Care.com offers you benefits and many features and cost savings for you as the caregiver.
Remember to always be cautious as it does also work the other way around.
We go into houses where it is clearly not safe.

Lets all work together to create the love for all of us that need it:

Caring for our seniors is perhaps the greatest responsibility we have. Those who walked before us have given so much and made possible the life we all enjoy.

I really think if all of you had a mother father in a nursing home (medicaid), that would be harder for a caregiver to recoup costs, or assisted living (self paid), I have done a survey in my area. Over 350 people that I have talked with one on one and the Assisted Living managers say that companion care/concierge care is a much needed thing. The 2-4 hour that allows those suffering from Alzheimer's one on one care, and attention, not the busy buildings they are in. For in-home, it is much easier, but again, I have never had an issue using HomeCare by Breedlove. My W-2 is sent directly to me, and the client ends up know that there is no mess, nothing to worry about financially.

Please let's support each other. Senior Living is a Profit Center, and I want to see the hard working men and women in our world know they can earn double. There are many other websites, that allow you to put your own profiles in.

Thank you all for listening and believing that there is good in all of us that are good loving caregivers.
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ArtistDaughter Jun 2019
I used care.com when my son was caring for my mom, as care.com did the taxes and social security for me. I didn't have to do a background check, of course. I had been working through agencies and returned to them when my son burned out, and only 2 people from the agencies were perfect. Neither could work full time. If I had it to do over I think I would find a live-in care giver from care.com for my mom, with another person to come in on days off. Whatever the situation with home care though, I eventually found my life was taken up with managing the care for my mom. She is in assisted living now and I have more freedom. My main complaint there is that if she says no to anything, they just let her sit and do nothing. If she says no to her bath, they don't seem to know how to convince her. The home care people and I always could convince her. Difficult, yes, but it could be done.
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Going to preface to say I see that you are making a case of private vs agency caregiving. But I wanted to also give another theory as to why it can be hard to find families wanting to hire a private caregiver.

The big thing for me while I was caring for my father in my home was cost. He only had Medicare and no money other than his very little SS which went towards his living in our home to cover his costs. He no longer had a home, as his previous home was unsafe and 3 hours from ANY family. There was not really much leftover to bring in a private caregiver as often as needed, and Medicare doesn't cover many of the duties I needed to be relieved from. He had been denied Medicaid for long-term care previously so I didn't try again. So no private caregiver and no agency. I looked into it many times, especially when I would get to a breaking point, but with my husband's income and needing to keep up with house bills, food, medical, school etc while raising kids we didn't have the extra money either. In my area, private caregivers and agencies alike charged $20-30/hr. When I calculated the hours needed, it was something like $400-500/mo. So I took care of him myself, as stressful and mentally incapacitating as it was for me, until he had more strokes that put him into a facility due to my not being able to care for him any longer. The facility managed to get Medicaid approved for him, so he's good now. The smaller thing was having essentially strangers in my home. I have 4 children under 18 here, and even with them only hired babysitters that weren't friends or family twice in 17 years. When a couple of my kids who have disabilities needed in-home therapies when younger, I never left them alone. So having someone I really don't know in my home is something I struggle with as it is, and as much as I really wanted help with my dad, I had trouble justifying having another person here if I was still going to be spending the time watching over everything. Just another perspective as to other potential reasons why many families refuse private caregivers (and even agency caregivers).
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Makeadifference May 2019
I wanted to tell you that you can file for Social Security Disability on top of Retirement income, as well as if you have Medicare there is a website that talks about ways to pay for home care.

I understand your position, because I would be in the same boat for myself. Meaning, I don't have 20.00 per hour hanging around to pay someone.

I have checked endless websites, and found numerous ways to pay for it.

if you would like I will list them and let you know.

God Bless and your work is really hard, I do know, my mom was 10 years Alzheimer's and it is very very hard without a break.
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I also heard of a family who used a private agency/person. I think she had all the credentials, but very expensive for 24/7 care. It would have been better if the mom was moved into a facility so she could have had more people around for activities, and games, etc. at a much more reasonable cost.
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freqflyer May 2019
Mayday, how true that is regarding costs of having 3-shifts of caregivers per day at the house compared to moving to an apartment at senior living.

For my Dad, it was costing him $20k per month to have around the clock caregivers. When Dad checked around he was surprised that senior living was more like $5k-7k per month [in his area], so he jumped at the chance to move, and had enough to budget one short shift for a private caregiver.

Even though my Dad wasn't a social butterfly, he enjoyed having his meals with other guys who were also living at the facility. He just loved the menu based restaurant style dining :)
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I was told about a husband and wife, both passed away a few years back, had a private caretaker. Well that caretaker got "injured" on the job and sued the couple. They lost everything. Perhaps they didn't have the correct homeowner insurance and/or the caretaker found an easy way to "cash" in. This may be one reason. Do go out and get a business license, insurance, workmans compensation insurance, or whatever you may need, and have it readily available to show your new potential clients. Perhaps you already have it. Accidents happen especially with elder people. I know too many elders who have fallen or were dropped for one reason or another. I know three people who died from being dropped. They didn't fall, they were dropped.
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It seems that it’s the luck of the draw, with agencies, the people they employ, and private carers. ‘I will pay my own tax and insurance’ doesn’t comply with the legal requirements, so the employer is either ignorant or very optimistic. If there is enough in this for you, it might be worth thinking about setting up your own business, with a $2 company or contracting under a business name. There will be a lot for you to learn and paperwork to do, so perhaps it’s more realistic if there is more than one of you and/or you hire a person or a business to do the business details. There are many small book-keeping firms that do this for small businesses and are more reliable than a bad carer! In any event, you could advertise at Marketplace, Craig’s List, a local Day Care centre? - anywhere likely to be seen by your target group. But you may still need to have a formal business support structure, unless you find another ignorant or optimistic employer family. Good luck.
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In my area, the nationwide caregiving Agencies are at the top of the list. My Dad had used one agency for over a year with zero problems. Not once was Dad ever left on his own because no one had showed up.

The Agency was licensed, bonded, insured, and had workman's comp for their employees in case one should get hurt on the job. The caregivers had their flu shots and yearly TB tests. Background checks and fingerprinted. The agency had monthly meetings and classes for their employees. I couldn't have asked for anything better. The cost was $30/hour which is the going rate in my area.

My Dad got to interview many of the caregivers when they came for their shift and he choose two to be on a regular schedule. These two caregivers had similar upbringing as Dad so they had a lot in common, and they both had a great sense of humor as my Dad was pretty funny. Even when my Dad sold his house and moved to senior living, he brought along the two caregivers, thus it gave Dad a routine he needed.

Rndaughter2, the Agency sent over a Rep who toured the house, she interviewed me about Dad's needs, and I in turn interviewed her. Dad needed someone to help him with daily routines, plus light housekeeping, and light cooking. Dad's day time caregiver would take Dad at noon time over to see my Mom who was living in long-term-care, and she helped feed Mom. The caregiver also took Dad to his numerous doctor appointments and was involved with his health. One caregiver would help Dad with light yardwork, she was glad to help as she wanted Dad out of the house to get some fresh air.
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Rndaughter2 May 2019
Thank you freq flyer. This sounds good. Im wondering if he needs someone to spend the night. He seems to be confused right now. Do they sit outside bedroom all night? I dont know if he would be confused to see someone there. And i dont know if 2 people can work around the clock if needed. May be too much on them. Maybe 3 or 4 people maybe needed to handle shifts. Any thoughts? Still probably cheaper than. AL. ITS 300$ a day and i dont think if he comes in hall in middle of night he can find anyone. Because i can hardly find anyone there in the day.
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For me its because i dont know what they charge. And not sure do they cook? Do they give meds? Concerned too many different people will come in and out and confuse dad. If just 2 people could come a wk that might work.
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Racheld17 May 2019
Discussing the needs of your loved one and the needs in the household with a potential caregiver in the beginning is very important. I can’t speak for every caregiver but in my clients household we cook and bake for her, she has a sweet tooth and I was a pastry chef previously so I also make special desserts for her. We are also responsible for light housework. We fill the med trays and pass the meds. We take care of her hygiene needs, and assist her through her whole schedule every day. There are things outside of our job responsibilities that we also do for her because we care. Having strangers coming in and out is not ideal for anyone, finding two responsible caregivers is a good idea. It allows more options for coverage and time off, and also allows for each to have a break and recharge before working with your loved one again.
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I am not saying this about you.

But my god. Read the post about caregiver taking pics of mom's stuff and sending to some man.

We ruled out private caregivers because so many are unreliable. Dink around on phone. Are lazy.,did I mention unreliable.

Again, I am not saying this about you. But goodness. It's appalling.

This is an industry which needs more regulation.

That said, attorneys with whom I work, have used a private caregiver for years. One in particular. But she is beyond our reach financially, but very good.

And that referral network is word of mouth amongst very very high earners.

And they pay her insurance and set up a 401k. She is well known in the FIRM. she is never without work. When one passes, others snatch her up.
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Racheld17 May 2019
I have heard similar stories and it is very sad, part of the reason I got into this field is because of hearing of and experiencing first hand the result of abuse and neglect of an elderly loved one. Far to often the elderly are taken advantage of because of their vulnerable state. It never stops being heartbreaking and I agree there should be far more regulation and oversight.
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I see several people basically saying it can be more of a hassle, and that's understood.. dealing with the care of a loved one in general is already very stressful, so going through the process of finding a private caregiver can seem like an extra added burden. Simultaneously though, I would argue it's worth it, I have been on both sides of this predicament. I also had a loved one who needed care and who was in another state, and I remember vividly my mother contacting me crying in frustration over the quality of care, or lack there of that was being provided, and I've heard those same frustrations echoed over and over by people I have come into contact with. The fact is most agencies don't vett or drug test the caregivers they hire.. There is such a high turnover rate in agencies, they are just concerned with hiring as many people as they can in order to fill shifts and keep their money coming in. I have personally seen caregivers come in extremely high to work, and also have worked with caregivers and heard from acquaintances of caregivers stealing money, or things from around the house ..even in one case taking a clients car without permission while on shift, crashing it and trying to hide the accident. I could go on I have heard of and experienced so many nightmares families have dealt with when dealing with agencies. I was hired in previously by two care giving agencies who did not vet their caregivers or drug test. My friend was also hired in with the same experience. When you hire through agencies for your loved one you are really leaving it up to chance whether or not that person will be someone who will responsibly take care of your loved one.
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That's a fair point, the way my current employers do it is probably the most simplistic way a family can go about hiring a private duty caregiver. They do not provide worker compensation, I set aside and pay my own taxes every year so they do not deal with that aspect, and my insurance is my own. That being said, I recognize that is not the normal situation. I also understand what you mean about having no back up, my client does have two very reliable private caregivers so there is always someone to provide back up, and actually when my clients family were going through an agency, they found that the so called "backup" the the agency was supposed to provide was never guaranteed. People would call off, or just simply not show up, and they would have no one trained to come in and cover.. I have also had the same experience every time we have tried to bring in an agency just to provide some vacation time or extra backup for me and my coworker. We have had one catastrophe after another with several agencies we have tried. Perhaps you are right about advertising in the wrong places, I'm sure there are plenty of people out there who are burnt out on agencies, maybe the key is just to look harder in the right places.
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faeriefiles May 2019
Unless you have a business set up in your name, an independent contractor agreement signed with your employer and in place with your TIN on it, and are paying a business owners tax, then what they are doing is most likely illegal. The taxes you pay on your income for federal income taxes protects you from most liability in the tax evasion thing, but doesn't protect your employer who is supposed to file quarterly statements and pay an equal amount of income and other taxes on you. If you are working on employee status are hurt at work and go to a hospital and do not have workers compensation in place things can get really messy in a hurry. I've seen it happen. If your medical insurance doesn't know you're operating a business and the hospital lists you as being hurt at work it's likely that your medical insurance will not cover your injury. Injury is a very common carer issue and especially back injuries can be lifetime debilitating things. Hopefully you already know about all this and have purchased your own workers comp, etc. If not maybe it's something you can look into. On the flip side if you are operating as an independent contractor and you don't carry liability insurance and your employer sues you that could cost you everything too.
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If I hire a private care-giver I then become an employer. I've been an employer. It's a lot of work. Piles of employee rules and regulations to follow, liability insurance to be purchased, paperwork to fill out, taxes to be paid, worries about who steps in when my carer is sick or gets injured etc etc. It's expensive and time consuming. It's one more major stressor in an already stressed out situation. Many people just don't have the energy, money, and/or skills to pull it off. If I hire an agency I get to skip all that paperwork, pay a flat rate for a specified service and if one caregiver is sick or injured they send over another. I think that's why most people hire from a company rather than hiring a private carer.
If you have your own business license, liability insurance, are bonded, have backup carers lined up for when you are ill, etc and operate as a company on your own then you could be hired as an independent contractor which might make someone more likely to consider you.
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Maybe because they don’t want to have to deal with the business side of it? Legally they have to have some sort of workers comp insurance & pay payroll taxes & make the SS & Medicare contributions. They can’t just write out a check on payday & call it a day.....
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People don't want to have to go through all the rigmarole of being an employer - tax withholdings, workers compensation, extra insurance etc., not to mention the lengthy interview process. They don't want to be dependent on one person who may turn out to be unsuited, They don't want to have no back up if their caregiver is sick or needs time off for another reason, and for vacations.
That said there are many people who would rather hire privately because they can get more for their money, perhaps you aren't advertising in the right places?
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Shane1124 Jun 2019
Exactly.
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