Hiring Private Care

The decision to access additional care and support is a personal one with many considerations. As Parkinson’s disease progresses, individuals may notice increasing difficulties with daily activities, such as medication management, bathing, meal preparation, and other day-to-day tasks. If you are considering the need for additional support, there are two options to explore: publicly subsidized home and community care services, and private pay services. Utilizing these services provides the benefit of staying in one’s own home and retaining independence. These services also provide much-needed respite for caregivers, allowing them to better care for themselves (“Hiring In-home Help,” n.d.).

Publicly Subsidized Home and Community Care Services

Regardless of which route is chosen, it is recommended that public health services be explored first (“The Ins and Outs of Hiring Private Care,” 2017). Individuals who meet the provincial eligibility criteria, as determined by a formal assessment, are assigned a case manager (“Publicly Subsidized or Private Pay Services,” n.d.). The case manager then acts as a gateway for receiving services, which are subsidized through the Ministry of Health (“Publicly Subsidized or Private Pay Services,” n.d.).

While the services available differ depending on one’s health authority, the following are examples from Vancouver Coastal Health of services that may be available through the public health system (“Costs for Home & Community Care,” n.d.):

Home care nursing, which may include wound care, intravenous therapy, health education, and referrals to helpful community services.
Caregiver support, which may offer respite care, as well as assistance with caregivers’ personal care, recreation, and laundry.
Occupational therapy, which may be used to increase a person’s independence through work, self-care, and recreational activities. There may also be a focus on improving domestic skills, such as housekeeping, gardening, and cooking.
Physiotherapy, which may teach and assign beneficial exercises to do at home, such as stretching or walking.
Community nutrition, which may provide nutrition assessments, food and nutrition education, and medical nutrition therapy.
Personal care for eligible palliative clients, which may provide basic medical care focused on symptom control, medical supplies as needed, counselling, respite care for caregivers, and bereavement services.

Although personal preferences are considered, the primary needs of individuals are identified through the formal assessment (“Publicly Subsidized or Private Pay Services,” n.d.). Sometimes, the individual may disagree with the assessment and believe they need access to more frequent or specialized care. In this case, conflict resolution measures should be applied, such as speaking with their case manager’s superior, and in more complex situations, a formal complaint can be filed with the local health authority.

Other Publicly Funded Programs

Choice in Supports for Independent Living (CSIL) is a publicly funded, provincial program that provides people with significant physical limitations the funds to purchase their own home support services (“Choice in Supports for Independent Living,” n.d.). Eligible clients are given control over many aspects of their CSIL care, including which provider to hire, as well as how to spend the funds (“Choice in Supports for Independent Living,” n.d.).

CSIL clients receive a set amount of funding each month, calculated by multiplying a CSIL hourly rate (which is predetermined annually) by the number of hours of home support they need (“Choice in Supports for Independent Living,” n.d.). Individuals typically pay a small monthly contribution amount for these services (“Choice in Supports for Independent Living,” n.d.). However, for those receiving certain government income benefits or meeting specific criteria, the monthly contribution may be reduced or waived (“Choice in Supports for Independent Living,” n.d.). To learn more about CSIL, please visit https://bit.ly/CSILsupport.

Private Pay Services

Individuals may wish to hire private pay services for a wide variety of reasons, including gaps in what is offered through the public health system, or a need for more consistent and/or frequent care. The benefit of private pay services is that they are directly accessed from the service provider, and as a result, there is no need for a formal assessment (“Publicly Subsidized or Private Pay Services,” n.d.). Individuals are also free to compare service providers to find an ideal match between their needs and the provider’s offerings (“Publicly Subsidized or Private Pay Services,” n.d.). However, such services receive no government funding and are paid for out of pocket.

When hiring private care, the choice can be made to go through an agency or directly hire an independent care provider (“The Ins and Outs of Hiring Private Care, 2017). Agencies are a common first choice, as they normally handle administrative matters, such as criminal background checks and employee training (“The Ins and Outs of Hiring Private Care,” 2017). Some individuals may prefer to directly reach out to prospective independent care providers, using newspaper classifieds or online postings (“The Ins and Outs of Hiring Private Care,” 2017). This option may provide more flexibility and a larger talent pool, but can also be riskier and more time-consuming (“The Ins and Outs of Hiring Private Care,” 2017).

Considerations for Hiring Private Care

Person-centred care is an emerging care practice that places a holistic focus on an individual’s emotional, as well as physical, needs and preferences (“Person-Centred Care in Nursing Homes and Assisted Living,” 2017). Because life with Parkinson's disease is a journey of different stages and challenges, choosing a person-centred care provider will ensure individuality is respected (“Person-Centred Care in Nursing Homes and Assisted Living,” 2017). Reading a care provider’s values and mission statement, is a good place to get an idea of their approach.

After a shortlist of options is compiled, an interview process should take place to find the right fit for your particular care needs. Interview questions can cover a wide breadth of topics, including previous work experience and why they are the ideal candidate for the job, as well as situational questions, such as how they might handle a complex matter regarding confidentiality or client aggression (“The Ins and Outs of Hiring Private Care,” 2017).These questions may include:

How many years has this agency/individual provided services of this nature?
What are the costs, and is travel time included?
Does the agency/individual have any form of accreditation, usually granted by a third-party organization?
Will they supply references to verify the quality of their work?
If using an agency, are criminal background checks required of all employees providing direct patient care?
If using an agency, will the same care provider render services every time, or will staff rotate frequently?
What happens if the provider is unable to attend a scheduled visit? Is there a refund policy in place?

Once a provider has been chosen, duties and expectations should be stated clearly. For this, a service contract can be extremely helpful (“The Ins and Outs of Hiring Private Care,” 2017). The service contract should state the responsibilities of the job, including hours to be worked, rate of pay, and obligations for termination, amongst others (“The Ins and Outs of Hiring Private Care,” 2017). Agencies typically have contract templates available (“The Ins and Outs of Hiring Private Care,” 2017). It is also important to ensure that appropriate insurance coverage is in place, such as WorkSafe BC and home insurance (“The Ins and Outs of Hiring Private Care,” 2017). Additional motor vehicle coverage may also be required, depending on the nature of the care arrangement (“The Ins and Outs of Hiring Private Care,” 2017).

If you are hiring a care provider as an independent contractor or employee, depending on the details of the working arrangement, you may need to enter into an employer-employee relationship (“The Ins and Outs of Hiring Private Care,” 2017). If you have specific questions and concerns about the legal obligations related to hiring contractors, further information is available at https://bit.ly/ESAfactsheet.

Last but not least, checking references and receiving photocopies of any certificates or credentials is an important final step (“The Ins and Outs of Hiring Private Care,” 2017). By viewing a provider’s professional distinctions, along with testimonials of past success, individuals can feel assured they have chosen the right care for their needs.

Additional Resources

Choice in Supports for Independent Living | https://bit.ly/CSILsupport

Canadian Database of For-hire Caregivers | www.caregiverjobs.ca

Employee or Independent Contractor Fact Sheet | Employment Standards BC | https://bit.ly/ESAfactsheet

WorkSafe BC | Hiring Someone to Work in Your Home | https://bit.ly/WorkSafeBChome

Sources

Choice in supports for independent living (n.d.). Government of British Columbia. Retrieved from https://www2.gov.bc.ca/gov/content/health/accessing-health-care/home-community-care/care-options-and-cost/choice-in-supports-for-independent-living

Costs for home & community care (n.d.). Vancouver Coastal Health. Retrieved from http://www.vch.ca/your-care/home-community-care/costs

Hiring in-home help (n.d.). Family Caregiver Alliance. Retrieved from https://www.caregiver.org/resource/hiring-home-help

Person-centred care in nursing homes and assisted living (2017, July). Alzheimer's Association. Retrieved from https://www.alz.org/media/greatermissouri/person_centered_care.pdf

Publicly subsidized or private pay services (n.d.). Government of British Columbia. Retrieved from https://www2.gov.bc.ca/gov/content/health/accessing-health-care/home-community-care/care-options-and-cost/publicly-subsidized-or-private-pay-services

The ins and outs of hiring private care (2017, January 27). Family Caregivers of British Columbia. Retrieved from https://www.familycaregiversbc.ca/archives/6634

This content was published in the Spring 2022 edition of our quarterly magazine, Viewpoints. The content was accurate as of this publication date.

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