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When you need care at home, who you gonna call?

When you know the time has come to bring in assistance for yourself or a loved one, to whom might you turn? For many people, it’s friends, neighbors or family. But if there is a need for ongoing, personal, perhaps hands-on care, or if there is a diagnosis of dementia, it might be time to consider hiring a caregiving agency.

As in most choices, there are pros and cons to working with an agency. Here are some “cons” from people who have voted against this choice, and my additional “pro” comments:

• Agencies have a minimum number of hours and I don’t need that much help. (This minimum is true in some cases. But, there is often more care that’s needed than can be covered in a brief visit.)

• The caregivers are not paid as well as those who work privately, so they’re not as competent. (It is true that caregivers are paid approximately half of the fees you’re paying to the agency. Private caregivers, earning more per hour, still need to pay their own taxes, which narrows this apparent difference. What is not a fact is that agency caregivers are less competent. Some just don’t want to be in business for themselves, and appreciate that an agency can keep their schedules full.)

• I never liked the caregivers the agency sent my way. (During the initial assessment and intake, it’s important to stress those characteristics that you’re looking for. And, you can always call the agency and let them know that this person is not exactly your cup of tea and they will offer another caregiver.)

What an agency does provide has a great deal of value. Let’s look at some of these benefits. You might ask yourself if you could honestly provide this if you were employing caregivers on your own. An agency:

• Is bonded and insured and actually employs their caregivers (pays all social security and taxes, unemployment and worker’s compensation insurance, plus pays professional liability insurance), and verifies they are legal to work;

• Conducts rigorous abuse and criminal background checks;

• Trains initially and provides ongoing training; and

• Provides back-up caregivers, if and when needed.

One more wrinkle in this is that not all caregiving companies are actually licensed as agencies. There is no way to tell simply by their names or how they advertise themselves. Some are what are called a registry or referral agency. In these cases, the company does not necessarily employ the caregivers and therein lies the potential problem. Years ago, a colleague was surprised to find out that a caregiver she hired through an “agency” was not actually employing and providing liability insurance for this person. When the caregiver stole some money from the client, the “agency” was not responsible for her actions. This is learning the hard way, and even a professional can misunderstand how these companies are licensed. So, if you’re going this route, asking upfront is of paramount importance. Be sure the company performs all of the tasks named in the above list.

In Ashland, we currently have no licensed caregiving agencies. The ones that are based in Medford and Central Point do provide services to residents here, as well as the rest of Jackson and Josephine County. Here is a short list that I know for sure are agencies. In no order of priority, they are Right at Home (www.rightathome.net/southern-oregon; 541-414-0800); Interim Healthcare (www.interimhealthcare.com/medford/home; 541-779-0054); and Home Instead Senior Care (www.homeinstead.com/476; 541-734-2700). Please check the Jackson County Senior Resources Directory (localseniordirectory.com/jackson-county) for more options.

A final comment: Even if you have a private caregiver in the home, you might still consider bringing in an agency for some hours a week. No one person can be expected to always be available, and backup is vital. Also, consider that each person brings different skills and talents to their client, and this is always an added benefit.

—Ellen Waldman is a certified aging life care professional. Submit questions about aging and Ashland-area aging resources and column suggestions to her through her website, www.SeniorOptionsAshland.com.