By Rona S. Bartelstone, LCSW, BCD, CMC
As time went on, Mrs. L continued to have minor
strokes that left her increasingly debilitated.
After 18 months, Mrs. L was quite incapacitated and
had lost her ability to speak. At that point, the
family decided to ask the aide to live in full-time
and provide total care to Mrs. L. This relationship
was very loving and lasted until Mrs. L passed away.
Because the aide had given up all of her other
clients to care for Mrs. L full-time, she had no
other immediate employment when Mrs. L died. Since
she needed income to support her family, the aide
filed for unemployment benefits. It was at that
point, that the IRS became aware of the employer and
filed a lawsuit for back unemployment taxes,
penalties and a fine. The family of Mrs. L did not
understand their responsibility as an employer and
found themselves in a legal action that took over
two years and many thousands of dollars to resolve.
Workers' Compensation and Liability Issues
As the employer, the individual or family paying
for the private home health aide would be held
liable for any work-related injury that occurs on
the job. This can include the cost of all medical
expenses and any disability payments that might
Since the home-care industry is noted for
work-related injuries, this can be a huge risk,
especially if the caregiving tasks include lifting,
transferring or bathing. There are also risks
related to communicable diseases if the aide does
not abide by universal precautions that are required
by all licensed agency personnel.
Furthermore, the employer retains any liability
that arises out of an injury to the person being
cared for or any other person on the premises. If
the home health aide were to cause an accident, for
example, in which other family members suffered any
harm or losses, the employer would bear the full
responsibility for all costs and compensation.
Case Example: Home health aide, Myra Jones had a
history of back injuries after many years of work in
rehabilitation facilities. Her injuries always
responded well to treatment, and were kept at bay
with back supports provided by her employer. When
Mrs. Jones had the opportunity to follow one of her
clients home from rehab as a private aide, she took
advantage of the offer and worked privately for Mr.
Mr. S didn't need a lot of physical care when he
first left the rehab facility. He was there because
he had had surgery that left him weak and a little
confused. Unfortunately, the confusion did not clear
up as the anesthesia left his body. It seemed that
he had begun to develop a dementing illness, and
would need increasing supervision for safety.
Over time, Mr. S began to need increasing amounts
of physical care, especially for transferring and
dressing. Mrs. Jones found herself increasingly
taxed by the care of Mr. S, but she had become so
attached to him that she did not express her
concerns to the family that had hired her.