How to find and hire non-agency private caregivers who can physically do max assist stand pivot patient transfers/lifts for Parkinsonism/Pisa?

Hi,

We're in need of physically strong at home caregivers who can do max assist stand pivot transfers & other lifting for a patient who cant get to standing on their own. They have a movement disorder (Parkinsonism), Pisa Syndrome (severe lean to their side), & advanced dementia (cant do almost all ADLs). Ive seen some well off families seem to have found private caregivers, not through agencies, that they directly hire to do this. I've seen on other forums that family caregivers recommend hiring former army medics, strong men/women (a family posted on another forum they apparently found success with caregivers who have backgrounds specifically from Southeast Asia, such as from Samoa, Philippines, etc where they're known to be physically fit/strong). I'm wondering the process for finding these caregivers online/elsewhere & how they're hired. I get the sense these wealthy families are directly hiring the aides as their employees and as I understand it are thus responsible for payroll, payroll tax, all legal implications of the aides being their employees, etc. I havent found any guidance/resources/organizations/information online who provide families with any tips on even how to practically hire these aides (such as what you'd need to set up thru a lawyer such as an employment agreement). I imagine these aides may be paid an annual or monthly salary versus hourly (like with agencies), as it seems they're providing care every day-including travel with the family (including single caregiver transfers of patient from their wheelchair into the passenger car seat) & advanced skills like feeding tubes, etc. For us, we need physically strong aides who can lift on their own our loved one from their wheelchair to their hospital bed, from bed to their manual transport lift, lift to toilet (if we get back to using that, as our loved one cant stand up from toilet & it takes 2 of us to pull them up). We've looked into the electric sit-to-stand (STS or SARA) lifts that use a sling to help get our LO up from a seated position, so the aide would have to be skilled enough to use a lift and sling like that too.

We havent been comfortable with the quality and physical ability of the aides thru agencies (often older women who aren't able to do any type of transfer or seem strong enough to use the manual transporter lift or transfer patient onto sliding shower chair for weekly showers). We even shared a video on how to do a stand pivot transfer before starting with a new 'high end' agency & even after assuring us their CNAs were trained, she wasnt

We tried facilities but the quality of the care there was also so poor (and staffing ratios so horribly dangerous) we didnt pursue the electric sit to stand lift there & didnt even feel comfortable with their rotating untrained aides using the manual transporter lift. Our loved one leans heavily to one side (Pisa Syndrome or PS or pleurothotonus) as part of their poorly defined Parkinsonism movement disorder, so you have to be strong enough to transfer them and get them standing while they're leaning their full body weight in often the opposing direction youre trying to transfer them to. We have the monthly budget of what the facility cost, so I feel like we should be able to find stronger, skilled caregivers at home that we can pay directly if needed. I've also heard that if you hire caregivers directly, they're more likely to stay/there's less turnover, as they get paid directly & keep more of the money versus going through an agency who takes out a significant portion of the hourly wage (without providing benefits like paid sick leave etc).

Thanks for any help or places folks can point us to to try to learn more-ideally we'd prefer not to have to do the work of setting caregiver(s) up as our employees, but if that's the only way to find the physically strong aides we need, then I just want to understand how to find them & how to set them up (through our lawyer drafting documents?) as employees.

T