How To Hire a Caregiver | Private vs. Agency

You have come to the realization that you need additional help to care for a loved one.  The big question is, do I hire a private caregiver or use an in-home care agency?  

This series of articles will give you information on  how to decide which option is best and how to hire a caregiver, whether you go through an agency or hire privately.


Hire a Private Caregiver or an In-Home Care Agency?

Maybe you’re experiencing burnout as a primary caregiver.  Or, you might live out of town and, during your recent visit to see an aging parent, you realize that daily tasks are becoming more difficult for them to do.

I’ve been there too.  When my mother became disabled due to MS, I moved her in with me.  Since she required 24 hour care, I needed to hire a caregiver to be with her during the day while I was at work.

The decision a lot of families struggle with is whether to hire a private caregiver or use an in-home care agency. 

Let’s compare the two options.


Using a Home Care Agency


1. They are the employer

The home care agency will be the employer.  They will handle all hiring, firing, background screens, paying the caregiver, withholding taxes, etc.  They will also be responsible for any workers compensation issues should there be a work-related injury.  

Note: There are also some agencies that will handle the paperwork (taxes, social security, etc.) if you find a home care worker on your own and want to “hire” them through an agency.

2. Substitutes

If the caregiver is sick, the agency will send a substitute.

3. Variety of skills

Agencies can provide caregivers with a variety of skills to meet different needs (e.g., skilled nursing care, physical therapy, occupational therapy, etc.).

4. Help covering costs

If you use an agency, in-home care costs may be partially covered by Medicaid or private insurance.


1. Multiple caregivers

Often several workers are used (depending on how much care you require) which can be confusing or distressing for the person receiving care.

2. Less control in hiring

You do not have as much individual choice in caregiver, although you do have the option of interviewing the caregiver(s) before they assign one.

2. More expensive

Hiring a caregiver through an agency can be more expensive than privately hiring an individual (although the agency is charging more because they assume all employment-related liabilities).  So, this can also be a Pro, depending on how you look at it.


Hiring a Private Caregiver

There can be advantages to hiring a private caregiver.  However, it should be noted that you assume a lot of risk and liability when acting as the employer, especially in a state like California.


1. Continuity of care

A strong one-on-one relationship can develop between the caregiver and the person receiving care, although this can also happen through an agency when there is a commitment to continuity.

2. Less expensive

It is typically less expensive than going through an agency, though you do assume liability as the “employer”.

3. Control over hiring

You get to choose the person you think will be the best to provide care to your loved one.


1. No substitutes

If your caregiver is sick, no substitute is readily available.

2. You are the employer

As the employer, you are responsible for screening, hiring/firing, and work-related injuries.  You must also pay the caregiver and withhold applicable taxes, etc.

3. Private pay

If you hire your own caregiver, the cost may not be covered by Medicaid or private insurance.


How Do You Decide?

At the end of the day, you need to do what is best for you and your family. Before making such an important decision, please research both options and understand what the decision will mean for you, your family, and of course, your loved one who requires care.



You can also check out these other resources.


In Conclusion

Regardless of whether you choose to hire a private caregiver or employ a home care agency, hopefully you will be fortunate enough to find a devoted caregiver.

Becoming comfortable with a caregiver in your home may take a little while, however their immense value will be quickly realized. Good communication, clearly outlining work expectations, and providing positive feedback, will create a good relationship and bond with your caregiver.

Caregivers, like most of us, need to hear praise for good work and appreciation for what they do. Caregiving is a tough job.  This effort will in turn encourage your caregiver to develop a sense of loyalty and devotion to your parents and family.

If you do decide to use an in-home care agency check out the 9 Questions To Ask When Choosing an In-Home Care Agency.   

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