Is It Better to Hire a Private In-Home Caregiver or Use an Agency?

Before hiring a caregiver for in-home help, you first must assess your own management abilities, according to Leslie Eckford, a nurse and geriatric clinical social worker who coauthored Aging with Care: Your Guide to Hiring and Managing Caregivers at Home with Amanda Lambert.^[01]

If you have a management background or experience collaborating with others, you may be well suited for managing private caregivers. If you don’t have experience managing others, it may make sense to work with an agency.

Read more:Home Care vs. Community Care: How to Decide What's Right for Your Family

Hiring a caregiver through an agency offers a more streamlined approach for busy families but it does comes with its own set of pros and cons.

Benefits of agency caregivers

A major advantage to using an agency is that they generally guarantee coverage for all your loved one’s care visits which can alleviate stress for families.

“If a private caregiver quits or doesn’t show up for a shift, the family is responsible for finding a replacement or covering the shift,” Lambert says. “An agency is going to replace that person.”

Agencies also provide a wide range of services:

• Agencies typically perform background checks and verify caregivers’ certifications and experience in addition to taking care of payroll and scheduling.
• Reputable agencies typically require caregivers to attend periodic training on a variety of subjects and skills, some of which are regulated by the state.

Another thing to consider when hiring an agency caregiver is the sense of security it can provide. For example, if there is a conflict between the family and an agency caregiver, or the caregiver is suspected of wrongdoing, agencies typically have a process for communicating with the family and resolving the issue.

“Hiring through an agency brings peace of mind, especially with regard to liability,” says Lambert.^[01]

Drawbacks of agency caregivers

You’ll typically pay more for agency caregivers than private caregivers. The median hourly cost is $30 an hour, according to A Place for Mom’s proprietary data. Agencies pay salaries and benefits for multiple employees which is factored into the hourly rate.

Another drawback may be that there’s no guarantee your loved one will have the same caregiver each visit. A family can request a specific caregiver but care obligations to other families and staffing requirements may force the agency to send whoever is available.

Lambert recommends asking agencies these questions:

• How can I monitor what the caregiver does? Will they keep notes, and can these notes be shared? Is there an online family portal where notes can be viewed?
• How many of your caregivers are certified nursing assistants (CNAs)?
• What are your training requirements?
• Who is the main person to communicate with about problems? ^[01]

Is home care the right fit?

Hiring a private caregiver — sometimes called an independent caregiver — may seem like the easier option, but it depends on how much of the hiring and caregiver management responsibility you are able to take on.

Benefits of hiring private in-home caregivers

The main reason families hire private caregivers is the lower cost, Lambert says.^[01] With a private caregiver, the client pays only the caregiver’s hourly wage which can generally keep costs lower.

Additional reasons families hire private in-home caregivers may include:

• You have more control over who takes care of your parent. “Many people want to select the person who will do personal care for their loved one,” Eckford says.
• You can communicate directly with a private caregiver rather than having to go through an agency manager.
• There’s more freedom in determining caregiver duties. Agencies are generally restricted by state laws regulating which tasks caregivers can perform.

Drawbacks of hiring a private in-home caregiver

Choosing to hire a private in-home caregiver may save money but keep in mind that it’s your responsibility to complete background checks, payroll, and taxes. If you choose to hire a private caregiver, they’ll likely be considered your household employee.

“The worker is your employee if you can control not only what work is done, but how it is done,” according to IRS household employee guidelines.^[02]

It’s best to consult with an attorney or financial expert in your state to learn more about the worker status of a potential independent caregiver.

Some people choose to purchase additional liability insurance coverage for injury or theft, depending on what they can afford and how much they trust the caregiver. You could even incur legal fees if a caregiver accuses a family member or another caregiver of assault or sexual harassment.

“If you have work experience with interviewing and hiring, this would be a natural progression for you,” Eckford says. “If not, but you want to hire the caregiver yourself, do your homework first.”

Before hiring privately, Eckford recommends asking yourself these questions:^[01]

• Do I enjoy managing people and completing administrative tasks?
• Am I able to communicate clearly what I want and need?
• Do I have supervisory and management experience?

Home care questions? Get expert help

It’s important to know what kind of caregiving resources are available before you need them. The worst thing you can do is wait and make rushed decisions when a parent or senior loved one becomes ill, or is being discharged from the hospital, Lambert says. In addition to in-home caregivers, Lambert recommends exploring multiple senior care options.

“Have three agencies in place. Tour assisted living communities,” Lambert says. “Be as prepared as you can and recognize that your parent is going to eventually need some help.”^[01]

Caring for a loved one can be challenging but there are several resources to help you understand your in-home care options. If you decide that hiring a caregiver through an agency is right for your family, Senior Living Advisors at A Place for Mom can help you explore home care agencies in your area.