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

You and your family hoped this day would never come: Your parent or senior loved one used to be independent, but now they might not be able to cook, clean the house, or be left alone for long periods of time. You realize they’ll need help from a caregiver.

Families looking for caregivers have two options: They can find an agency caregiver through a licensed home care business, or they can directly hire a private caregiver who provides services independently. This process can be overwhelming, and there are pros and cons to each approach.

Here’s what you need to know before making any decisions.

Interview yourself first

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.

If you have a management background or experience collaborating with others, you may be well-suited for managing private caregivers.

Should I find a caregiver through an agency?

There are pros and cons to using an agency to find a caregiver.

Benefits of hiring a caregiver through an agency

You’ll receive more in services. For example:

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

“Private caregivers can explain their background and training, but there is often no way to verify the information,” says Lambert.

One of the biggest advantages of using an agency is that it covers all shifts. “If a private caregiver quits or doesn’t show up for a shift, you’re responsible for finding a replacement or covering the shift yourself,” Lambert says. “An agency is going to replace that person.”

Another consideration is that if an agency caregiver is accused of stealing or some other infraction, agencies typically have a process for communicating with authorities, suspending the caregiver during an investigation, and reporting the incident to your state’s department of human services. “Hiring through an agency brings peace of mind, especially with regard to liability,” says Lambert.

Drawbacks of agency caregivers

You’ll typically pay more for agency caregivers than private caregivers. Agencies pay salaries for multiple employees, workers’ compensation and liability insurance, and payroll. Then agencies factor those costs into the hourly rate; the median hourly cost was $23 in 2019.

There’s also no guarantee you’ll have the same caregiver every day. You, a parent, or senior loved one may not even like the person the agency sends. You can voice your concerns, but managers may not address them to your satisfaction. You’re not the one doing the firing or hiring, so you relinquish control.

Lambert recommends asking agencies these questions:

1. How can I monitor what the caregiver does? Will they keep a daily or overnight notebook record, and can these notes be sent monthly? Is there an online family portal where notes can be viewed?
2. How many of your caregivers are certified nursing assistants(CNAs)?
3. What are your training requirements?
4. Who is the main person to communicate with about problems?

Should I hire a private caregiver?

Private caregivers for hire — sometimes called independent caregivers — may seem like the easier option, but it depends on how much responsibility you want to handle.

Benefits of hiring independent caregivers

The main reason people hire private caregivers is lower cost, Lambert says. The average hourly rate for private caregivers in 2018 was about $17, according to Care.com.

Other reasons people hire private caregivers 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 home caregiver

You might save money with a private caregiver, but you’ll spend extra time on background checks, payroll, and taxes. 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 have 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:

1. Am I good at supervising others, and do I enjoy managing people and administrative tasks?
2. Am I able to communicate clearly and regularly what I want and need?
3. Do I have supervisory and management experience?

The worst thing you can do is wait and make rushed decisions when a parent or senior loved one is discharged from the hospital, Lambert says. Know what kind of caregiving resources are out there before you need them.

“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.”

How to find a caregiver near you

Contact A Place for Mom’s Senior Living Advisors to learn about in-home caregiver resources and senior living options in your area.