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

The following pros and cons of hiring a private caregiver — sometimes called an independent caregiver — can help you understand if this is the best option for your family.

Pros of hiring private in-home caregivers

Lower cost

The main reason families hire private caregivers is the lower cost, says Amanda Lambert who coauthored Aging with Care: Your Guide to Hiring and Managing Caregivers at Home with Leslie Eckford, a nurse and geriatric clinical social worker. With a private caregiver, the client pays only the caregiver’s hourly wage, which typically keeps costs lower.

Freedom to choose a caregiver

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.

Direct communication

You can communicate directly with a private caregiver rather than having to go through an agency manager.

Greater participation in care planning process

There’s more freedom in determining caregiver duties when hiring a private caregiver. Agencies are generally restricted by state laws regulating which tasks caregivers can perform.

Cons of hiring private in-home caregivers

Elevated administrative responsibility

Family is responsible for hiring, completing background checks, and managing payroll and taxes. Choosing to hire a private caregiver means they’ll likely be considered your household employee.^[01] It’s recommended that families consult with an attorney or financial expert to learn more about the worker status of a potential independent caregiver.

Potential gaps in care

If the caregiver a family hires decides to quit, the family is responsible for hiring a new caregiver. If a caregiver is unable to show up for a shift, a family member may have to provide care or find a substitute caregiver.

Risk of legal accountability

Families could incur legal fees if a caregiver accuses a family member of assault or sexual harassment. Some families choose to purchase additional liability insurance coverage for injury or theft.

If you have a management background or experience collaborating with others, you may be well suited for managing a private caregiver. If you don’t have this type of experience, Eckford recommends that you do research before hiring a private caregiver. You may also want to work with a home care agency to get a better understanding of how the hiring process differs.

Before hiring privately, Eckford recommends asking yourself these questions:

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

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

Pros of hiring in-home caregivers through an agency

Reliability

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. The agency is responsible for finding a replacement if a caregiver quits or calls out sick.

Management of administrative tasks

Agencies handle the hiring process of caregivers. This may include interviewing, performing background checks, and verifying caregivers’ certifications and experience. Agencies also create and oversee caregiver schedules in addition to managing payroll and taxes.

Assessment and care planning

Home care agencies are responsible for assessing a senior’s level of need. They will use the information from an assessment — along with interviews with the client and their family — to create a care plan that’s reviewed regularly.

Trained staff

Reputable agencies typically require caregivers to attend periodic training on a variety of subjects to learn new information and refresh their skills. Some of these trainings may also be mandated by the state in which the agency operates.

Accountability

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.

Cons of hiring in-home caregivers through an agency

Higher cost

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 2024 Cost of Long-Term Care and Senior Living survey. Agencies pay salaries and benefits for all employees, which factors into their hourly rates.

Fewer opportunities to build a relationship

Often, home care agencies aren’t able to 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 these questions before hiring through an agency:

• 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?

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.”

If you decide that hiring a caregiver through an agency is right for your family, contact A Place for Mom’s Senior Living Advisors to learn about in-home caregiver resources and senior living options in your area.