Home Care Services - Use an Agency or Hire Your Own CaregiverHome Care Services: Use an Agency or Hire Your Own Caregiver?

When you’re ready for help at home, your next choice is whether to hire a caregiver directly or use a senior care agency. Hiring a caregiver gives you total control of the process, but the tradeoff is more time spent on administrative tasks. There are other considerations, too. Here are some questions to ask before you make your choice.

Can you manage the hiring process yourself?

Hiring someone is a job in its own right. Unless you already have an independent caregiver in mind, like a family member or a neighbor, you’ll need to post job ads, choose among the responses, schedule interviews, and check professional and personal references. You should also ask to see proof of CPR and first aid training as well as recent negative test results for tuberculosis and the contagious “superbug” MRSA (Methicillin-resistant Staphylococcus aureus). A criminal background check is a must as well.

A professional agency will handle these tasks for the caregivers it hires. That can free you up to focus on making a match between caregiver and care recipient.

Do you mind handling payroll, paperwork, taxes and insurance?

Hiring an employee means taking responsibility for writing paychecks, paying Social Security taxes, and keeping everything square on your income tax returns. You’ll also need to talk to your insurance agent. Most homeowners’ policies don’t cover household employees, and you’ll want protection in case your caregiver is ever injured while working in your home.

On the other hand, agency caregivers are covered by the agency’s policy.

How will you manage caregiver vacations, sick days, and family emergencies?

Agencies coordinate backup care if your regular caregiver is sick or on vacation.

If you hire your own caregiver, you’ll need backup caregivers you can call on short notice. If your caregiver has family members who can help, that may be your best plan. If not, you’ll need to interview, screen, and hire a backup caregiver or two.

How good are you at delivering feedback?

Some people are pros at giving feedback to the folks who work for them, and they get good results. Some people are hesitant to speak up, and that can lead to problems.

If you’re comfortable being politely direct about what you need, managing your own care will be easier than if you’re uncomfortable. If you’re really conflict-averse, agency management can serve as a third party to relay your concerns to your caregiver.

What if you need to change caregivers?

Agency clients can request a new caregiver if the current one isn’t working out. If you’ve got a pool of applicants you can hire directly, you have options, too. When you hire people you know, things are trickier. What if you need to fire a well-meaning friend or relative who can’t handle the work? Consider how your professional relationship might affect your personal relationship, especially if your daily care needs are complicated or physically demanding.

It’s important to remember that this choice doesn’t need to be “either-or.” It can be “both-and.” For example, you might hire a trusted relative for daily care and use an agency to cover her vacations. You might hire an agency for the daily routine and bring in a friend for tasks that he or she enjoys, like coloring your hair or whipping up meals to freeze for later. When you know your options, you can build a care network that works with your strengths.

To learn more about home care services and for a checklist of questions to ask as you interview caregivers, please click here. You can also call (866) 592-8119 to speak with a local Home Care Advisor for more info on the agencies in your area.

Casey Kelly-Barton is an Austin-based freelance writer whose childhood was made awesome by her grandmothers, great-grandmother, great-aunts and -uncles, and their friends.


  1. The Care Centers May 27, 2016 Reply

    Thanks for sharing these tips. This really proves helpful for the people who are hiring their own care giver or using an agency providing such services.

  2. Comfort Keepers July 2, 2016 Reply

    Helpful information sharing article..

  3. Raymond Cooper September 18, 2018 Reply

    It’s good to know that a home care agency handles the hiring of qualified caregivers for you. This would be nice since it would save me a lot of time when looking for a caregiver for my mother-in-law. I’ll probably stick to using a home care agency for this reason.

  4. Katie Wilson February 1, 2019 Reply

    You make a good point when you suggest considering how a caregiver handles vacation and sick days. It makes sense to find out about how they handle backups, as you say. I’m looking for someone to help take care of my mom now that I’m moving out of state, so I’ll have to consider her budget as well as mine when I choose someone.

  5. Taylor Bishop April 2, 2019 Reply

    Thank you for this advice for working with an agency or getting a caregiver. You mentioned that when working with an agency they can coordinate backup care if a caregiver is sick. This seems very useful especially if the person needs daily care.

  6. Daphne Gilpin April 2, 2019 Reply

    Thanks for explaining that we probably can benefit from using a health care agency if we have a tendency to avoid conflict. My husband and I are trying to help choose senior care services for my aunt, so I’ve been looking online for any tips that could help with that. My aunt is pretty non-confrontational, so I think finding a health care service would be the best path to pursue for her.

  7. Angela Waterford August 6, 2019 Reply

    I believe I’m ready to get help for my father, and it would be nice if it’s an in-home care service. If I were to choose, I think I’ll hire from an agency because I don’t know how to process their payroll. It’s also quite a complex task to handle their vacations, and since the agency will take care of that in case it happens, my father will still be taken care of.

  8. Luke Smith September 9, 2019 Reply

    I’m open to hiring an in-home care service for my grandfather, and it would be nice if an agency helps me reach out to one. Since I’m out of the house most of the time, it will be great if an experienced caregiver can assist me with this. I will take note of all the paper works including the payroll system and insurance so that I can start devising a system that can be readily available.

  9. Tammie Houston October 30, 2019 Reply

    My mom got a stroke last month and she is unable to eat and bath by herself. My sister and I are planning to hire an experienced in-home caregiver that can assist us in taking good care of mom while we are at work. I am glad that you talked about getting a criminal background check is a must to ensure that everything will run smoothly.

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