The Pros and Cons of Hiring Private Caregivers

You and your family hoped this day would never come. Your parent or senior loved one was always independent, but now he or she has trouble with activities of daily living (ADLs) like bathing, dressing and preparing meals. Maybe Dad or Mom can’t clean the house, cook or be left alone for long periods, or even at all.The Pros and Cons of Hiring Private Caregivers

Your parents need more help, but deciding whether to hire through an agency or to hire private caregivers can be overwhelming. Here’s what you need to know before you make any decisions.

Interview Yourself First

Anyone hiring a caregiver must first assess his or her own abilities, says Leslie Eckford, co-author of “Aging with Care: Your Guide to Hiring and Managing Caregivers at Home.” Eckford, an R.N. and geriatric clinical social worker specializing in mental health, co-wrote the guide with Amanda Lambert, owner of Lambert Care Management. Eckford and Lambert also operate the caregiving blog Mindful Aging.

Do you have experience collaborating with others or a management background? If so, you may do well at managing private caregivers. On the other hand, if you’ve never supervised anyone, letting an agency do all the firing, hiring and managing may work better.

There are pros and cons to both approaches. Read more about the benefits and drawbacks of each.

Pros and Cons of Agencies

You’ll pay more for agency caregivers but you’ll receive more in services. For example, the agency performs background checks and verifies caregivers’ certifications and experience in addition to taking care of payroll schedules.

“Private caregivers can explain their background and training, but there is often no way to verify the information,” says Lambert. On the other hand, reputable agencies require caregivers to attend yearly training on a variety of subjects and skills, some of which are regulated by state requirements, she says.

One of the greatest advantages of using an agency is that the agency must cover 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,” says Lambert. “An agency is going to replace that person. They make it work.”

Another consideration is that if an agency caregiver is accused of stealing or some other infraction, the agency will handle the fallout. “Hiring through an agency brings peace of mind, especially with regard to liability,” says Lambert. At the same time, using an agency has its drawbacks.

There’s no guarantee that you’ll get 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 a lot of control.

Lambert recommends asking the following questions of agencies:

  1. How can I monitor what the caregiver does? Will he or she 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 (CNA)?
  3. What are your training requirements?
  4. Who is the main person to communicate with about problems?

Pros and Cons of Private Caregivers

The main reason people hire private caregivers is lower cost, says Lambert. Agencies pay salaries for multiple employees, workers’ compensation and liability insurance and payroll. Then agencies factor those costs into the hourly rate, so you’ll typically pay more for agency caregivers. Another reason that people hire privately is that it allows family members to have more control over who takes care of their parent or senior loved one.

“Many people want to select the person who will do personal care for their loved one,” says Eckford. Agencies are generally restricted by state laws regulating which tasks caregivers can perform. When hiring privately, you will determine whether the caregiver can administer medications or perform other duties. You’ll also have direct communication with a private caregiver, rather than working through an agency manager.

You might save money with a private caregiver, but you’ll have to spend extra time on background checks, payroll and taxes. You may have to purchase additional liability insurance coverage for injury or theft. You could even have legal fees if a caregiver accuses a family member or another caregiver of assault or sexual harassment. You’ll pay for background checks, an essential part of the hiring process.

“If you have work experience with interviewing and hiring, this would be a natural progression for you,” says Eckford. “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 in a panic when a parent or senior loved one is discharged from the hospital, says Lambert. Have a good idea of what kind of caregiving resources are out there before you need them.

“Have three agencies in place. Tour assisted living communities. Know which rehab facilities are good,” says Lambert.

“Be as prepared as you can and recognize that your parent is going to eventually need some help.”

Have you considered hiring private caregivers? Why or why not? We’d like to hear your thoughts in the comments below.

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