The Surprising Challenges of Hiring a Caregiver Directly

For many families, it’s a common scenario: When an older adult needs more care than family members can provide, it’s time to bring in help—and fast. Reasons to seek professional support may vary, from a loved one’s cognitive impairment or chronic condition to their mobility issues or need for post-hospitalization care. A Google search for “at-home help” points you to hiring a professional in-home caregiver. But how do families looking to hire a private caregiver quickly find someone whom they can trust?

You may ask for recommendations from family, friends, and colleagues as well as from your local place of worship or nearby senior center. However, hiring a caregiver based solely on word of mouth might not have the same benefits as using a home care agency. “It’s a lot easier to find a caregiver through an agency when you need one right away,” says Ruth Lippin, JD, LCSW, the founder and CEO of Alighieri Care Management, now a part of TheKey. “When you hire through an agency, you get extra support [throughout the process]. It’s financially safer, too.”

If you’re considering hiring a caregiver on your own, here’s what to expect when you try to navigate the process.

6 Things You Might Not Realize About Hiring a Caregiver Directly

Finding a caregiver on your own can be challenging and time-consuming. Here’s what the process involves:

1. You Will Have to Handle All the Interviewing

This is a big job—and an extremely important one—for families looking to hire a private caregiver. Naturally, you want to feel confident about a caregiver’s training, experience, and trustworthiness. Interviewing potential candidates will give you a sense of what they’re like and if they’re a good match for your loved one. Ideally, you should conduct the interview in person or via Zoom. If that’s not possible, a phone interview will suffice to start with a plan to meet face-to-face later if they seem like they may be a good fit. Here are some key questions to ask during the interview:

• How long have you been a caregiver?
• Why are you interested in this type of work?
• Where was your last job? How long were you there and why did you leave?
• Can you give me references?
• Can you drive? If so, do you have a valid driver’s license?
• Have you had formal caregiver training? If so, what was it and can you provide documentation? Also, do you have CPR and first aid training?
• What experience do you have with caring for someone with my loved one’s condition?
• What experience do you have with bathing, dressing, lifting, and whatever else will be required?
• Pose a scenario the caregiver might find themselves in with your loved one and ask what they would do. For example: Mom sometimes gets angry and yells when I try to help her. How would you handle something like that?
• Give me an example of a difficult situation you’ve handled with a care recipient in the past.
• What days and times are you available?
• What are your expectations for time off?

2. You Will Need to Do Background and Reference Checks

Some candidates might sound great—maybe even too good to be true. For this reason, families looking for private caregivers will want to conduct a thorough background check to confirm the candidate’s prior employment, call their references, and corroborate their certifications or licenses. It’s also advisable to do a criminal background check (you’ll need a signed release from the interviewee to do this) as well as ask to see their Department of Motor Vehicle records if driving your loved one to appointments is part of the job. Lastly, verify—by asking to see a passport or green card, for example—that they are legally eligible to work in the U.S. (this is required by law).

Doing all this can be quite involved and incredibly time-consuming. If families looking for private caregivers don’t have the hours to devote to it, they may be able to hire a lawyer or private investigator to do the work, but their services can be pricey.

3. You Will Be Responsible for the Caregiver’s Payroll, Insurance, and Taxes

Hiring a professional caregiver on your own makes you their employer. With that new role comes the responsibilities of setting up a monthly (or biweekly) payment system that includes managing withholding for Social Security, Medicare, and federal and state income tax, Lippin notes. “There can be significant financial penalties if this is not done properly,” she warns.

In addition, families looking for private caregivers will have to get worker’s compensation/disability insurance, she says. And be sure to check your homeowner’s or renter’s insurance for liability coverage. Otherwise, if a caregiver is injured or claims to be injured while on the job, you could be facing a lawsuit. You have to “make sure these policies are in place and up to date,” Lippin advises. “It can be very daunting.” However, a good home care agency will take care of this work for you. They handle payroll and withholding and also provide worker’s compensation and insurance. You still will need to make sure your loved one’s homeowner’s or renter’s insurance is up to date.

4. The Quality of Care Your Loved One Receives Might Not Meet Your Expectations

When you hire directly, the caregiver may see your loved one only as someone with a certain problem, such as cognitive decline, rather than as a well-rounded person. While they may provide adequate care, it might not be as personalized as it could be. A respected home care agency, on the other hand, will take a more customized approach to the care they provide. Look for a home care provider that specializes in your loved one’s specific care needs.

5. If the Caregiver Calls in Sick, You Will Be Left Without Coverage

Illness, a family emergency, and car trouble—there are numerous reasons a caregiver may not make it to work. That could leave you scrambling to find someone to fill in at a moment’s notice. Or you might have to stay home from work to care for your loved one yourself. A home care agency will be able to provide another skilled professional caregiver within their approved network to assist and support your older adult until their regular caregiver returns.

6. You’re Responsible for Performance Management

Having a problem with your caregiver? Perhaps you don’t like their driving and you worry about them transporting your loved one. Or they’re not assisting your dad when he goes up and down the stairs. Maybe valuables, such as cash, have suddenly gone missing. Whatever the issue is—safety, a clash of values, or even a suspected theft—you are ultimately the one who will have to figure out how to handle it.

A home care agency, on the other hand, would work with you to resolve these issues. “Agencies typically have a client services person or a social worker who can help you negotiate and resolve whatever issue you’re having,” Lippin explains.

Pros and Cons of Hiring a Professional Caregiver Directly