How do I hire a caregiver directly, instead of from an agency?

6 answers | Last updated: Oct 27, 2016
A fellow caregiver asked...

I've hired a companion from an agency to help care for my dad who lives with me. She stays with him while I am at work. I am paying so much money to the agency that the companion doesn't get ($20/hr versus her pay of $10.50/hr). Can I just hire her directly and pay her social security, taxes, etc? How do I do that? At this point I am not using the agency to supply backups etc. We only use this one woman. Thanks!

Expert Answers

Mary Koffend is the president of Accountable Aging Care Management (AACM), an eldercare consulting and care management firm that works with elder clients and their families to find the best care providers and services to meet their needs.

Many caregivers have questions about the direct hire of caregivers or using an agency. There are certainly pro's and con's to be considered.

Issues for Direct Hire:

  • Able to direct the caregiver more directly as you are employer.

  • Must perform all of the management and supervisory tasks of an employer including correcting behaviors and firing if appropriate.

  • Requires additional time and effort to do payroll, unemployment and other records and tax payments.

  • Need to conduct effective background checks for caregiver. Most caregivers are outstanding people but there are predators in the workforce so need to do all you can to validate references.

  • Have a back-up plan if caregiver is ill, has transportation troubles, or quits.

Issues for Agency:

  • Delegate all behavioral and training issues to agency. As you are not the direct supervisor, can allow some positive distance for you and your elderly parent.

  • Have insurance bond and do thorough background checks and you can ask to see these.

  • Do not have to deal with all the issues of unemployment, Social Security, workman's compensation and other taxation issues as agency does.

  • Can change caregivers at any time, add or decrease hours without concern for caregiver as agency can compensate or deal with caregiver needs, etc.

  • Have a license and are required to perform certain tasks including supervisory visits.

As you see there are certain implications to your choice. Be aware of them.

If you originally start working with an agency, you may have signed an agreement that prohibits you from hiring the person directly as the agency has done all of the background work and does the payroll, etc. Some agencies are willing to serve as a broker for a flat fee to help you in hiring someone that you would directly hire.

The hiring of a caregiver privately or through an agency is a significant decision as this is a person that will directly relate to your parent when you are not around and often has access to personal and financial information. Think through your options and decisions carefully.

Community Answers

Malarky answered...

Thank you! I am going to ask the agency about the "brokering" you mentioned. The caregiver we have has been with us for over five years and we don't use anyone else from the agency.

Dejadelee answered...

You can find many people who do home care its just the fact if you pay out of pocket and thier are no taxes taken out it can cause an issue for ur employee.. as a cna any company you pay charges double ad the employee only gets about half.. my employer gets 60 an hr for me and i get 17 of that.. you can always call the irs and state and they can tell you how to go about paying her and have taxes taken out of her check as if you were a regular employee/ business..

Sho b answered...

Thank you Ms. Koffend for providing your expert advice!

Hello Anonymous! Thank you for posting your question. Given the positive experience you've had with your current caregiver, I encourage you to take part in's ratings and reviews program by sharing your experience with other caregivers in our community through our Senior Living Directory. We know the right fit is different for each family and individual, and we believe ratings and reviews from those with firsthand experience are valuable to others with similar needs and preferences -- and helpful to service providers as well. You can learn more about our program here: and if you feel so inclined to write a review, you may do so here: Please don't hesitate to get in touch with the Team if you need help finding resources for you and your loved one!

Kind regards, Sho from the Community Team

Shawno answered...

Hiring others either directly or through an agency can be worrisome, given that we may be at our job or at another location when the work is performed. Questions arise. Does the person that we selected actually perform the task, or do they switch with someone else? Do they work within the agreed time window? Do they provide the actual number of minutes or hours contracted? And even, what does the work look like? There's a new service now that tracks people while they perform tasks, and provides real-time notices through email, text messages, or the Internet. Its called TaskAssure. You may want to consider it.

Belovedcaregiver answered...

Ms Koffend's reply to the question was accurate only if you get an agency that goes by the book. In most cases a lot of agency out there goes by their pockets. They hire caregivers and give them an individual contractors status, pays very low but charge very high. Doesn't give insurance and can't claim unemployment and works mans comp. if anything happens since your under individual contractor and not an employee. All they do is get their daily take on your pay and you'll be lucky enough if they pay you on time. So my advice is if you go through agency look not only what they offer you, check if they compensate the person whose going to take care of your loved ones Right. I work for this kind of agency and I truly care for my patient, the family loves me and I enjoy my work. That's the only reason why I'm staying but how long can I hold on, I don't want to leave my patient but I have to think of my welfare too. I don't want to ask for a raise because I know they'll increase my patients fee and I think their paying high enough. If they only knew they keep almost half of what I make. I never called in sick and never give my agency any problem. Yet I know if anything happens to me I'm on my own.