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

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 Answer

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.