Private Hire Caregivers: It’s Not What You May Think


Your elder loved one has come to a new stage in life, where she or he is requiring more assistance with everyday living.  Most people would rather stay in their home, avoiding institutionalization for as long as possible.  Given the right circumstances and care, your loved one may never have to leave their home.


It is possible, with the right help, for your loved one to comfortably stay in their home, even until the end of their time here on earth.  The question is, what kind of help, is the right help?

Choices in Care

When it comes to professional in-home care, there are a few options:

  • Staffing/Registry caregivers
  • Home care agency caregivers
  • Private hire caregivers

Of these options, the home care agency caregiver is the more expensive.  The least expensive is the private hire option.  The lower wage may be appealing, at first, but you need to be fully informed about what the less expensive option buys.  What you save in money will cost you elsewhere.  The registry option can cost as much as the home care agency, yet offers less support than a home care agency.  This article explores the differences between a home care agency caregiver, and a private hire caregiver.

Brief Description of Home Care Agency and Private Hire Caregiver

Non-medical home care agencies provide home health aides, homemakers, and companions.  The agencies are often monitored by an organization that holds the agency up to standards of care.

A private hire caregiver is considered a household employee, making you or your loved one an employer.  These caregivers are found, screened, paid, and managed by you.

Side by Side Comparison


As you can see by the comparison, a home care agency is the most supportive and flexible.  If you called a health care agency today, requesting a professional in-home caregiver, they more than likely could have someone out the next day.  Hiring on your own, however, is an entirely different process.  If, after seeing the comparison above, you’d still like to privately hire a caregiver, I want you to be as informed as possible about the process.

Hiring a Private Caregiver

Hiring privately requires you to do the legwork.  The best place to begin is by writing a description of what you’d like the caregiver to do.  Consider the following:

  • What type of care are you looking for?  Personal Care such as bathing, dressing, eating, toileting?  Household Care such as cooking, cleaning, laundry, and shopping?  Healthcare such as medication management, making and traveling to doctor’s appointments?  Emotional Care such as companionship, meaningful activities, and helping achieve a sense of purpose?
  • Your answers to the choices above will help you decide what level of care your loved one needs — CNA, NA, RN, LVN, or companion.
  • If you’d like the private caregiver to drive your loved one around, you’ll need to make sure they have a valid driver’s license.  Also be sure yours, or your loved one’s insurance will cover any job related injury, in case of an accident.
  • If your loved one requires special equipment, such as a lifting device, then your caregiver will need experience in this, or have the ability to be trained.

Where to Find a Private Pay Caregiver

privatehirecaregivernotwhatyouthink4In addition to posting on job lines, you can also try to find someone who will give a personalprivatehirecaregivernotwhatyouthink5 recommendation.  Ask friends, relatives, people in senior centers, and doctors’ offices.  Another idea is to post the job opening at churches, and on message boards in a nursing school or social work program.  Once someone calls, and your phone screen deems them a possible candidate, the next steps are interviewing, background checks, reference checks, developing a contract, implementing payroll, and making sure you have proper insurance coverage.

After Hiring, Remain Vigilant

Once hired, it’s important you stay involved.  It’s not over; it’s just beginning.  Your job now, as employer, is to monitor and evaluate the work of the caregiver.  Schedule regular times to meet with your loved one and caregiver to go over the plan of care.  Discuss changes, expectations, and any concerns at these meetings.  A week after the meeting, follow up on what was discussed at the meeting, to determine if the changes implemented are working.  It’s important to keep regular contact with the caregiver, keeping the lines of communication open, day and night.

What Hiring at the Lower Wage Has Cost You

As you can see, there is much involved in hiring a private pay caregiver.  Although hiring privately may be tempting because of the lower hourly wage, the reality is, it may privatehirecaregivernotwhatyouthink6cost more in the long run.  When hiring privately, you must also take into consideration the time investment, insurance costs, and accountant and legal costs for advising.  In addition, you’re at risk for liability if any injury to the caregiver happens while caring for your loved one.

It’s important to consider the entire picture before deciding to hire out privately.  Home care agencies may cost a little more in the interim.  However, they save you money in the long run by taking responsibility for payroll, liability insurance, and workers’ compensation insurance.  They can also prevent the need for you to take time off of work to cover a last minute sick call from a private hire caregiver, further saving you money in lost wages and retirement contributions.

Have you used a home care agency or a private hire caregiver?  I’d love to hear your experiences.

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About Pam Witt

Pam Witt is a licensed RN and has more than 32 years of experience in the caregiving, home care, home health and healthcare industries. She has more than 10 years of successful marketing experience with one of the largest healthcare software companies in the world. Pam’s philosophy is that “life is a gift” and it should not be wasted. Pam’s main objective through the NAPHC and is to make a positive impact in the home care, home health and home hospice industry by providing the best information and training available.

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