Hiring a Private Caregiver versus Using a Caregiver Agency
Caregivers can be helpful for so many things in the world of personal care. Caregivers can assist with self-care tasks, such as bathing, dressing, and using the bathroom. They can also provide assistance with home management, meal preparation, and companionship. We covered in a previous article “How to Choose the Right Caregiver Agency,” the different types of caregiver agencies, and the services that they provide. There is another option to consider, and that is hiring a private caregiver. Clients often ask me, “Should I hire a caregiver privately, or use an agency?” Here are tips to guide you in this decision-making process.
Before you begin to make your decision, you should have a list of the needs that must be met, with the most important at the top. Your needs can include things like:
Need for physical assistance
Need for transportation
Need for a consistent caregiver
Need for 24-hour care
Need for home management
Need for accountability
Need for experience with a specific diagnosis
Once your have your list, with your ultimate goal in mind, you can move ahead with the process. There are benefits and challenges with each option.
Hiring a Private Caregiver
Private caregivers can be found through a variety of sources including recommendations from friends and colleagues, use of web listings, and classified adds.
Benefits:
Consistency: There is a certain sense of security knowing that your care will be provided by the same person, each and every time. This caregiver will get to know you and/or your loved one, including your preferences, needs, skills and personality. That being said, most agencies make great efforts to ensure that there is consistency with the caregiver team. This is a question you can ask during your interview.
Flexibility: Private caregivers often have greater flexibility in their schedules to accommodate changes in needs on a given day. They may also accept positions without an hourly minimum, for those who require only, occasional care.
Decreased Regulation: For some, this may be a benefit, and for others a challenge. Private caregivers are not regulated in the same way that agencies are, meaning, they may be able to provide some services that a corporation may not. For example, if you asked your caregiver to stop and drop off your dry-cleaning on their way home, or help clean out your garage, this can be done, if both parties are in agreement. Larger agencies would not be able to accommodate this request, if it was not listed in their services agreement. On the other hand, there is no oversight for private caregivers in terms of compliance or accountability.
Personal Choice: One of the biggest benefits, is the ability to hand-pick your caregiver. You can consider traits such as personality, specific skill-sets (can be diagnosis-specific), and experience, as you will have the opportunity to interview them first-hand.
Challenges:
Callouts: If your private caregiver must call out for an illness, personal appointment, car trouble, vacation, etc., you may not have another back-up option to cover your care for that period of time. This can be troubling if your loved requires supervision and/or assistance and may be at risk for a fall or injury if a caregiver is not present.
Accountability: If your caregiver is known and trusted, this may be less of an issue. But if you have hired someone into your home, there is not an agency that is overseeing their care, their qualifications, and their performance. Communication is strictly between you and your caregiver to manage conflict, complaints, or concerns if they arise, without a mediator.
Things to Ask for When Hiring a Private Caregiver:
In-Person Interview: Do not leave it to a phone-call or email to make this decision. Meeting someone in person will give you a sense of their promptness, personality, communication, abd connection with you and your family, which are essential traits for a caregiver.
Background Check: This is a MUST! Do not be afraid to require this of anyone you are considering bringing into your home.
Driver’s License: This should be required if your caregiver will be expected to assist with transportation.
CPR Certification: This should also be required, in the event of an emergency.
References: These caregivers have not been vetted by an agency, so you should speak to at least three references prior to deciding to hire. You can also request a copy of their resume or CV.
Experience: If you or your loved one have a specific medical condition that requires additional skills to manage, ask if they have experience in this area.
Liability Insurance: A caregiver should have their own liability insurance policy, for protection in the event of an accident. You can ask for a copy of this policy.
Hiring a Caregiver Agency
There are a few different categories of caregiver agencies available, depending on the type of care you need. Please see our article on “How to Choose the Right Caregiver Agency” for more detailed information on this topic. Here are some highlights to get you started. Once you decide which type of care you need, there are other things that are important to consider:
Benefits:
Accountability: When you are using an agency, they are in charge of ensuring that all caregivers are vetted, trained, reliable, and are completing the tasks that are assigned to them. They will also assist with finding a replacement, in the even your caregiver calls-out for the day or is unavailable, which can be a lifesaver.
Coordination of Care: Often, caregiver agencies have a nurse on staff who can help with coordinating care, establishing a care plan, and referring to other providers, as needed. This can be a valuable asset as your needs grow and change over time.
Regulation: The agency is responsible for meeting strict guidelines for safety, compliance, and competency of their staff. While some may view this as “red tape,” it does help knowing that the providers in your home are following protocols to keep you and your loved ones safe.
Challenges:
Knowing the Rules: With increased regulation, comes additional rules, that can be off-putting to some, despite their well-meaning intensions. Each agency has their own rules and restrictions for services that they are/are not able to provide, as well as regulations on how you may be able to communicate with the staff and caregivers. It can take a little extra work to learn the agency that you are working with to coordinate your care.
Consistency: Despite best efforts, there is not a guarantee that you will always have the same caregiver(s). There is, consistency, however knowing that a replacement will be found for you, in the even of a last-minute change or cancellation.
Inflexible Scheduling: When working with an agency, many have hourly minimums and may also require a consistent schedule be set for each week. For those only needing light or occasional care, this can be difficult to navigate.
Questions to Ask When Hiring a Caregiver Agency:
What types of services do you provide?
Do you have an hourly minimum per day or per week? Do your rates change based on the number of hours provided?
Will I be able to keep the same caregiver(s), each shift, or will it be a different one each time?
What is the protocol if my caregiver calls out for the day?
What kind of training/certifications do your caregivers have/receive?
What do I do if I need to change the care plan?
Who oversees supervision of the caregivers? What is their role?
Will I receive updates on how my loved one is doing with his/her care?
Are your caregivers able to help with lifting or mobility? What is your lifting policy? Are they trained in the use of mechanical lifts?
What do I do if I have a concern or complaint?
If your loved one has a specific diagnosis (Stroke, Parkinson’s, ALS, Alzheimer’s, recent joint replacement, etc.) you will want to ask if the caregivers have experience with that specific condition.
Adding a caregiver to your care plan can be valuable and rewarding service, ensuring your loved one gets the care that they need and deserve. Going into this process, having weighed all your options, will help you to feel more confident in the decisions that you make regarding your care. For more information, feel free to check out our other blog post “Questions to Ask When Interviewing a Caregiver Agency” If you want more caregiver resources, feel free to check out our publication A Therapist’s Guide to Caregiving for a comprehensive guide on adaptive equipment and techniques for providing safe care in the home. Also, feel free to check out our full video training course for detailed video instruction.
A Therapist’s Guide to Caregiving
The book includes 170 pages of full-color, step-by step instructions, to provide you with all the skills you need to provide safe, thorough, and compassionate care at home.
This is your comprehensive guide to giving you with the skills you need to provide safe, effective, and compassionate care to family members, friends or clients in the home. This course includes 6 hours of instructional video covering client basic adaptive equipment, functional mobility, lifting techniques, transfers, self-care skills, bed level care, use of client lifts and transfer devices, and managing falls. Click "Preview Caregiver Course" below to preview the lessons and descriptions.
