Most families compare these two on price, find that hiring privately is cheaper per hour, and stop there. That comparison is not wrong, it is just incomplete, and the parts it leaves out are the parts that tend to matter at the worst possible moment.
Here is the whole picture, including the case for hiring privately, because sometimes it is the right call.
You become an employer
This is the piece families genuinely do not see coming.
When you pay someone directly to care for your parent in your parent’s home, you are not hiring a contractor. In most cases you are a household employer. That brings payroll taxes, and in California it can bring a workers compensation obligation too.
Which leads to the question nobody wants to think about. If a caregiver hurts their back helping your mother out of the bath, who is responsible? With a private arrangement, that usually lands on the family. Homeowner’s policies sometimes cover part of it and sometimes do not, and the time to find out is not after an injury.
With an agency, that sits with the agency. Golden Years caregivers are our own employees, not contractors, which means payroll, taxes, workers compensation and liability insurance are ours to carry.
California licenses this work
Since January 2016, California has required home care organizations to be licensed, and it keeps a public online registry of home care aides who have passed a criminal background check.
That is a real consumer protection and it exists because this work happens behind a closed front door, usually with someone who cannot always tell you what went on. A private arrangement sits outside that system entirely. It is legal, but nobody has checked anything on your behalf.
Golden Years holds HCO Licence #344700040.
The backup problem
Of everything on this page, this is the one that bites hardest.
A privately hired caregiver gets the flu. Takes two weeks in July. Has a family emergency. Gets a better offer and gives notice, or sometimes does not.
On every one of those days, the backup plan is you. In practice that usually means a daughter burning her own vacation days, or a son driving across the county before work. Families absorb it for a while and then they cannot.
An agency sends someone else. That is most of what you are paying the difference for.
Changing someone without having to fire them
Sometimes a caregiver is perfectly good and simply not right for your mother. Wrong pace, wrong personality, wrong energy in the room.
With a private hire, fixing that means firing a person you have come to know, who may need the work, while you are already exhausted. Most families put it off far longer than they should.
With an agency you make a phone call and we change the match. Nobody loses their job and you do not have to have the conversation.
Supervision and a plan
A privately hired caregiver works from whatever you tell them. An agency caregiver works from a documented care plan, and a care manager checks in on how it is going and adjusts it as things change.
With dementia in particular, things change. What worked in March stops working in September, and someone needs to notice that who is not the family member standing too close to see it.
When hiring privately does make sense
It would be dishonest to pretend there is never a case for it.
If you need a few hours a week, you have found someone your parent already knows and trusts, your situation is stable, and you are prepared to handle the employment side properly, a private arrangement can work well and it will cost less.
The point at which it usually stops working is when the hours increase, when nights get difficult, or when one person’s absence becomes your family’s emergency.
The honest summary
Hiring privately costs less per hour and gives you one consistent person. You take on the employment obligations, the screening, the supervision and every gap in the schedule.
An agency costs more per hour and the difference buys cover, insurance, screening, supervision, and the ability to change your mind.
Most families we meet have already tried the first and are calling about the second.
Talk it through
If you are weighing this up, a free in-home assessment is a good place to start, and there is nothing to sign. Someone comes to the house, looks at the actual situation, and tells you what would genuinely help.
Call 1-800-HOME-CARE or your nearest Golden Years office.
Golden Years Home Care is family owned and has been caring for California families since 1996. HCO Lic. #344700040.
