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The ABC's for Hiring through an Agency or Privately for Home Care Assistance

There are pros and cons for deciding to use an agency or hire in-home caregiving help privately. Here are the ABCs you need to consider. As the primary care partner, much of the work in organizing the additional help will fall on you. So, it is important to understand what will be the most helpful to you, not an additional burden. For many, the below items are too much which leads people to choose an agency path over individual care companions. Only you can know what would work best for you and your family.


Hiring privately involves running ads, screening applicants, doing background checks, verifying that the person is eligible to work in the U.S., doing payroll including filing forms and paying taxes, at regular intervals during the year, supervising, evaluating, and if necessary, firing the worker.


If the worker becomes ill or has a family emergency, who will provide service? Agencies usually can provide another worker relatively quickly; this may not be true for someone you hire privately.


In most cases, hiring privately will cost less than hiring through an agency.


An agency may not be able to provide the same person every time. You may end up having to train several workers.

Independent Contractor Status

Independent contractors are responsible for reporting their income and paying their own Social Security and Medicare taxes. Some care partners and workers want to claim the status to avoid paperwork and/or paying taxes. This is often the case if you hire through a placement agency that uses foreign workers. The Internal Revenue Service (IRS) has strict requirements for individuals operating as independent contractors. The IRS rule is, "Anyone who performs services is an employee if you (the employer) can control what will be done and how it will be done - what matters is that you have the legal right to control the method and results of the services."

​Hiring someone as an independent contractor might affect your ability to deduct in-home care expenses as part of your medical expense deductions and might also affect payment from a long-term care insurance policy that covers in-home care. You should check with your tax preparer and your long-term insurance agent before hiring someone with independent contractor status.

In some cases, you might also want to check your Home Insurance policies. Some can have rules and stipulations for when it comes to hiring in-home care. It is important to make sure that if you do hire a person privately for care, they are certified and insured should there be an injury while on your property. Most agencies will protect you and the employee they provide in these matters.

​While going through an agency can be more expensive, it does take away much of the frustration and headaches that can come from trying to manage the above details on your own.


Parkinson's Foundation. Page 92. Deciding to hire through an agency or privately. Chapter 5. Getting Outside Help. Caring and Coping. A Care Partner's Guide to Parkinson's Disease. "Booklet."


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