Agency or Private Care?

Hiring a caregiver privately may cost less upfront, but working with a reputable agency can provide important safeguards and support—including caregiver background screening, training, backup coverage, continuity of care, workers comp, stability and ongoing oversight.

Here’s what families should consider before deciding which option is right for their loved one.  Cheaper isn’t always better.

“With private care, families may be tempted to focus on the hourly rate without realizing how much responsibility comes with it,” said Shelley Kutina, Community Liaison in Houston. “An agency is managing a lot behind the scenes so the family can focus on their loved one instead of managing an employee.”

Who is the employer?

The biggest difference between hiring privately and working with an agency is straightforward: Who employs and manages the caregiver?

With a private caregiver, the family recruits and screens candidates, checks references and backgrounds, manages payroll and taxes, handles scheduling and addresses performance issues. Families also need to understand their responsibilities under employment laws and consider insurance and liability issues if a caregiver is injured while working in their home.

With Cambridge Caregivers, caregivers are W-2 employees. The company handles payroll, taxes, workers’ compensation coverage and other employment responsibilities. Caregivers also undergo a careful vetting process before being placed with clients.

That structure becomes particularly valuable when something changes — as it almost inevitably will.

What happens when needs change?

Imagine you hire a private caregiver who becomes a good companion for Mom. She drives Mom to doctor’s appointments, prepares lunch and accompanies her to social activities.

Then Mom falls. Suddenly, she needs help with bathing, toileting and transfers, at least temporarily. The caregiver who was an ideal match last week may not have the skills needed today.

An agency has a larger pool of caregivers with different skills and experience. Cambridge Caregivers can assign someone better suited to the client’s new needs or, in some cases, arrange additional training for a preferred caregiver.

“Aging isn’t static, and care needs aren’t static either,” said Shelly Schultz, Community Liaison in Houston. “A caregiver may be exactly right for someone today, but six months from now, that client may need a different level of support. Our job is to keep paying attention and adjust as those needs change.”

When your caregiver can’t be there

Even the most dependable caregiver will occasionally be unavailable. Caregivers get sick, have family emergencies, take vacations or simply need time off.

If you’ve hired privately, finding a substitute is your responsibility. For a family member living hundreds of miles away — or juggling a career, children and other obligations — an unexpected absence can quickly become a crisis.

An agency can provide backup coverage, sometimes on short notice. But continuity matters, too. Some agencies may fill shifts with whichever caregiver is available. Cambridge Caregivers makes a concerted effort to provide the same one or two caregivers day after day, helping clients build comfortable, familiar relationships with the people caring for them.

Cambridge Caregivers also considers far more than a checklist of required tasks when pairing caregivers and clients. The team looks at personalities, preferences, routines, pets, schedules and specialized skills, including experience with brain change, wheelchair transfers and Hoyer lifts.

“We’ve learned that a successful match is about both skills and chemistry,” Kutina said. “You’re inviting someone into your home and your daily life. We want to find someone who has the right experience but also feels comfortable with the client and the family.”

Training and ongoing support

Training is another important consideration. Agencies vary considerably in what they require and provide. Cambridge Caregivers requires ongoing caregiver training — and pays caregivers for the time they spend completing it. The company also offers 42 training sessions each year.

That can become especially important as a client develops more complex needs. Someone living with brain change, for example, may require specialized knowledge of communication, behavior changes, wandering risks and safety.

Families who hire privately must determine whether a caregiver has the appropriate skills and experience. If problems arise, they are also responsible for providing feedback, seeking additional training or finding someone new.

With Cambridge Caregivers, Community Liaisons stay in contact with clients and families to help ensure the caregiver remains a good fit. If a problem arises, they can work with the caregiver to address it or arrange a different match.

What are you really paying for?

There’s no getting around it: Hiring privately is often less expensive. With an agency, the hourly rate covers more than the caregiver’s wages. It also supports recruiting, screening, training, scheduling, supervision, payroll, insurance, backup staffing and ongoing support.

For some families, the lower cost of hiring directly may outweigh those advantages. Others may have the time and experience to manage a caregiver themselves.

But for families who need dependable coverage, carefully vetted caregivers, continuity, ongoing training and someone to call when needs change, an agency can provide peace of mind.

“You’re still very much involved in your loved one’s care,” Schultz said. “But you don’t have to handle every staffing problem or figure everything out on your own. There’s a team behind the caregiver, and that can make a tremendous difference for families.”