April 6, 2018

Once a family has made the decision to hire a caregiver for their elderly loved one, they are faced with the question of whether to hire an independent caregiver or to use a home care agency. There are Pros and Cons to both approaches but first, however, it is helpful to have a clear understanding of the differences between an independent caregiver and a caregiver who is hired through a home care agency.

Home Care Agency 

Home care agencies are licensed businesses that employ caregivers and send them to the home of your loved one to provide in-home care. They can provide medical care or non-medical care. Professionals, such as nurses or nursing assistants, provide medical care. Non-medical care, also called personal care, consists of assistance with the activities of daily living, such as preparing meals, eating, and bathing, and can be provided by persons without professional training.

Independent Caregivers

Independent or private caregivers are employed directly by the family. There is no intermediary agency between the care recipient and the caregiver. Independent caregivers are also able to provide medical care (if trained to do so), but this is much less common. Independent caregivers are more likely to provide personal care. Families who hire independent caregivers must take on the responsibilities of being an employer or use a 3rd party payroll management service. However, by taking on this employer role, rather than going through an intermediary agency, they can sometimes save on home care costs.

Financial Comparison

As mentioned previously, home care agencies can be more expensive than independent caregivers. Nationally, the average hourly rate for home care through a home care agency in 2017 is $20 per hour. Independent caregivers are paid 20% – 30% less than home care agencies; they receive $14 – $16 per hour. The difference between home care agency costs and independent caregivers’ costs remains relatively constant throughout the 50 states.

A 20% – 30% savings in the hourly cost may sound like a significant difference, but there are factors that must be considered to gain a more accurate estimate. Most relevantly, is the hidden cost of being an employer, which one must be in order to legally hire an independent caregiver. The hidden cost may be thought of as additional hours the family must put forth in the hiring, managing, and making of payments to the independent caregiver. There are services that manage caregiver payroll and greatly simplify the complicated process of deducting social security and other taxes, but a family still must hire and manage the independent caregiver.

Types of Care

The types of care and support services that can be provided in the home is very broad, ranging from medical care, like injections, wound care, and monitoring vital signs, to simple assistance with the activities of daily living, like preparing meals, and helping with bathing and grooming. Non-medical caregivers can also provide assistance with the instrumental activities of daily living, such as shopping, housework, and running errands.

Both home care agencies and independent caregivers can provide either home health care or non-medical care. However, if it is home medical care that a family is seeking, there is a much greater challenge in finding an independent caregiver who is professionally training and licensed. As a result of the added difficulties associated with medical care (and the added liabilities), most families tend to use home care agencies for this purpose.

With non-medical care, independent caregivers and home health agencies can usually provide similar services, such as driving, running errands and assistance with activities of daily living.

Quality of Care

A difference between these two options that is worth mentioning is that when a family working with a home care agency decides they are unhappy with the quality of care they are receiving, they can simply request a different caregiver from the same home care agency. In contrast, families who have hired an independent caregiver and are unhappy with the quality of care must go through the process of searching for, hiring, and training a new independent caregiver.

Ease of Hiring

The ease of hiring the caregiver is one of the bigger differences when working with a home care agency vs. an independent caregiver. When looking for a home care agency, it is a very simple process. There are many free matching services available, and most local agencies like Companions for Seniors is just a google search away. Finding an independent caregiver, on the other hand, can be a challenge. It is analogous to hiring an employee. One must write up a job description and post that description in various locations. Alternatively, one can ask family or friends or search through pages of Craigslist and other local postings. The family and the care recipient will want to meet with the caregiver to “interview” them, and multiple interviews may be required. Earlier in this article we mentioned flexibility as one of the main reasons families hire independent caregivers. However, the difficulty in finding independent caregivers is one of the main reasons families opt for home care agencies instead.

It should be mentioned that over the past few years several web-based, startup organizations have tried to make the process of hiring independent caregivers much easier. Unfortunately, there is also a long list of failed organizations that have tried to solve this problem. If and when our organization discovers a business that has solved the challenge of finding an independent caregiver, this article will be updated with that information.


Hiring someone to come into your loved ones home is an extremely important decision, but hopefully considering what we’ve said above, that decision has become at least a little easier. One last thing to note, Home Health agencies must be licensed, bonded and insured should the worst happen. With Independent Caregivers, this is usually isn’t the case.