Pros and Cons of Using Caregiver Agencies

older woman and nurse
November 29th, 2016

No one can care for your aging loved one as well as you. But for many family members, it often becomes necessary to assess the pros and cons of caregiver support for an older loved one living at home. There are two options: employing a professional caregiving agency, or finding a local friend, neighbor, or referral from an acquaintance. Both approaches have advantages and disadvantages.

Here is a summary of the major pros and cons to take into account before deciding which alternative to choose:


The biggest advantage to hiring a professional caregiving agency is that it assumes liability, which is a critical consideration in a society prone to lawsuits. “We take on all the responsibilities and risks of an employer so that our clients do not have to bear them,” explains Terry Dixon, owner of the Charlotte, North Carolina–based branch of Senior Helpers, a national caregiving agency. “Our employees are bonded and insured, and they are covered by our workers compensation program. We do traditional reference checking, criminal background checks, verify citizenship, and pull driving records.” Agencies can also handle accounting and payroll tax matters.

To duplicate background checking for an independent caretaker would be difficult, and this also leaves the senior or family member hiring the person responsible for filing payroll taxes and legal liability. For that reason, if you choose to hire an independent caregiver, you should consider an umbrella liability policy of at least $1 million.


Caregiving agencies today evaluate a potential employee’s ability to serve as a caregiver and provide ongoing training for all employees. For instance, Senior Helpers has initiated a specialized training program for Alzheimer’s and dementia care in conjunction with an expert in dementia, as well as training courses in Parkinson’s and diabetes management, two other ailments common in the older population.


Caregiver agencies provide ongoing supervision of their employees through implementation of a care plan that includes duties required and all medications, medical records, and emergency contacts. In addition, agencies make intermittent on-site visits with an older adult and/or his family members to identify any issues with caregiver support. Alternately, an independent contractor reports only to her clients.

Selection of Caregiver

One major advantage of hiring caregiver support directly is having more control over selection of an individual who has the right chemistry with your loved one. Agencies can send different caregivers at different times, but agencies also provide 24-7 backup if the regular caregiver is unable to show up — something an independent caregiver usually cannot guarantee.


The greatest disadvantage of caregiver agencies is their hourly costs, which can be generally double that of the hourly wage paid an independent caregiver.

No matter which route you choose, your aging loved one is far more likely to be happy staying in her home with caregiver support than moving to a nursing home or assisted living facility. After watching his mother deteriorate rapidly in a nursing home, Dixon and his sister brought her home and hired caregivers. “The situation was so good that it motivated me a few years later to leave hospital administration and go into the home caregiving business,” Dixon says.