How to Hire a Caregiver for Your Elderly Parent
Your parent needs more help than you can provide. Whether it's a few hours a week or full-time care, hiring the right caregiver is one of the most important decisions you'll make.
Get it right and your parent gets compassionate, competent care. Get it wrong and you're dealing with unreliability, theft, neglect, or worse.
This guide walks you through every step of finding, vetting, hiring, and managing a caregiver.
Agency vs. Hiring Directly
Your first decision: hire through an agency or find someone independently?
| Home Care Agency | Private/Direct Hire | |
|---|---|---|
| Cost | $30-45/hour (2026 avg) | $18-28/hour + taxes |
| Screening | Agency handles background checks, references, credentials | You must do it yourself |
| Backup care | Agency provides replacement if caregiver is sick | You need to find your own backup |
| Taxes & legal | Agency handles payroll, taxes, workers' comp | You're the employer—handle payroll, taxes, insurance |
| Supervision | Agency provides oversight and care plans | You supervise |
| Flexibility | Less—agency assigns caregivers, may rotate | More—you choose and keep the same person |
| Best for | Complex care, need for reliability, limited time to manage | Budget-conscious, want relationship with one caregiver |
If you hire directly, you become a household employer. That means: Social Security/Medicare taxes (7.65% employer portion), state unemployment insurance, workers' compensation insurance, and W-2s at year end. Services like HomePay or GTM can handle this for ~$100/month.
Step-by-Step: Hiring Through an Agency
1Define Your Needs
Before calling agencies, know what you need:
- How many hours per week?
- What time of day? (Morning routine, overnight, 24/7?)
- What tasks? (Bathing, meals, medication reminders, transportation?)
- Any special needs? (Dementia experience, lifting ability, language?)
2Get Referrals and Research
Start with:
- Ask your parent's doctor for recommendations
- Hospital discharge planners often know good agencies
- Local Area Agency on Aging
- Friends who've been through this
- Google reviews (look for patterns, not just star ratings)
3Interview Multiple Agencies
Call at least 3 agencies. Ask:
4Meet the Assigned Caregiver
Before they start, meet them with your parent present. Look for:
- Do they talk TO your parent, not just about them?
- Are they patient and warm?
- Do they ask good questions about preferences and routines?
- Does your parent seem comfortable with them?
5Start with a Trial Period
Ask for a 2-week trial. During this time:
- Drop by unexpectedly
- Ask your parent how it's going (privately)
- Check that tasks are being done
- Provide feedback early if something's not right
Step-by-Step: Hiring Directly
1Find Candidates
Where to look:
- Care.com: Large database, includes background check options
- Local nursing schools: Post on bulletin boards
- Church or community boards: Word of mouth in trusted communities
- Referrals: Ask other families with caregivers
- CNA training programs: Recent graduates looking for work
2Screen Resumes
Look for:
- Relevant experience (caregiving, CNA, medical background)
- Consistent work history (gaps aren't disqualifying, but ask about them)
- References from previous care jobs
3Conduct Thorough Interviews
Interview questions that reveal character:
4Run Background Checks
Non-negotiable. Check:
- Criminal background (state and national)
- Sex offender registry
- Driving record (if they'll be driving)
- References (call at least 2-3 previous employers)
Services like Checkr, GoodHire, or Care.com's background check can help.
5Check References—Really Check Them
Don't skip this. Ask previous employers:
6Create a Written Agreement
Put everything in writing:
- Hours and schedule
- Specific duties (and what's NOT included)
- Pay rate and payment schedule
- Time off, sick days, holidays
- Termination policy (usually 2 weeks notice)
- Confidentiality expectations
If you hire directly, you're legally an employer. You must pay employer taxes, provide workers' comp insurance (required in most states), and issue a W-2. Paying "under the table" is illegal and leaves you exposed if something goes wrong. Use a household payroll service.
Red Flags to Watch For
During the Hiring Process
- Vague or inconsistent work history
- Unwilling to provide references or consent to background check
- Speaks negatively about previous clients or employers
- Talks more than listens during the interview
- Seems rushed or disinterested in learning about your parent
After They Start
- Frequently late or calls in sick often
- Your parent seems anxious or withdrawn around them
- Things go missing from the house
- They seem more interested in their phone than your parent
- Unexplained bruises or injuries on your parent
- They discourage visits from you or other family
- Changes to your parent's finances they can't explain
What to Pay in 2026
| Type of Care | Hourly Rate (2026) |
|---|---|
| Companion/Homemaker (light duties) | $18-25/hour |
| Home Health Aide (personal care) | $22-35/hour |
| Certified Nursing Assistant | $25-40/hour |
| Live-in Caregiver | $200-350/day |
Rates vary significantly by location. Major metros pay 20-40% more than rural areas.
Managing the Caregiver Relationship
Set Clear Expectations
Provide a written list of:
- Daily tasks and routines
- Medication schedule
- Emergency contacts and procedures
- House rules (smoking, visitors, phone use)
- What decisions they can make vs. need to check with you
Communicate Regularly
- Daily log or app for updates (we recommend a simple notebook)
- Weekly check-in call or meeting
- Clear channel for reporting concerns
Show Appreciation
Good caregivers are hard to find. Keep them happy:
- Pay on time, every time
- Respect their time off
- Say thank you regularly
- Give bonuses for holidays or great work
- Treat them as a professional, not a servant
Caregiver Interview Checklist
Download our complete checklist with interview questions, reference check scripts, and background check guide.
Get the Checklist