Most families start hiring a private caregiver after something has already happened: a fall, a hospital discharge, a parent who has stopped eating properly or can no longer manage the stairs. The decision is made fast, often from a distance, and the person you choose will be alone in your parent’s home with their medicines, their post and their bank cards.
This guide covers what gets skipped in the rush: defining the care, choosing between a caregiver you hire, an agency and clinical home health, the real risks of the private route, and the rules that can make your family an employer in the United States and the United Kingdom. Americans say caregiver, Britons say carer; the job is the same.
Start with the care needs, not the advert
Before you look for anyone, write down with your parent what they need help with, and when. An older person who has chosen their own carer usually accepts help more readily.
- Personal care: washing, dressing, using the toilet.
- Mobility: getting out of bed or a chair, walking, stairs, the risk of falls.
- Household: meals, shopping, laundry, light cleaning.
- Medicines: whether a reminder is enough or someone has to give them.
- Company and supervision: memory problems, confusion, loneliness.
- Nights: whether they wake and need help, or only need someone in the house.
Then separate out the clinical tasks. Wound care, injections and anything needing clinical judgement belong to nurses; a private caregiver is there for personal care, the household and company. The hours matter as much: visits, daytime shifts, waking nights and live-in care are different jobs that attract different people.
Private caregiver, home care agency or home health: who does what
Families often combine these routes: a private caregiver on weekdays, an agency at weekends, a nurse visiting for a wound. What changes between them is who carries the responsibility.
| What changes | Private caregiver you hire | Home care agency | Home health (clinical) |
|---|---|---|---|
| Who employs them | You or your parent, directing the work | The agency; you are its client | A home health agency (US) or usually the NHS (UK) |
| Who runs the checks | You: identity, references, right to work, background | The agency; in England it must be CQC-registered for personal care, in the US licensing depends on the state | The provider, under health regulation |
| When they are ill or away | Nobody, unless you arranged cover | The agency should send someone else | The provider reschedules the visit |
| What drives the cost | Hours, nights, live-in or visiting, level of need, and your employer costs | Hours, weekends, minimum visit length, the agency’s overheads | Often Medicare or insurance (US) or the NHS (UK) when the need is clinical |
The risks of hiring a private caregiver, and how to reduce them
Private care gives continuity and control. Its risks are real, and each has a practical answer.
- No backup. When the caregiver is ill, on holiday or leaves, nobody replaces them. Decide in advance who covers: a second part-time caregiver, a family rota, or an agency you have already spoken to.
- Employer duties. In most private arrangements you or your parent are the employer, with tax, pay, holiday and insurance obligations. Set them up before the first shift, not after an injury or a tax letter raises them.
- No oversight. An agency supervises its staff; nobody supervises yours. Replace that with a written care plan, a daily log book, family visits at varied times and a regular conversation with your parent alone.
- Financial abuse. Whoever does the shopping sees the purse, the post and sometimes the PIN. Most caregivers are honest; the arrangement should not rely on it. The money rules below protect an honest caregiver as much as your parent.
Writing the job post without exposing your parent
A good caregiver post is specific about the work and discreet about the person. Describe the help, the hours and anything you genuinely need, such as a driving licence, a language your parent speaks or dementia experience. Saying that family is involved and there is a care plan attracts experienced caregivers.
Keep these out of the post: your parent’s name, the home address, details of any diagnosis, and any hint that they live alone. The neighbourhood or area, the type of help (personal care, mobility support, company, waking nights) and the hours are enough to find the right people. Share the rest at interview, with the candidates you have chosen to meet.
Posting a job on Hirovo is free. The post joins the job listings for its country and area (see the United States and United Kingdom job pages), where people nearby who do care work can see it, apply or message you in the app. You decide who to meet and who to hire. Hirovo does not verify candidates, run background checks or confirm qualifications, and it is not an employer, an agency or a care provider, so every check in this guide stays with you.
Describe the help your parent needs, the hours and the area, not the address. People nearby who do this work can apply or message you, and you decide who to meet.
Post a free job →Hiring a private caregiver in the United States
If you hire a caregiver yourself and decide what they do and how, they are usually your household employee rather than a contractor. Our guides to hiring a nanny and hiring a house cleaner cover the tax side, including Schedule H and household payroll, and it applies here too. Federal overtime rules have exemptions for some directly employed caregivers, with strict conditions, and several states go further; check before you set long or live-in hours.
Paying for care is where families are most often surprised. Medicare covers intermittent skilled home health care for people who are homebound, but it generally does not pay for ongoing custodial care, meaning help with bathing, dressing and meals, when that is all someone needs. Depending on your state, Medicaid home- and community-based services may fund personal care at home, and some let the person choose their own caregiver, sometimes a relative. Your local Area Agency on Aging, found through the Eldercare Locator, can explain the options.
Before the first shift, ask your home insurer whether an injury to a household employee is covered, and whether your state requires workers’ compensation for domestic workers. Run background checks through a consumer reporting agency: the Fair Credit Reporting Act requires a standalone written disclosure and the candidate’s written permission first, and, if the report leads you not to hire, a copy of it and a summary of their rights before that decision is final. Some states add their own rules.
Employing a carer privately in the UK
Start with a free care needs assessment from your parent’s local council. In England, the Care Act 2014 gives it to anyone who appears to need care and support, whatever their savings; Wales, Scotland and Northern Ireland have their own laws, and in Northern Ireland you go through the health and social care trust. You can ask for a carer’s assessment for yourself at the same time.
If the council funds care, you can usually take it as direct payments and employ a personal assistant. Whoever holds the payments, your parent or you on their behalf, becomes an employer: PAYE with HMRC once earnings pass the thresholds, pension auto-enrolment duties, at least the National Minimum Wage, a written statement of terms (in Great Britain, by day one) and 5.6 weeks’ statutory paid holiday. Councils commonly expect employer’s liability insurance; ask yours. They generally won’t let the payments go to a close relative in the same household unless they agree it is necessary.
In England, a home care agency providing personal care must be registered with the Care Quality Commission, and its inspection reports are on the CQC website; Scotland, Wales and Northern Ireland have their own regulators. A self-employed carer working directly for you is not CQC-registered, and nor is an introductory agency that only puts you in touch, so the checks fall to you. In England and Wales, ask a registered DBS umbrella body which level of check you can request; Scotland and Northern Ireland use Disclosure Scotland and AccessNI. A basic check shows only unspent convictions.
Also look at Attendance Allowance, a benefit for people over State Pension age who need help with personal care because of illness or disability. It is not means-tested and does not require a carer to be in place, so it can help pay for one; in Scotland, ask Social Security Scotland.
Interview with your parent in the room, then a trial
Your parent should meet every serious candidate and have a real say. Watch whether the candidate speaks to them directly and patiently. Ask what they did when someone refused to wash, fell at night or became frightened.
- Check identity against a photo document, and right to work: in the US with Form I-9, in the UK with a right-to-work check.
- Phone two previous families or employers yourself and ask whether they would hire the person again.
- Check any training they mention, such as first aid or moving and handling, with whoever issued it.
- Agree a paid trial of a few shifts while a family member is in the house, with tasks and hours in writing.
Afterwards, ask your parent privately how it went.
Keeping your parent safe once care starts
Write these routines down and give the caregiver a copy on day one.
- Medicines: agree who is responsible. Prompting from a pharmacy pack is one thing; giving medicines should be agreed with the doctor or pharmacist, and injections or dose changes stay with health professionals.
- Falls: clear trip hazards, keep a phone or personal alarm within reach, and agree that after a fall, if in doubt, nobody lifts; they call for help.
- Money: the caregiver is never given a bank card or PIN. Shopping comes from a small cash float, with every receipt kept and checked weekly. No loans, no gifts of money.
- Emergency list: on the fridge, with emergency numbers, the doctor, the pharmacy, two family contacts, allergies and current medicines.
- Log book and visits: a daily note of meals, medicines, mood and anything unusual, plus family visits at varied times with a few minutes alone with your parent.
- Cameras: tell the caregiver if you use one. Hidden recording, especially audio, is legally risky in many US states and in the UK, and no camera belongs where your parent washes or dresses.
If you suspect abuse or neglect, contact Adult Protective Services in the US or the council’s adult safeguarding team in the UK; in an emergency, call the police.
In short
Hiring a private caregiver works when you define the needs with your parent, choose between private, agency and clinical care deliberately, and plan cover for the first sick day. In the US, expect to be a household employer and don’t rely on Medicare for daily care. In the UK, start with the council assessment. Everywhere, interview with your parent present, run the checks yourself and keep money rules strict.