When Tommy Schnurmacher of Montreal hired a live-in caregiver recommended by a friend for his mother, Olga, who was in her 90s and had Alzheimer’s, he assumed his mom was in capable hands. Soon, however, he had serious doubts.

One night, the caregiver tapped on the door of Schnurmacher’s apartment, which was in the same building where Olga lived. “Your mom is on the floor,” the caregiver told him. “She slipped out of bed.” That wasn’t the only time the caregiver was neglectful, either.

“This caregiver had all kinds of issues. She was forgetful and careless,” says Schnurmacher. When Olga had to go to the emergency room repeatedly over a period of weeks, Schnurmacher discovered that his mom’s health issues were caused by the caregiver administering Olga’s medication improperly. 

Schnurmacher fired that caregiver. But then he had to find another to take her place.

Private caregivers: pros and cons

Over five years, Schnurmacher hired several caregivers to take care of his mom. “The ones I hired ranged from lazy and inept to one best described as an angel from heaven,” says Schnurmacher, author of Makeup Tips from Auschwitz, a memoir about Schnurmacher’s relationship with his mother, a Holocaust survivor.

Schnurmacher’s experience with private caregivers isn’t uncommon, says Jennifer FitzPatrick, author of Cruising Through Caregiving: Reducing the Stress of Caring for Your Loved One. “Home care agencies are not infallible, but there are a lot more risks in hiring a caregiver who is not with an agency,” says FitzPatrick.

Still, cost-prohibitive agency rates prompt many people to hire private caregivers, which are typically less expensive. Schnurmacher paid his mom’s caregivers between $12 and $15 per hour, considerably less than home care agency rates, which range from $17 to $30 per hour. He paid his mom’s live-in caregiver $600 per week, including accommodations.

Depending on the geographic region, level of care needed and living arrangement, cost for a live-in caregiver ranges from $1,000 to $5,000 per month, according to Paying for Senior Care.

While experienced agency recruiters may be able to spot red flags during an interview, you and other family members probably won’t.

Hiring privately may be less expensive than a home care agency, but with a private caregiver, you or another family member must take care of all the tasks that an agency typically handles, says caregiving expert Pamela D. Wilson, author of The Caregiving Trap

“You have to ask yourself if you’re really up to doing all the footwork,” says Wilson. For example, most home care agencies perform criminal background and work reference checks on applicants. Someone hiring a private caregiver needs to do the same. You’ll also have to develop a care plan for your loved one, something an agency typically creates.

Home care agencies usually handle payroll taxes and employment agreements, tasks you’ll need to manage yourself or pay to have done when you hire privately. Another factor to consider is that while experienced agency recruiters may be able to spot red flags during an interview, you and other family members probably won’t, at least not at first. 

“Much of the time, families who hire caregiving aides on their own rely on gut feelings or are so exhausted and burned out that they bring in the first person who seems nice,” says FitzPatrick. Agencies have experience screening applicants, and the agency — not you or your family — must fire or transfer caregivers that aren’t a good match, she says.

5 tips for hiring private caregivers

Despite drawbacks, many families opt to hire a private caregiver to save money or because they’ve had a bad experience with a home health agency. If you’re considering hiring a private caregiver for an older loved one, read these 5 suggestions before you begin the search.

1. Ask around

A good source for finding a list of private caregivers is your local Area Agency on Aging (to find yours, go to www.n4a.org), says FitzPatrick. “Of course, word of mouth from someone you personally know and trust is a great place to find someone as well,” she says.

2. Screen carefully

Performing a background check, including the applicant’s driving record, on a potential caregiver is crucial, says Wilson. After all, the caregiver may be driving your parent to doctor’s appointments. “There are people out there with DUIs and traffic tickets who can’t pass a driving record screening,” Wilson says. 

Do you want to unwittingly hire someone previously convicted of violence or theft? To help prevent that scenario, order background checks from specialty companies or from the state police. You’re legally required to obtain the applicant’s permission first.

3. Assess your management skills honestly

Do you have experience interviewing, hiring and managing employees? What about doing payroll and handling employment taxes? Be honest with yourself about whether you’re up to the task.

4. Let a care manager do the hiring

Does the thought of interviewing caregivers fill you with dread? If so, Wilson recommends hiring a geriatric care manager, a professional with extensive knowledge of benefit programs and in-home services, to find, interview and select caregivers. Search for a reputable care manager at the Aging Life Care Association, a non-profit organization offering professional development and education.

5. Have a written agreement in place

Make sure the caregiver you hire signs a written agreement or contract stating the job description, pay rate and amount of notice that either party must provide for termination. With a live-in caregiver, be sure the agreement states that the caregiver must move out if terminated, says Wilson.

How to interview potential caregivers

It’s a good idea to have multiple family members interview potential caregivers. “It shouldn’t be just one person’s opinion driving the hiring process,” says FitzPatrick. Allow your loved one to meet the caregiver before hiring, and observe how the interaction goes, she says.

During the interview, ask the applicant whether he or she has been a caregiver for someone with your loved one’s specific condition.

During the interview, ask the applicant whether he or she has been a caregiver for someone with your loved one’s specific condition and what that experience was like to help determine whether the person is a good match. Find out why the person chose to become a caregiver.

To get a good idea of how the caregiver works, talk about a recent problem experienced with your loved one and ask what he or she would do if faced with a similar issue, says FitzPatrick. 

Ask about past stressful caregiving situations and how the caregiver handled them. “A red flag is when the person answers with a situation that really isn’t all that stressful,” says Wilson. More red flags include fidgeting, avoiding eye contact and any feeling you have that the person is not being completely honest, says Wilson.

Good private caregivers: they’re out there

When Schnurmacher finally found a compassionate and reliable caregiver for his mom, she remained Olga’s caregiver for nine years. “She was as concerned about my mother as I was,” says Schnurmacher, whose advice to those hiring private caregivers is to check references. Dig deeper for more information when someone recommends a caregiver. 

“A lot of times, they’ll say, ‘Well, maybe this one would be better,’” says Schnurmacher. “Always ask that second probing question.”