Once you've decided your parent needs in-home care, the next question is: how do you find a caregiver? Most families end up choosing between two main paths—going through a home care agency, or hiring someone directly.

Both can work well. Both have tradeoffs. Here's what you need to know to make the right choice for your situation.

Option 1: Home care agencies

Home care agencies employ caregivers and assign them to clients. You work with the agency, not directly with the caregiver. Big names in this space include Home Instead, Visiting Angels, Comfort Keepers, and many regional companies.

How it works

You contact the agency, describe your needs, and they match you with a caregiver from their staff. The agency handles:

✓ Pros

  • Convenient—they handle everything
  • Built-in backup coverage
  • Liability protection
  • Caregivers are vetted
  • No employer responsibilities

✗ Cons

  • Expensive ($28-35/hour)
  • Less control over who shows up
  • Caregivers may rotate frequently
  • Caregivers are paid less (lower motivation)
  • Contract minimums and terms

The cost reality

When you pay an agency $32/hour, here's roughly where that money goes:

That overhead includes office staff, marketing, insurance, and profit margin. It's not wrong—it's just the business model. But it means the caregiver in your parent's home is seeing less than half of what you're paying.

Option 2: Hiring directly

When you hire directly, you find a caregiver yourself and employ them (or pay them as an independent contractor—though this has legal nuances). You might find candidates through:

✓ Pros

  • Much cheaper ($15-20/hour)
  • Caregiver earns more (better quality)
  • You choose exactly who you hire
  • More consistent—same person daily
  • Direct relationship and communication

✗ Cons

  • You do the vetting yourself
  • No built-in backup coverage
  • You handle scheduling and issues
  • Potential employer tax obligations
  • More time and effort required

The real challenge: backup coverage

The biggest practical problem with hiring directly is what happens when your caregiver can't make it. Agencies have a roster of employees to pull from. When you hire direct, a sick caregiver means scrambling to figure out coverage—or taking off work yourself.

This is the main reason families go with agencies even when they'd prefer to hire direct. The peace of mind of knowing someone will always show up is worth a lot.

This is exactly the problem we solve. At HappyHelp, we help families hire caregivers directly—you pay them, you're in control—but we maintain a bench of vetted backup caregivers and handle the coordination. You get the cost savings of direct hire with the backup coverage of an agency.

A middle path

More families are realizing there's a third option: getting help with coordination while still hiring directly. Services like ours help you find and vet caregivers, manage schedules, and provide backup coverage—but you hire and pay the caregiver directly.

This gives you:

The bottom line

There's no universally "right" answer. Agencies provide convenience and coverage but cost more. Hiring direct saves money but requires more work. Your choice depends on your budget, your bandwidth, and what matters most to your family.

Whatever you choose, go in with clear expectations. Ask agencies hard questions about caregiver turnover and backup policies. If hiring direct, have a plan for what happens when someone calls in sick.

The goal is quality care for your parent. There's more than one way to get there.