If you're an adult child exploring care options for an aging parent, this step-by-step guide walks you through assessing needs, finding candidates, conducting background checks, handling legal and tax responsibilities, and managing the caregiver relationship — with real cost comparisons between private hire and agency.
You want to hire someone to sit with your mother while you are at work. That part is simple. What you are about to learn is that hiring a private sitter means becoming an employer — not just finding a helper.
I have filed the Schedule H, run the background checks, and once managed backup care from a hotel room during a business trip. The savings are real — $400 to $1,200 per month — but that number only holds if you do the legal and logistical work correctly. If you skip the taxes or fail to plan for the sitter’s sick day, those savings disappear, and the stress multiplies.
The guide below covers everything I had to learn the hard way. Read it in 15 minutes, then bookmark it. You will come back to it.
Most families assume a private sitter can handle any care task. That assumption can get you into legal trouble. Under Department of Labor regulations, companionship services primarily involve fellowship and protection; medical or personal care tasks cannot make up more than 20% of the companion’s total weekly work hours.
In concrete terms, a private sitter can:
A private sitter cannot, without more training and licensure:
Before you start looking for a sitter, sit down with a piece of paper and assess your parent’s needs. The Family Caregiver Alliance recommends reviewing the person’s needs across four categories: personal care, health care, emotional care, and household care. The most practical tool for this is the ADL (Activities of Daily Living) and IADL (Instrumental Activities of Daily Living) framework.
I have used this framework to figure out whether Mom needed a companion or someone to help with bathing. If your parent can manage the six core ADLs (bathing, dressing, toileting, transferring, continence, feeding) but needs help with IADLs like medication management, transportation, or meal preparation, a private sitter is often sufficient. If they need help with ADLs, you may need a higher level of care.
If you are unsure whether your parent needs help at all, read our decision guide: Signs Your Aging Parent Needs Home Help. And for a full breakdown of the ADL/IADL framework, see ADLs and IADLs: The Assessment Framework Every Caregiver Needs to Understand.
The main reason families hire privately is cost. The numbers speak for themselves.
| Agency | Private Sitter | |
|---|---|---|
| Hourly rate | $35–$45 per hour | $25 per hour |
| Monthly cost (20 hrs/week) | $2,800–$3,600 | ~$2,400 all-in |
| Monthly savings (private) | — | $400–$1,200 |
| Caregiver's take-home | $15–$20/hr | $25/hr |
The savings come from cutting out the agency’s overhead, which can take up to 50% of the caregiver’s wage. When you hire directly, the caregiver keeps more, and you pay less. But — and this is the critical but — those savings only materialize if you handle the administrative costs yourself: payroll service ($50–$75/month), workers’ comp insurance (~$40/month), background check ($50–$100 one-time). Add those in and the all-in cost is still lower than an agency, but it is not a free ride.
If you want a deeper comparison of the trade-offs, read Private Companion vs. Agency Companion: A Decision Framework.
Once you know what you need and have decided to hire privately, the next question is where to look. These channels work:
Word of mouth is how I found my best sitter. If you are completely new to caregiving, start with our Elder Care Help: A Step-by-Step Guide to Figuring Out What Your Aging Parent Needs and Where to Start. It will save you from chasing dead ends.
A quick $10 national database check will not cut it. National databases are incomplete. I recommend paying $50–$100 for a comprehensive background check that includes county-level criminal records, a driving record, and a Social Security number trace.
The National Council on Aging puts it plainly: When hiring independently, it is critical to conduct criminal background checks and review driving records.
Here is what to verify:
This is where most families cut corners. Do not. The IRS rule is simple: if you pay a household employee cash wages of more than approximately $2,800 per year (2025 threshold) (adjust for current year before you sign), you become a household employer. That means you must:
You can manage payroll yourself using IRS forms, but a payroll service ($50–$75/month) handles tax filing, direct deposit, W-2s, and compliance. It is worth the money for the peace of mind. Payroll services charge a flat fee per month and then per employee.
For help paying for care, see How to Pay for Elderly Home Care: A Practical Funding Guide for Family Caregivers.
You cannot know whether a sitter is a good fit from an interview alone. Plan a trial period of two to four weeks. Pay them the agreed rate during the trial. During that time, watch for:
After the trial, if everything is working, sign a written agreement that spells out tasks, hours, pay, time off, and expectations. The Family Caregiver Alliance recommends writing a job description that spells out tasks including details on driving, transferring skills, dementia experience, language, housekeeping, and smoking. Do not rely on verbal agreements.
The sitter will get sick. They will take vacation. They may quit with two weeks' notice or with none. If you do not have a backup plan, you are not ready to hire privately.
I learned this the hard way. My mother's sitter called in sick on a Monday morning while I was 500 miles away on a business trip. I spent four hours on the phone scrambling, finally hiring someone from a registry for double the rate. The savings from months of private hire disappeared in three days.
Build your backup plan before you need it:
Without a backup, your entire arrangement is fragile. Do not skip this.
Hiring privately means you are responsible for ongoing management. Have a weekly check-in — even a 10-minute phone call. Keep a log of hours and any concerns. Address small issues before they become big ones.
Set clear boundaries early: how to request time off, what to do in an emergency, how you prefer to be contacted. This is a professional relationship. Act like an employer, not a friend.
If you have just become a caregiver, our First 30 Days as a Caregiver for an Elderly Parent: An Actionable Roadmap will help you navigate the early weeks.
The savings are real if you do the work. If you don’t, an agency is a better bet. I’ve seen both succeed and fail. Now you know what it takes.
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