Hiring and supervising paid caregivers — the management role you never wanted

Disclaimer: This article provides guidance on working with paid caregivers. It does not constitute legal advice. Consult with an attorney about employment laws, tax obligations, and proper hiring practices in your jurisdiction. Always verify credentials and references before hiring any caregiver.

You're suddenly an employer. You never trained for this. You wanted to be a son or daughter, a family member providing care and love. Instead, you're reviewing resumes, conducting interviews, checking references, figuring out what to pay, managing schedules, and supervising someone who's helping with your parent's most intimate needs. The role feels foreign and uncomfortable. You might feel guilty that you can't provide all the care yourself. You might worry about trusting someone else with your parent's wellbeing. But having reliable paid help might be what makes caregiving sustainable for you and what ensures your parent gets the consistent care they need.

Hiring and supervising paid caregivers is a skill you'll develop through necessity. It matters that you do it thoughtfully. The quality of care your parent receives from paid help depends significantly on your ability to clearly communicate what you need, to hire the right person, and to provide appropriate supervision.

Figuring Out What You Need

Before hiring anyone, understand what your parent actually needs. How much help do they need with activities of daily living? Do they need help bathing, dressing, toileting, or eating? Do they need someone to manage medications, prepare meals, do laundry, or clean? Do they need someone who can safely transfer them if they have mobility limitations? Do they need someone to provide companionship and activities, or is this about physical care?

Consider how many hours per week help is needed. Full-time care? Part-time? A few hours a week? Some people need care five days a week while family helps on weekends. Others need someone present around the clock.

Think about what qualities matter for your parent. Do they need someone with specific medical training? Someone who speaks their language? Someone whose personality is compatible with your parent? Someone who has experience with dementia? Your parent will be spending significant time with this person, and the relationship matters.

Consider your budget. What can you realistically afford? Paid caregivers range from minimum wage to very experienced skilled nurses earning much more. Your budget will influence what level of care you can access and whether you'll hire someone formally or informally.

Sources for Finding Caregivers

Agency-provided caregivers are hired through an agency, which handles background checks, training, tax withholding, and matching caregivers to clients. This is more expensive but takes a lot of burden off you. The agency is responsible for finding replacements if your regular caregiver can't work and for managing employment issues.

Private caregivers hired directly by you offer more flexibility and potentially lower cost, but you become the employer. You're responsible for background checks, taxes, and all employment issues.

Word-of-mouth referrals from friends, neighbors, or your parent's doctor sometimes lead to good caregivers. Personal recommendations can be valuable.

Online platforms now connect families with caregivers. These provide some structure and background checking but vary in what they offer.

Senior centers or Area Agencies on Aging sometimes have caregiver registries or can point you toward resources.

Hiring: Doing It Right

Conduct background checks. This is essential. You need to know whether the person has a criminal history, particularly for violent crimes or crimes against elderly or vulnerable people. Some states require caregiver background checks by law. Do it even if it's not required.

Check references. Call previous employers. Ask directly about the caregiver's strengths, weaknesses, reliability, and ability to handle difficult situations. Ask why they left their previous position.

Conduct an interview. Meet the person in person or via video. Assess their demeanor, their ability to communicate clearly, their patience, and their apparent liking for and comfort with your parent. Can you imagine your parent being cared for by this person?

Discuss expectations clearly. What specific tasks will they perform? When will they work? What's the rate of pay? What happens if they call in sick? How will you handle time off? What's the trial period? Everything needs to be clear upfront so there's no confusion later.

If you're hiring privately, consult with an accountant or attorney about tax obligations. You might need to register as an employer, withhold taxes, and pay unemployment insurance. The requirements vary by state.

Do a trial period. Have the caregiver work while you're present and observe. Do they interact well with your parent? Do they follow directions? Do they show up on time? Do they handle tasks the way you want them handled? After the trial period, sit down and discuss how it's going. If it's not working, make a change now rather than waiting.

Supervision and Quality Control

You're not being distrustful if you supervise. You're being a responsible manager and a protective family member. Your parent depends on this person for intimate care. Oversight matters.

Be present sometimes. Occasionally show up earlier than expected or return unexpectedly. See your parent and the caregiver together. Observe interactions. Notice whether your parent seems safe, clean, and engaged.

Create a daily log. Ask your caregiver to document what happened during their shift: what your parent ate, whether medications were taken, any concerns or activities. This gives you information about your parent's day and about whether care is being provided as requested.

Check your parent directly. Ask them how the caregiver is doing. Is the person kind? Is your parent being treated well? Is anything concerning happening? Your parent's perspective matters.

Notice changes in your parent. If their health is declining rapidly, if they seem sad or withdrawn, if they have unexplained injuries, these warrant investigation.

Be specific about what you want. If you want your parent bathed on Monday, Wednesday, and Friday, say that specifically. If you want meals at certain times, say that. If you want your parent taken outside on nice days, say it. Don't assume the caregiver will figure out what you want. Be clear.

Give feedback regularly. If something is done well, acknowledge it. If something needs to change, discuss it respectfully but clearly. Most caregivers want to do a good job and will adjust if they understand what you need.

Managing Challenges

If the caregiver is frequently late or doesn't show up, address it immediately. Reliability is essential. If it doesn't improve, consider finding someone else.

If you're concerned about theft or inappropriate behavior, address it directly. Ask about specific items that are missing or specific behaviors you observed. If you suspect serious problems, you might need to involve authorities, but try direct conversation first.

If your parent complains about the caregiver, listen. If your parent says the caregiver was mean or rough, that's a serious concern. If your parent says the caregiver is lazy, try to understand whether this is dementia-related confusion or a legitimate concern.

If the caregiver becomes emotionally involved with your parent in an unhealthy way, or if they take on more authority than they should, set boundaries. Your parent is still their own person, and you're still making decisions about their care.

If your parent and the caregiver just don't mesh personally, consider finding a different caregiver even if the care itself is adequate. These relationships work better when there's genuine compatibility.

Payment and Legal Issues

Agree on payment before care starts. Hourly rate? Weekly payment? How will you pay? Cash, check, bank transfer? How often? Will you increase pay after a certain time? Will you pay if the caregiver can't work due to illness?

Keep records of payments. This is for your own protection and for tax purposes if you're required to withhold taxes.

Understand your legal obligations. In many states, if you hire someone privately, you have obligations as an employer. You might need workers' compensation insurance, unemployment insurance, and you might need to withhold income tax. Not doing this correctly can create legal liability for you. Consult with an accountant or attorney.

Create a simple agreement in writing. It doesn't need to be a formal contract, but it should say what's agreed to about hours, rate of pay, tasks, and what happens if either party wants to end the arrangement.

The Emotional Complexity

Hiring paid care might trigger complex feelings. You might feel guilty that you're not providing all the care yourself. You might worry about trusting someone else. You might feel judged for needing help. These feelings are normal. Having paid help doesn't mean you're shirking responsibility. It means you're making a realistic assessment of what you can manage and ensuring your parent gets consistent, reliable care.

Having good paid help actually allows you to be a better family member. You're not burned out from trying to do everything. You have energy for connection and for being present. Your parent gets the physical care they need from someone trained to provide it, and they get emotional support and love from you.

Finding the Right Person

The best caregiving relationships happen when you find someone who genuinely cares about your parent's wellbeing. You notice this in how they interact: their patience, their attentiveness, their kindness. These qualities can't be taught in an interview, but you can sometimes sense them.

Sometimes it takes a few tries to find the right person. That's okay. The time spent finding a good fit is worth it. A caregiver who genuinely likes your parent and provides care with kindness and competence makes an enormous difference in your parent's quality of life and your own peace of mind.

This management role you never wanted is actually an act of love. You're making sure your parent has reliable, quality care. You're creating structure that allows your parent to be safe and well cared for. You're doing work that matters, even though it's uncomfortable and outside your usual role. That effort is significant, and your parent is fortunate to have someone willing to take it on.

Disclaimer: This article provides guidance on hiring and supervising paid caregivers. It does not constitute legal or employment advice. Consult with an attorney and accountant regarding employment law, tax obligations, and proper hiring practices in your jurisdiction. Always verify credentials, conduct background checks, and check references before hiring any caregiver. Requirements vary by state and by whether a caregiver is employed as a household employee or works through an agency.