The Pros and Cons of Hiring a Professional Caregiver

As seniors become more dependent on others for their basic needs, family and friends often take on various caregiving duties. These may start simply, like with rides to the doctor or help with paying bills. Perhaps the neighbor regularly volunteers to cut their grass or shovel snow. Later, families may find themselves helping with making meals or getting them dressed.

Sometimes the transition from small amounts of support to a large amount happens gradually, like in the case of seniors with Alzheimer’s disease, arthritis, or COPD/asthma. Other times, the transition is almost overnight, like in the case of a stroke.  

While many people feel that support should be provided by family, hiring a professional caregiver is often a wise decision.

Why Might You Hire a Professional Caregiver?

You may have already invested in making significant upgrades to the home to make it safe. That’s an important step to prolonging their independence. Seniors may nevertheless get to a point where they depend heavily on you or other family members. Most caregivers experience genuine gratification from their caregiving role, but this isn’t always enough.

You manage to a point until it gets a bit overwhelming. This is when many family caregivers begin exploring the possibility of hiring a professional caregiver. So, what’s the difference between professional and family caregiver duties, and when is hiring a professional caregiver a good idea?

Well… a few things might tip the balance for you. 

You Have Too Many Things On Your Plate

You may have a full-time job, kids, a partner, and perhaps you’re grappling with your own personal life challenges – poor health, recent job loss or new job, a divorce or new marriage, or other major life events.

Most caregivers would have never imagined needing to give up so much to care for another person – except for new parents, perhaps. Family caregivers rarely get a break from any of it, and soon their entire existence feels as though it is centered around the care needs of their loved one.

Caregiving is hard enough when your life is relatively straightforward. When there’s a lot going on, the role quickly becomes impossible.

The Physical and Emotional Toll Becomes Too High

It’s no wonder that a family caregiver’s lifespan is shorter than non-caregivers.

Family caregivers may look to their faith, friends, and other forms of emotional support to get them through the day. Others become socially isolated, depressed, and withdrawn.

Cultural expectations around the care of aging family members can also be quite strong. Caregivers’ faith and cultural background may lead family members to never question the sacrifice and commitment and see it as their duty.

Yet, sometimes you’re simply giving too much away when you’re caring for someone else – and don’t have enough left for yourself or the rest of your life.

You Can’t Do Everything

Your parents and loved ones may need additional support and care for short periods of time or for much longer.

However, catering to a loved ones’ needs 24/7 may not always be feasible. The closest kin may still be living too far away or may not have the means, time, or willingness to help support their loved one.

When seniors are still mostly mobile and independent, providing care may be more manageable. When seniors’ condition worsens, family members may find themselves completely overwhelmed and unable to keep up.

How Paid Care Can Help

With paid caregiving services, someone else is doing some of the tasks that would otherwise be yours.

This is incredibly important, as it frees you up emotionally and practically, giving you more time and energy. In fact, hiring a caregiver might even allow you to support your aging loved one more and better, as you have the emotional resources to do so.

Securing professional help allows the burden of care to be distributed. The family gets the desired peace of mind and much-needed breaks when they seek the right help at the right time.

Family caregivers and professional caregivers share approximately the same mission: provide care and comfort to seniors and assist them with activities of daily living.

Hiring a Professional Caregiver

You’ll need to first assess the essential care needs to help determine the caregiver experience you’re looking for.

• It could be that your loved one is still mostly physically independent and mobile, but would benefit from companion care.
• Another senior may need motivation and help with moving about or complete help with all chores at home, including meal preparation.

In this part of the article, we’re digging deep into the types of assistance you can expect or arrange from various caretaker types, as well as the advantages and disadvantages of bringing in reinforcement to your care team at home.

Professional Caregiver Duties

Professional caregivers that provide direct care or respite care can go by many names. It can make your search for help a little confusing. Direct Care Workers (DCWs) is the umbrella term that includes Certified Nursing Assistants (CNAs), Home Health Aides, and Personal Care Aides (a.k.a. personal care attendants).

• Certified Nursing Assistants (CNA) assist residents with activities of daily living (ADLs) such as eating, dressing, bathing, and toileting. They can perform some clinical tasks like administering insulin, taking blood pressure, or changing wound dressings. Although many CNAs may work in nursing homes, assisted living facilities, or other medical facilities, some do work directly for clients in their homes, or for a home health agency.
• Home Health Aides provide essentially the same care and services as nursing assistants, but they assist people in their homes or in community settings under the supervision of a nurse or therapist. They may also perform light housekeeping tasks such as changing sheets or preparing food.
• Personal Care Attendants, also known as Personal Care Aides or home care workers, these people often assist seniors with home chores, cleaning, making meals, bathing, and more.

All of the professional caregivers noted above can aid with scheduling appointments with doctors, providing invaluable companionship, and stimulating their minds by playing games or the senior’s favorite recreational activities.

Where to Find Professional Caregivers

Some professional caregivers work for home health agencies or can be hired directly by families through public sites like Care.com or local directories. You can also place ads on public job boards, such as Indeed or SimplyHired.

The senior’s own health insurer or Medicare may have a preferred list of home health agencies to select from. You can further narrow the list of home health agencies through Medicare Compare to review the quality rating of the home health service agency and patient satisfaction scores.

Hiring directly from a home health agency has its benefits. You’ll have someone who is bonded and insured. There is more oversight and organization. The caregiver would’ve needed to have completed some degree of training and has presumably passed a background check. In cases where one calls in sick, the agency can send a replacement to minimize any disruption to your work or personal schedule.

More advanced skilled nursing care can be provided by a Registered Nurse (RN), but is typically far more expensive and limited to post-acute care after a serious incident or hospitalization and only for a short period of time.

Drawbacks of Hiring a Professional Caregiver

1. They’re Not You

Some loved ones won’t accept care from anyone but their loving, doting, self-sacrificing child. You succumb to their every will and understand all their quirks. You know how to make their favorite meals and traditional dishes. You’re familiar and tolerant, and comfortable.

However, getting used to another person in the home is not impossible, as with most relationships, seniors will form strong bonds with formal caregivers.

2. Cultural, Ethnic, and Language Differences               

Hired caregivers may be from a different cultural or religious background, or not be fluent in the senior’s preferred language. In fact, immigrants make up the majority of caregivers. If your loved one wasn’t raised with a sense of openness and is not welcoming to diversity, this can make your recruitment efforts very difficult.

I’ve occasionally heard that caregivers sometimes have to ask agencies to send caretakers of certain backgrounds and avoid others. Not from any prejudice they personally have, but because they’re afraid their loved one might insult the hired caretaker.

3. High Turnover

Just as you get accustomed to one caregiver’s personality, approach, and abilities, the caregiver may switch jobs or move on to a new career or full-time client. If you were working with a respite care agency or local area agency on aging, they may have decided to contract with another home health care agency.

Most direct care workers earn minimum wage, work part-time, and have to cobble together several part-time jobs to earn enough money to put food on the table. They may be running from one client to another.

At one point my grandmother had a caregiver who was juggling four clients in one day. She arrived and prepared a delicious smoothie from my grandmother. But oops! She mixed up her clients and forgot that my grandmother has type 2 diabetes and could not have that rich, sugary smoothie she just prepared.

Burnout is real, and at some point, they realize that they can get paid more working at Walmart or driving for Lyft without the back-breaking work, plus benefits. That leaves you high and dry.

Now, you have to introduce the new caregiver and get her accustomed to your loved one’s needs and routine.

4. Inconsistency

When my mom was receiving occasional respite care from an agency in San Diego, she loved how one caretaker handled my father, whose advanced Alzheimer’s had become unpredictable. He was so skilled. Granted, he provided mostly companion care.

Then they switched agencies. The new respite care worker would come in and keep an eye on my dad to make sure he wasn’t wandering off. But, to kill the time, that caregiver spent some time tidying up the house. My mom just loved that too.

Each caretaker had unique strengths and very different styles of engagement.

5. Costs

This will certainly vary from one family to another, depending on your financial circumstances and eligibility for public benefits. Check with your loved one’s insurance to determine if they have a preferred list of home health service agencies and what percentage of care they cover.

Because of shortages in funding for the National Family Caregiver Support Program, many local agencies can only provide a certain number of limited hours of respite care to qualifying seniors and their caregivers. At any time, local public elder care services may ask families to pay a co-share amount, based on your income.

Hiring from home health agencies will certainly cost more than paying co-share with a local non-profit elder service agency. Home health agencies may also have a minimum number of hour blocks before sending anyone out to the home.

Benefits of Expanding the Care Team

1. You Get Time to Refresh and Handle Other Business

Professional caregivers keep a watchful eye on the seniors during their shifts. Although these caregivers also experience stress from their role, they are offered the much-needed break at the end of their shifts (something you wouldn’t get as a family caregiver).

This essential break enables them to detach themselves from the caregiving role for a while and pamper their mental health. Such breaks also allow professional caregivers to reclaim the ability to focus for the next caregiving shift.

Depending on the senior’s health condition, it is not always possible to take them with you to run errands or doing so is a monumental anxiety-ridden task for everyone.

My father, now in advanced stages of Alzheimer’s, has gotten in the habit of wanting to fix people’s collars. He would approach them (sometimes from behind) and just fix their collar. Let’s just say that rarely went over very well with strangers. My mother couldn’t comfortably shop for groceries, always on the alert that he would leave her side.

Knowing that someone else is looking after your loved one makes it easy for you to do whatever tasks you need to.

2. Experience and Skills

Care providers who have worked with dementia patients or had extensive training will be more creative in their ability to communicate effectively with seniors with Alzheimer’s, for example.

Family caregivers are highly unlikely to be educated on medical care terms unless they are health professionals already. There’s a definite learning curve. However, the hands-on training that family caregivers acquire cannot be understated.

The general skill repertoire of a family caregiver might not include knowledge on changing wound dressings, for instance. Caregivers may not have the backing of an organization or colleagues with whom to connect and seek advice from on caretaking matters.

Home health and nurses are trained in providing specific types of medical support. Registered nurses have the necessary medical qualifications for observing vital signs and administering medications well. Furthermore, home health aides are adequately trained to keenly observe and track a senior’s physical and mental health condition.

3. No Personal Baggage

The formal caregiver is removed from the emotional connection you have with the care recipient. A formal caregiver won’t harbor any resentment toward the senior. There is no history there or bad blood to contend with. The senior may therefore feel freer to be themselves, free of judgment.

The caretaker will approach care without any preconceived notions or expectations. That will make seniors more comfortable in many scenarios. They may even confide in the caretaker about life’s happenings and old times; things that they may not have shared with you.

4. Seniors May Overcome Their Modesty

Some family caregivers may feel uncomfortable while providing personal assistance. How do you think the elderly feel? Most shriek at the thought of having an accident or wearing an adult diaper around their spouse or children.

Seniors who grew up in very modest and conservative households are especially reluctant to be perceived as needing help with bathing or managing urinary incontinence. Having someone other than family help in this department helps to maintain that level of privacy and dignity they desire.

5. Return on Investment

When family caregivers lack the time to offer support or reside abroad, professional caregivers can sweep in to assist. You can go about your day, handling other matters with the reassurance that they’re taken care of.

We mentioned earlier that there may be a cost of furnishing paid care to your loved one. Still, if you speak to any economist, they may argue that the overall opportunity costs are still lower when you hire outside help.

Paying for outside help allows you to retain full or part-time work, which allows you to pay into your own retirement. Added help can also have unmeasurable benefits to your own mental and physical health, which in the long run saves you thousands of dollars in medical expenses.

People have even claimed that getting help saved their marriage, and we all know divorce can be nasty and expensive.

6. Save Your Back

Well meaning family members may injure themselves in the process of lifting a senior with limited mobility from one location to another. This could be from the bed to a favorite chair, or out of the bathtub. Back injuries are one of the most common injuries among caregivers.

If you’re worried about a senior’s care now, imagine if you were completely out of commission, or needing your own rehabilitation. Professional caregivers do get injured on the job; however, they are less likely to succumb to an injury because they’ve been trained on the proper technique and tools for transferring seniors safely.

Finding a Good Balance with Professional and Family Care

Even when professional caregivers are in the picture, family caregivers never fully relinquish their role. This is especially true if the family caregiver lives with the senior in their care, or lives close by.

The most common scenario is an intricate dance between the family caregiver and ‘paid help.’ In the perfect world, family caregivers and paid caretakers are in regular communication and have mutual respect.

In practice, however, there’s much to work out as things go on. Miscommunications may happen and you may not find the perfect caregiver the first time. Indeed, arrangements are typically customized and regularly updated, with everyone involved sort of figuring out as they go.

Final Thoughts

Some families may be fully capable of aiding and supporting their older loved ones, especially if they have flexibility in their work life, don’t have children of their own, and are in relatively good health themselves.

However, even the most capable family caregiver may need assistance as the senior’s health and mobility decline. Families may not be strong enough and emotionally prepared to shoulder the intense labor and commitment involved in full-time caregiving.

Family caregivers are likely to get so involved with care for an aging loved one that they miss out on opportunities to address their own health needs or find ways to reduce stress and continue living their own lives. Even occasional respite care can be helpful.

Getting past the sense of guilt for outsourcing part of the care responsibilities is sometimes one of the toughest aspects of this transition. However, in the long run, hiring a professional caregiver may be one of the best things you can do for yourself, your loved one, and the rest of your family.