If "interview strangers to spend time with mom in her own home" is on your caregiving bingo card, payroll, taxes, and background checks are probably on there too. Before you start dialing random numbers, read our guide to hiring home care. 

Less exciting than yelling BINGO, but the prize is a lot better.

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At some point, Mom needing a little more help turns into hiring help.

In 2026, private-pay non-medical home care runs about $35 an hour nationally, though it swings by state. And no, Medicare generally does not cover long-term non-medical help at home. It may cover limited skilled home health in certain situations, but not the ongoing “come help Mom shower, eat, get dressed, and stay safe” kind of care. That makes this an expensive thing to get wrong.

Home care usually means non-medical support at home: companionship, meals, bathing, dressing, transportation, light housekeeping, dementia supervision and medication reminders.

A non-nurse aide can often remind Mom to take medication from a pre-sorted pill box. But administering medication, like measuring doses, giving insulin, applying prescription patches, changing dosages or deciding what to do when Mom refuses, is usually nurse territory. Rules vary by state, of course. 

When it comes to hiring, this is not The Cheesecake Factory with a 30-page menu. You’ve basically got two paths and one hybrid in between.

Option one: Use an agency

An agency costs more because you are buying infrastructure. A reputable agency should screen caregivers, run background checks, handle payroll taxes, carry liability insurance and workers’ compensation, create a care plan, supervise the aide, and send a replacement when they call out sick.

Agencies often cost more than hiring someone directly. But the tradeoff is that you are not personally managing every piece of the job.

Ask questions that make them prove they're worth the overhead:

Option two: Hire privately

A private hire can be cheaper and more consistent. You're also now a recruiter, scheduler, payroll department, HR, and quality control.

Private hire means payroll, too. Do not assume you can hand someone a 1099 and call it a day.

The IRS may treat the caregiver as a household employee if you control not just what work gets done but how. That holds even if the work is part-time, hourly, or the caregiver came through a referral list. If an agency provides the caregiver and controls the work, the agency is usually the employer.

Want to keep it in the family? Wages you pay your spouse, your child under 21, or your own parent are generally exempt from these payroll taxes, though they still owe income tax on what they earn. A sibling, niece, or cousin is treated like a stranger. We’ll leave that joke alone.

For 2026, if you pay a household employee $3,000 or more in cash wages, Social Security and Medicare taxes generally apply. Hit $1,000 in any calendar quarter, this year or last, and federal unemployment tax may too.

You usually do not withhold federal income tax unless the caregiver asks and you agree. But you may still need an EIN, Form I-9, a W-2, Schedule H with your return, and depending on your state, income tax withholding, unemployment, or workers' comp.

Heads-up: Schedule H is not a year-end surprise you settle in April. The tax is owed as you go, through estimated payments or extra withholding, or you eat a penalty. And payroll is not just taxes. Caregivers are generally owed minimum wage, and live-out workers get overtime past 40 hours, which is wage-and-hour law and does not care that you meant well.

Start with IRS Publication 926: Household Employer’s Tax Guide and IRS Topic No. 756, then call a CPA or household payroll service before you get creative with Venmo emojis.

When interviewing a private caregiver, skip “tell me about yourself”. Ask what they would actually do in Mom’s house:

Pro tip: Try a paid trial shift before you commit.

Here’s the hybrid: caregiver registries or matching services. These can sit somewhere between an agency and a true private hire. They may help with screening, matching, insurance or payment logistics, but do not assume that means they are the employer. Before signing on the dotted line, ask: who is the legal employer, and who handles taxes, workers’ comp and liability?

Before you hire anyone, get clear on the job. Less: ‘Help with Mom’ and more ‘Monday, Wednesday and Friday from 9am to 1pm. Breakfast, shower cueing, laundry, medication reminder, walk around the block, and a note to daughter after each shift’.

Include what she actually needs:

Keep in mind, the first person you hire, may not be the best person. With an agency, call the supervisor, explain what is not working and ask for a replacement. Be specific: missed shifts, safety concerns, poor communication, boundary issues, or anything that made Mom uncomfortable. With a private hire, you are the one doing the dumping. Write down what happened, pay every hour owed through the last day worked, and keep the conversation brief and factual.

The menu may be short, but the standard is high: Mom should feel safe, respected, and well cared for in her own home.

Here’s last week’s results. Another quiz drops next week.

You said it. This week’s submissions.

"The forgetfulness is back... so hard not to lose my patience."

"Mom's friend in her new community has been a resource to me in caring for Mom."

"My sister asked if I saw the email from Dad about their estate planning documents and thanked me for talking to them about it."

"Mom has an Android, the rest of the family has an iPhone, and nobody can help her when there are issues."

"The humor/irony when my mom talks about how bad other drivers are and I'm sitting there gripping the door handle the whole time."