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Formal vs. Informal Caregivers: How to Decide Who and When to Hire

A caregiver is any person who provides care to another. There are both formal and informal caregivers that fit this description. A formal caregiver is a professional that is paid for their work providing care. An informal caregiver, on the other hand, is typically unpaid for their work (at least, providing care is not their profession). Typically unpaid caregivers are members of the care recipient’s family or a close friend. This is why informal caregivers are also known as family caregivers. Commonly, informal and formal caregivers work in tandem to satisfy the needs of the care recipient. In this article, we will define the common roles of formal vs. informal caregivers.

The Role of Formal Caregivers

The role of a formal caregiver will vary depending on your loved one's needs and your needs as a caregiver. If there are tasks ‌you are struggling to handle yourself, or just would prefer not to have to handle, these are examples of things that you can delegate to paid caregivers. Here are some questions to ask yourself before you decide to hire a formal caregiver.

What services do you need the most help with?

You can try to write down all the tasks you manage on a weekly basis and organize it into a job description. This will help you ‌get a clear idea of who you’re looking to hire.

What services does the professional caregiver specialize in?

You can compare their experience and specialties to your job description to see if you and the prospective formal caregiver align.

How flexible is their schedule?

For example, will they work nights, weekends, holidays, on-call, etc? Make sure their availability aligns with your needs.

Are you hiring an agency or a specific person?

If you decide to hire an independent person, you take on the role of employer. If you decide to work with an agency, the costs will be higher but the obligations will be lower. You can find great care with either option, so it’s up to your ‌preference, but it’s good to understand the expectations upfront.

How will you pay for care?

Hiring a formal caregiver adds a significant expense. Many families cannot afford the added cost of formal caregivers. Unfortunately, Medicare doesn’t pay for custodial care only skilled care but there are options. First determine whether your loved one has Long Term Care Insurance and/or Veteran’s Benefits (Aid & Attendance or Housebound benefits). Another option is to evaluate whether your loved one qualifies for government programs (based on income/assets) such as In Home Support Services Program (must be Medi-Cal eligible).

Next, we will explore the role of informal caregivers and offer ideas to help you get paid for your efforts. It’s important to exhaust what exists in regards to formal and informal caregiving.

The Role of Informal Caregivers

As we touched on, informal caregivers are usually family or friends that provide care to a loved one in need. Just as it’s true that the role of a formal caregiver varies depending on your loved one's needs, your role as an informal caregiver will vary in the same way. There are many tasks you may need to manage, such as:

In-Home Daily Life Tasks

You could be tasked with basic needs care tasks that help your loved one maintain a sense of normalcy in the home. This would include things like:

  • Bathing

  • Dressing

  • Cooking

  • Feeding

  • Grooming

  • Caring for pets or plants in the home

  • Managing incontinence

  • Hydration

  • Etc.

Home Safety Tasks

There are also many home safety tasks that may escalate with time (if your loved one loses memory or mobility, for example). This would include things like:

  • Moving furniture downstairs

  • Adding lights to uneven or poorly lit walkways

  • Putting safety railing near toilets

  • Wheelchair-proofing a space

  • Adding safety or emergency shut off switches (to protect against leaving the stove on, for example)

  • Putting in alarms that alert when external doors open

  • Etc.

Transportation Tasks

You may need to assume driving responsibilities for your loved one, which may make you responsible for things like:

  • Running errands (groceries and pharmacies, for example)

  • Managing their social calendar of events

  • Chauffeuring them to and from doctor appointments

  • Etc.

Health and Wellness Tasks

Beyond managing basic necessities, you may also need to manage health and wellness tasks to keep up their health and fitness, such as:

  • Regular exercise

  • Eating a well-balanced diet

  • Getting time outdoors

  • Drinking enough water

  • Avoiding vices like alcohol and cigarettes

  • Etc.

Beyond these more definitive tasks, you will also become their patient advocate. This means things like maintaining a list of prescriptions, managing emergency plans, putting together a care plan, etc. may all fall on your shoulders.

Closing Thoughts: Formal vs. Informal Caregiving

Becoming an informal or family caregiver means a lot of extra work for little to no compensation. This work and commitment may take away from your actual paying job and add additional expenses you had not had before. You can delegate almost all tasks that you would handle as an informal caregiver to a formal caregiver if needed. The balance of care will be up to you.

For further reading and resources, we invite you to check out our library of information for family caregivers by clicking here. You are also welcome to call us at 800-543-8312 to find out more about how we can support you in your caregiving journey.


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