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Don't Hire a Caregiver Until You Read This!
You finally made the decision to hire a caregiver from an agency rather than the classified ads or Craigslist. You did this because you assumed that agencies screen, perform background checks, drug test caregivers, ensure citizenship and train their caregivers to perform the necessary tasks needed to be a caregiver, including receiving a certification in First Aid and CPR.
Well…think again! A new study (published in the Journal of American Geriatrics Society, July 13, 2012 issue), led by Dr. Lee Lindquist of Northwestern University Feinberg School of Medicine finds that nearly half of the agencies that send caregivers to help seniors in need do a poor job of screening, testing and training the caregivers they hire. The study reveals that many agencies recruit random strangers off Craigslist and place them in the homes of elders suffering from dementia, or long-term illness. The findings are disturbing to say the least.
According to Dr. Lindquist, a geriatrician, “Some of the paid caregivers are so unqualified it’s scary and really puts the senior at risk.”
Northwestern researchers posed as consumers and surveyed 180 agencies around the country. Their findings are pretty astounding:
• Only 55% of the agencies did a federal background check and many agencies didn’t check for any type of criminal record.
• Only 1/3 of the agencies did any type of drug testing. That means that paid caregivers who might have a drug problem have access to a senior’s medications.
• Only one in three agencies test their caregivers’ skills or do any kind of home visit to check on performance. (So much for CPR and First Aid competency)
• Two-thirds of the agencies advertise that their caregivers could assist with financial transactions, such as bill paying.
• And sadly, many agencies appeared to lie about their screening practices by making up assessments that do not even exist.
You might be wondering how this happens? Simply put: it’s because caregiving agencies are not regulated. The typical caregiver is a female immigrant earning $7.25 per hour on average and $5.44 per hour for live-in work. It’s a dreadful situation.
When you are interviewing a caregiving agency ask the following 10 questions. If they balk at any of your questions, move on!
1. How do you recruit caregivers, and what are your hiring requirements?
2. What types of screenings are performed on caregivers before you hire them? A federal or state criminal background check? Drug screening? Other? (Record the answers and research to make sure these screenings are authentic.)
3. Are caregivers certified in CPR or do they have any health-related training? (Ask for physical proof.)
4. Are the caregivers insured and bonded through your agency? (Ask for physical proof.)
5. What competencies are expected of the caregiver? (These could include lifting and transfers, homemaking skills and personal care skills such as bathing, dressing, toileting and training in behavioral management. This person is going to take care of your loved one. You must be on top of this process. )
6. How does the agency assess what the caregiver is capable of doing? (Make sure the agency is not just relying on the caregiver’s word that they have certain skills.)
7. What is the policy on providing a substitute caregiver if a regular caregiver cannot provide the contracted services?
8. If there is dissatisfaction with a particular caregiver, will a substitute be provided and may I interview this person in advance?
9. Does the agency provide a supervisor to evaluate the quality of home care on a regular basis? How frequently?
10. Does supervision occur over the telephone, through progress reports or in-person at the home of the older adult? (I always recommend that families make sure that the caregiver writes an hourly report and keeps track of all phone calls or door-to-door solicitors.)
This is a scary report, but the good news is that it has received a huge amount of media attention and now agencies are on notice. They will have to change their ways or go out of business. As a consumer you must be an absolute Empowered Advocate on behalf of your loved one.
Don't be afraid to ask questions. Ask them where they had their training. They are not required to maintain a CPR certification, so if that is important to you, ask if theirs is current (it expires after 2yrs).
If you are going through an Agency, ask the Agency what kind of training they offer their aides. Often it revolves around Agency policies and procedures, as well as some continuing education kind of information to brush up their skill set. If you are going through a Registry, know that their employees are only 1099's and that they do not offer anything additional to their staff as far as training is concerned (in this case, YOU actually become the employer).
When I had someone taking care of my dad I had them vetted. I ran a background check on all of them. I also informed them I had Nanny cameras in every room except the bathrooms and pointed them out to the care giver-I also had ones that I didn't point out to cover the blind spots. When they used the bathroom they could close the door but when they gave my dad his bath the door was left open-I arranged the camera to take video from down the hall for his privacy...the only thing one would see would be abuse such as hitting. This may sound extreme but I have had more than one prosecuted and several fired for sleeping in the blind spots. These cameras cost a little over a hundred dollars for two; I had twelve in all. Just as I had to provide identification for myself and my dad I required identification from his care givers. What is good for the goose is good for the gander. On the background checks I found thieves, a few with public intoxication records, one child abuser, one ex convict, child neglect and shoplifters. I paid an on-line agency to run the persons criminal history only and at 40 dollars a year it was well worth it. I always told the person I would check them out. So people, please don't trust the agency. Most are reputable but some may not be. Sometimes the agencies are short handed and will hire just about anyone. I have hired people who were honest with me when I asked the question have you ever been arrested and I have fired people who were nurses moonlighting and couldn't stay awake while doing their job for me; which was caring for my dad.
At times you get a retired nurse or a nursing student as part time worker. The agency rep comes and assesses the care that will be given and matches the caregiver with the aid. I also have come across agencies that requires a sequirity deposit. Stay away from those. I found an agency that requires no contracts that are 20 pages long. Keep a log of your hrs and a calendar and payments.
Hope this was helpful.
Equinox