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Within the first hour of working for his mom, she had inquired how much she was paying for the service, disclosed what she was being paid, and proposed that they dispose with using the agency entirely. I have tried to express to my boyfriend and his mom that not only is this unethical behavior, but that it could be a scam as well. His mom says that she won't break her contract with the agency, but she might give housekeeping and other work to the caregiver in question. I would appreciate input. This woman said she was going to be having a meeting with another family tomorrow concerning doing the same thing. Advice is appreciated. Thank you.

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Wow is all I can say. While it may not be illegal to the law, I'm sure that this woman has a contract with the agency to guard against something like this. If she is being sneaky with her employer, then I might have to wonder what she would be like caring for my loved one. Once a sneak always a sneak. It would absolutely bother me for someone to do this while working for someone elses company. I think I would have to inform the agency because I, for one, could not trust her with my loved one. Good luck
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I work for a non-profit community service organization that, among many other sevices to seniors, operates a home health agency...and I am also a client, as they provide aides for my mother.
As part of the hiring process of each home health worker, they thoroughly check out the person's background (both employment and criminal); evaluate the candidate's suitability for in-home work; train and orient the new employee on-job with supervisors and experienced workers; and then continually assess performance of the employee. In addition, they handle all the responsibility of finding and scheduling clients and assuring payment for services is made; they mak proper payroll deductions for taxes and other required fees, liability insurance, and handle all the other legal requirements of an employer (which the client in this case would be responsible for). So they take care of many expensive and time-consuming tasks for the client, in addition to provision of care...it's not all profit.
This worker is almost certainly violating terms of her employment contract, and exhibiting a character trait that I would not want in anyone caring for my family...she is dangerous.
Inform the agency of her proposal, and demand that she not return.
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If it sounds too good to be true it probably is. Also. the agency has insurance to cover problems if they occur, she doesn't. You could complain to the agency if there is a problem, no one to complain to if she is hired. Do you really want someone who sounds like she has a problem with loyalty to work for you? I would go to the agency and tell them what she said.
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Unethical at the very least. Against her contract for sure. I think Mom should call the agency and ask for a different caregiver to be assigned.

The worker is scamming the agency. She is only trying to use it to obtain private clients. If she wants private clients she can post her name on local bulletin boards and advertise in local papers. If she doesn't want to work for an agency she shouldn't get herself into people's homes on false pretenses.
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I understand why many aides do this, doesn't make it right... they are paid poorly, but should not use the agency to 'network'..... I simply put an ad in the paper, I have excellent references and because I live in small community, everyone knows everyone, so rarely are the references checked... and yes I make more money... but I am also responsible for my own taxes, ect...
But I do agree with all that said to call the agencey asap, and report her, this is blantan disrepect of the client if nothing else.....
No disresecpt intended to the person that posted about his/her agency, but it's like many nursing homes... some are wonderful, some are not...
It is just one more way our elders are falling thru the cracks, no legislation to protect the aide or the agency, or the client....
Hope you find someone trustworthy and compassionate to help, and sorry you are far away , that makes it even harder....
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Everything 2much said is true... this is why I am an independant caregiver... I refuse to let an agecny get more money as I work my butt off for min. wage... and to say again, there are very good ones out there, don't know if you could call the Better Business Bureu to see if they have had complaints first, then check into them... unfortuntley our elders are paying for this 'lack of care' and it is so difficult when a family really needs this extra care for a loved one.... seems much of our medical services now a days is a business as compared to acutal care... I walked off the floor and quit in the middle of a shift in a NH simply because of the treatment a resident was getting by an LVN, because she wanted a drink of water... and I turned them in..... it's a sad and frightening situation for our elders...
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In an ideal world you can talk "ethics" but the reality in the home heath care business, the agency has the advantage. There are more aides out there wanting work then there is work. So they get low pay, no beneftis, endure wear and tear on their cars, pay high gas which in not covered when the agency sends them from one end of town to the other for 3-4 hour jobs. And the client is losing also, untrained or poorly trained aides, some with no experience just sent out to fill a spot (and this is from my personal experience) aides working more hours than they should to make ends meet which results in your mother getting tired worn out aides who when they can do take advantage to make their phones calls, relax, etc. In my opinion, unless an agency is going to pay a decent wage, offer benefits and pay for background and health checks, then maybe they should only be acting as a placement agency where the client pays a fee and then after satisfied with an aide sent by the agency, from then on all hourly pay goes to the aide not the agency. If it does work out then for that fee paid by the client, they can find them another aide and start the process over again. I'd love to hear the other side from any home health agency out there. But based on my observations, this is what is happening. I suggest everyone call their aide's agency and find out whether the aide is considerent an independent worker, whether if injured or if they cause injury or theft, is the agency insured to reimburse the client, ask them who pays for background checks and medical certs and how often. Ask if agency pay mileage, vacations, sick leave. You might not want to hear the answers.
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LindahernerOT, I appreciate your input re home health aides since it serves as a good warning, but I have to say I've experienced issues with in home independent physical therapists. Like staying for about 15 minutes but charging medicare for a whole hour (and not b/c the client couldn't take any more) doing the same routine in bed exercises instead of making an effort to get the client out of the bed, cancelling appointments at the last minute (some excuses: I had to go to the other end of town to do an assessment on a new client) . Billing for visits that did not take place. Dropping clients when their scheduled vacations come up or it becomes too inconvenient to travel to that location based on their other client's locations. And if they do these things while I am around checking, what do they do when the elderly client is alone? It is very depressing to learn all this about the elder care business. Maybe this should have been a separate post but my point is, no one is watching over these agencies and people we entrust the care of our elders to and unless aides are treated fairly their problems will affect the care our elders receive.
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Cautious, Thank you for continuing to try to correct the system. i agree that's why i am joining groups that say they are working toward reforms, like National Consumer Voice for Quality Long-Term Care and the Family Caregiver Alliance. Because it is going to be worse when we start needing care. The problem with most caregivers is that we are usually too worn out during caregiving to fight the system. We need groups and elected officials to support us and the only way they will do that is if we group together.
Info about the groups i mentioned:
Founded in 1977, Family Caregiver Alliance was the first community-based nonprofit organization in the country to address the needs of families and friends providing long-term care at home. Long recognized as a pioneer in health services, FCA now offers programs at national, state and local levels to support and sustain caregivers.

The National Consumer Voice for Quality Long-Term Care was formed as NCCNHR (National Citizens' Coalition for Nursing Home Reform) in 1975 because of public concern about substandard care in nursing homes. The Consumer Voice is the outgrowth of work first achieved by advocates working for Ralph Nader and later for the National Gray Panthers.
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2much2cover, your screen name is perfect! There are so many things to say in the world of poor senior care, how sad. You are quite right that the problem is not limited to Aides. I rarely have agreed to work in Home Health because of the therapists and nurses, and their abuse of the system, and my fear of having to report them. I can say that the regulations are much tighter now, and client signature captures are required by the feds to prove that someone actually was IN the home. But they do cut visits way too short, and the other things you mentioned. From the therapist and nurse (and Aide side), I can say that, on a day when one has six patients scheduled and 40 minutes of unpaid drive time, plus extra and excessive required charting requirements between each one, it leaves very little time for actual patient care. The professionals are often painfully aware of their substandard services, and the only option is to see the patient longer times, then make up the difference on their own time (I spend two hours unpaid for every paid hour of patient care, but I do give each person a full hour). It is again the large corporations that own and run Home Health (a matter of business news, if you follow it, ugh) that create the need for unethical and substandard behavior while maximizing their profits. No wonder they have the worst turn-over rates in the health industry. It's not an excuse for doing ANY of the things you mentioned, though, and those should be reported also. I am always thrilled when a family member is able to show up, or even call me or return my call to discuss how treatment went. I can always be held accountable and discuss goals and progress. Clients should expect NO LESS. Being an independent contractor (along with jobs as therapy diretor, running my own therapy business, teaching, etc, over 26 years), I have set a high standard to assure that myself and others stayed busy and in demand. But I've witnessed some other things that gave therapy a bad name. Report those things, please, always. If you actually saw a situation where a visit was billed and did NOT occur, that is Medicare fraud and as bad as it gets. Therapist will get fined and suspended (which is why licensure helps, easy to punish and mean it). The only way to fix this mess, and all the bad apples involved, is to police it! Thanks for your input - therapists are no angels either!
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