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How Seniors & Family Members Can Avoid Risks When Hiring
Outside Help
This summer a Wall Street Journal article titled "Cases of Abuse by Home Aides Draw Scrutiny" discussed the increase in instances of senior abuse by hired caregivers. In the most extreme instance it cited, an 85-year-old California woman, the survivor of three heart attacks, was killed and her home ransacked by an aide who had a prior criminal record. Closer to home, the Winchester Star this year reported the arrest of a caregiver working for a local nursing agency on two outstanding warrants for larceny over $250 and for driving with a suspended license.
Incidents like these highlight the risks that can arise when bringing outside caregivers into the home. Many people decide to hire through a reputable agency, relying on their screening of candidates to reduce the chance of problems. This can work well and can also provide two additional reductions to risk: if you're contractual relationship is with the agency rather than with the individual, the agency usually handles any issues of worker's compensation in case of an accident to the caregiver, and the over all liability situation is improved when a caregiver is bonded through the agency. But it's still important to understand how an agency screens and monitors its employees.
Here are some questions to ask:
1) Are caregivers fully screened? How?
2) How many references are checked?
3) Are criminal background checks done?
4) Are the caregivers bonded?
5) Are any necessary licenses current?
6) Are the caregivers covered by general liability and professional liability insurance?
7) Are the caregivers covered by worker's compensation insurance?
8) Do your caregivers receive ongoing training? Please describe the training.
9) Does the agency have a quality control program? Please describe it.
10) How are caregivers supervised?
11) If I become unhappy with my caregiver, can I change?
12) Is there a 24-hour help line for reporting any problems?
One of the most critical reviews done by an agency is the criminal background check. Criminal background checks, even in the age of computers, are not as simple as one might think, and this, again, is where an agency can usually give you the benefit of access and experience. There is no single nationwide database to check, and, for privacy reasons, most of the sources that are available require that a person be authorized to use them. Two types of checks are especially common: a CORI check (Criminal Offender Records Information) which in Massachusetts accesses a state-wide database, and a "skip trace" provides seven years worth of addresses, helpful in verifying details on a resume. One common complication is that if the candidate being screened has lived in other states, sometimes records are available only at the county level, and each prior address may require a separate search.
While exercising caution about caregivers, also remember that there are others who may visit the home on a regular basis: cleaning people, lawn and landscape service people, builders, etc. A Better Business Bureau check can inform you as to whether there have been reports of any problems with any of these companies in the past. In addition to visits from people you know, at any time the door may be opened to a delivery person, or to some other unexpected caller. Especially if the senior involved is showing signs of diminishing awareness and lessening of judgment, steps can be taken to reduce the chances of theft in all instances:
1) Don't leave cash or jewelry out and visible. Avoid leaving a purse near the door.
2) File bank and credit card statements and other confidential documents in a secure place.
3) Consider setting up a separate smaller checking account and/or a credit card with a lower spending limit for shopping that is done with the caregiver involved.
4) Monitor overall spending each month to detect any problems.
The best protection against physical or mental abuse by a caregiver is the
close involvement of another trusted person such as a child or a good friend. This person can drop in occasionally, unannounced. Does everyone seem happy? Is there any tension in the atmosphere? Unexplained bruises, unusual fearfulness, nervousness, or an unwillingness to talk about the caregiver may be signs that something is wrong. If an agency is involved, they should be very willing to address such concerns and make sure that everything is resolved.
There are many warm and wonderful people working as caregivers for seniors. That said, it's still always wise to treat the situation as you would any hiring relationship. Don't hesitate to ask questions at the beginning or at any time thereafter, trust your instincts, take action if you feel uncomfortable about something, and stay on the alert for problems since situations can change. No one can be 100% secure all the time, but understanding, vigilance, and common sense will help ensure a safe relationship with those you hire.
Jack Cross is President of Home Instead Senior Care Lexington a provider of companionship and home care for the elderly. He can be reached at 781-402-0060, jack.cross@homeinstead.com.
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