Do you have an elderly loved one who would like to continue to live at home but can’t really attend to day-to-day functioning anymore?

Maybe he or she is memory-impaired or simply too frail to clean, dress and feed himself or herself.

That’s when many families turn to home health aides.

Problem solved!

Or is it?

A new study suggests that agencies that hire out home health aides are shockingly careless, and even unscrupulous, when it comes to choosing their employees—which means that you’re going to want to choose your aide very carefully.

AGENCIES ARE MORE LAX THAN YOU THINK

The report on home health aides, done by Lee A. Lindquist, MD, MPH, associate professor of medicine, general internal medicine and geriatrics at the Northwestern University Feinberg School of Medicine in Chicago and her colleagues, uncovered some disturbing facts.

Researchers posing as consumers contacted 180 caregiving agencies in seven states (Arizona, California, Colorado, Florida, Illinois, Indiana and Wisconsin). What they discovered…

  • 69% of the agencies said that they do not screen for illegal drug use before hiring caregivers.
  • 58% of agencies said that they assess skills just by asking applicants what they can do. Only 35% said that they follow up by actually testing the caregivers’ skills.
  • Just 15% of agencies said that they give on-site training or supervision while the aide is on the job at a patient’s home.
  • 38% said that they do not check job applicants’ references.

“Many caregiving agencies come across as professional, but a number of them are just trying to take advantage of consumers,” said Dr. Lindquist.

HOW IS THIS LEGAL?

You might be thinking, There ought to be a law. But there isn’t. Agencies that provide medical care are regulated and have to be licensed. Home health aides, however, aren’t supposed to provide medical care.

They may help with laundry, bathing, cooking and getting their clients in and out of bed…they may remind them to take their medications…but none of this is considered medical care. In terms of what sort of training is required, it varies from state to state, and the guidelines are loose. For example, in Illinois, an aide needs to have eight hours of training, but there are no guidelines that specify what the training should consist of, so it could entail reading a handbook over eight hours. Other states, on the other hand, require zero hours of training.

In fact, in the eyes of the law, as Dr. Lindquist puts it, home health aides are “like nannies or babysitters for seniors.”

The scary part is, with such careless screening, seniors are vulnerable to abuse, neglect and even financial fraud (some caregivers are given access to the client’s checkbook to pay bills for him or her).

QUESTIONS TO ASK

If you have a loved one in need of a home health aide, do your homework! Here are questions from Dr. Lindquist to ask the agency. If any agency refuses to answer a question (or dances around it), go to another one…

  • How do you evaluate a candidate’s skills before hiring him or her? The agency should tell you in detail how it tests each candidate’s skills. If the agency doesn’t do any testing whatsoever, don’t use the agency.
  • How do you supervise? Does someone come out to the house to actually watch the caregiver perform? The agency should provide home supervision at least once a month. If it doesn’t, don’t use the agency.
  • If a caregiver is unable to come on a given date, do you send a replacement? The answer should be “yes.” If it isn’t, don’t use the agency.
  • May I please see references for each candidate? If the agency doesn’t have any, don’t use the agency. If the agency provides them, read them carefully before choosing one (or, ideally, a few) candidates to interview, so you can weed out anyone who seems inexperienced or untrustworthy.
  • Do you do federal and state criminal background checks and drug screening? If the agency doesn’t, then don’t use the agency. If the agency does, insist on seeing the reports.

PROTECT YOUR LOVED ONE

Once you’ve hired a home health aide, drop by occasionally for surprise visits to evaluate him or her, said Dr. Lindquist. Is your loved one still in bed at 2:00 pm? Has your loved one showered? Eaten breakfast and lunch? Taken the correct dosages of the correct medications? You might even want to go through credit card bills and checkbooks to make sure that the bills are paid and that there are no missing checks or unusual payments with the credit card. These drop-ins are extra important when your loved one is mentally incapacitated, since he or she may not be able to explain to you later what went wrong.