A new report published in the Journal of the American Geriatrics Society found that many nursing staff agencies fail to perform background checks before recruiting people to be hired as in-home caregivers, often resulting in the selection of employees with no experience, not to mention histories of criminal activity, and drug and alcohol abuse. These factors may all contribute to elder abuse or nursing home abuse, the study concludes.
Dr. Lee Lindquist of Northwestern Memorial Hospital was the lead author on the study. To conduct the research, she surveyed 180 agencies that provided in-home caregivers for the elderly. Of those agencies, just a little over half of them conducted federally-approved criminal background checks and just one-third of them subjected employees to drug tests. The failure to perform drug checks was particularly concerning. "Considering that seniors often take pain medications, including narcotics, this is risky," she said. "Some of the paid caregivers may be illicit drug users and could easily use or steal the seniors' drugs to support their own habits."
The lack of experience is troubling, too. Lindquist recalls a situation she witnessed where an elderly patient was put in serious danger because of her caregivers' lack of experience. In that instance, the in-home aid for a 103-year-old woman was illiterate and often mixed up her own medications with those of her elderly charge, as she could not read the labels to distinguish between the two. "Some of the paid caregivers are so unqualified it's scary and really puts the senior at risk," Lindquist concluded.
Lack of Federal Laws Makes Regulation Difficult
Part of the problem is the fact that no federal laws regulate referral agencies for nursing homes, so anyone can set one up and recommend poorly qualified candidates, all while charging a substantial fee for the "service." In the absence of accountability to legal authorities, Lindquist recommends that those looking for caregivers pay careful attention and request to know the qualifications of any caregiver obtained through a referral service.
Other experts in elderly care recommend becoming your own personal regulatory agency, complete with drop-in visits. Beth Kallmyer, vice president of constituent services at the Alzheimer's Association recommends coming over—un-announced—to check in on an elderly loved one. "Drop in and see how it's going," she says. "These unannounced visits are a really good way to help people feel more comfortable about what's going on."
How to Pick a Qualified Home Caregiver Agency
Finding the right agency to set up your elderly loved one with a caregiver can be challenging. As mentioned above, the minimal regulations in this area open the door for unqualified individuals to step in and manipulate the vulnerability of seniors in need of caregivers. That’s why it is important for you to ensure your elderly loved one has a caregiver they—and you—can fully trust to provide care.
The questions below, courtesy of the Caregiver Partnership, can help you do just that:
- Do they have a state business license?
- Do they carry worker's compensation insurance?
- Do they have professional liability insurance?
- Do they have fidelity bond insurance (in case a caregiver steals something)?
- Have the performed criminal background checks on their employees?
- Can they be reached around the clock in case of an emergency?
- Do they have a supervision plan for their employees?
- How do they prepare care plans?
- How do they train their caregivers?
- Do they have any recommendations or references they can share?
When you meet with a caregiver or their referral agency, make sure to meticulously go through each of these questions. If you don’t like an answer they provided, or they simply can’t answer the question, that should be a red flag. Caregivers and agencies should be organized, prepared, and qualified to take care of elderly individuals, especially when complicated medication or physical needs are involved.
Don’t hesitate to investigate the qualifications and performance of a caregiver. This can help prevent nursing home abuse, elder abuse, or other issues.