Abigail assumed she had everything under control. Her elderly mother was beginning to get confused and she feared that it was an early sign of dementia. Or worse – Alzheimer’s! But she wasn’t ready – or willing — to put this fiercely independent woman, who still insisted on living alone, in either a nursing home or a long-term care facility. So she did the next best thing. She hired an aide to take care of her during the day.
Abigail had asked the doorman in her building for suggestions, and ended up with a woman who was extremely reliable – or so she had thought! Late one night, she dropped by her mother’s apartment, concerned that she hadn’t answered her phone all evening. Turns out her mother was in bed, fast asleep. All was well. That is, until she heard a rustling in the walk-in hall closet. She opened the door and found, to her astonishment, a woman hiding behind the coats, wearing pajamas.
When she demanded to know what this stranger was doing there, she sheepishly replied: “Well, my cousin is the day caregiver, and when I told her I was evicted from my apartment, she suggested I just spend the nights on your mother’s couch!”
A squatter? In a luxury high-rise in Manhattan? Seriously! Not only did that account for the high food bills, but when Abigail went to check that everything was in its place, she also discovered that the “cousins” had helped themselves to, among other items, a healthy portion of her mother’s antique jewelry, as well as her Chanel handbag and Dior scarf.
Alas, this is not an isolated case. Far from it! Indeed, the in-home healthcare workers industry has been facing a considerable amount of apparently well-deserved negative publicity. One of the most shocking cases happened just two months ago in Detroit. An aide was supposed to be caring for an 80-year-old woman with dementia. Instead, she was only taking care of herself, allegedly stealing more than $1.5 million from the family that hired her. Not only was the caregiver severely neglecting her client, there was even an outstanding warrant for her arrest – issued well before she got the job.
How can this happen?
“It shouldn’t,” says Kurt Kazanowski, the founder of Homewatch CareGivers and a health care executive with more than three decades of experience. “This horrifying story demonstrates how vulnerable the elderly can be and how naïve some families are when hiring a caregiver or home care agency.”
Kazanowski says that, in general, the home healthcare industry is full of dedicated professionals who truly love what they do and are making a difference for those for whom they provide care. “It’s a classic case of a few bad apples giving the entire industry a bad reputation.”
According to him, consumers can take some simple measures when hiring an in-home healthcare worker. The following are some important points he suggests to keep in mind before you do:
In the Detroit case, the agency failed to complete a background check on its employee. And one background check before the worker is hired isn’t enough. Employers should perform complete background checks every six months, and these should include a motor vehicle background review – something that some don’t include. “Unfortunately, good people turn bad, and bad people can only hide for so long. That’s why ongoing background checks are essential,” Kazanowski says. “In addition to those, always speak to other families who your healthcare worker provided care for and get their feedback.”
Hiring an in-home healthcare worker is one of the most important decisions a family can make. Even if the aid comes highly recommended and has an impressive résumé, the match needs to feel like a good one to the family, and especially the patient. Kazanowski always tells people it’s like buying a car, only more important. “You wouldn’t automatically buy the first car you test drive, so why in the world would you settle on the first home healthcare company you come up with?”
Meet Ahead of Time
Once you settle on an agency with which you are comfortable, the next step is to insist on meeting with the person who you will be letting into your home to provide the care. The problem is most families just meet with an administrator or salesman from the company, not the actual healthcare provider. “This isn’t good enough,” Kazanowski insists, “Any reputable in-home healthcare agency will accommodate this request. And make sure to meet prior to the first day on the job in case any issues or concerns need to be addressed.”
Quality Assurance Checks
A reputable in-home healthcare agency will provide regular quality assurance checks or ‘spot visits’ to check on the caregiver and make sure all is well in the home. It ensures that your loved one is properly cared for, bathed frequently, takes medication as prescribed, and is living in a clean and healthy environment. These can be scheduled, or unscheduled, but they assure that the aides are following the appropriate care plan.
Status Reports and Point of Contact
Most caregivers and the families they serve develop a strong bond — the aide becomes like family. Sometimes you can address very minor issues directly with the worker. Still, a reputable in-home healthcare agency should provide you an easy-to-reach company contact to discuss any concerns. In addition, regular status reports should be made available by the company to the spouse or immediate family of the person receiving care.
“These status reports are like an update or a progress report on how the patient is doing, what can be improved on and addresses other concerns the healthcare worker has,” Kazanowski contends. “The reality is that most relationships are a great match, and very rarely do any surprises arise as part of these status updates. But they are a good way to document that the care plan is being followed.”
Finally, the most important piece of advice that Kazanowski gives his own clients is that family members must be involved and constantly keep tabs on what’s going on. “Keep an eye on credit card statements, checking and saving account balances and other important financial documents,” he says. “Have mail forwarded to the children of the elderly family member. Children should make unannounced visits to the home. And ask the home care worker to provide receipts if he or she does the grocery shopping or makes any purchases on behalf of your loved one.”
If Abigail had just followed her hunch that the food bills were too high, she might have caught the “squatter” and her partner in crime before they had a chance to walk out with the entire household!
“Since the need for in-home care will continue to be in demand, especially as the aging of America crests in 2030,” concludes Kazanowski, “the lesson here is that with some due diligence, it is very possible to find an in-home healthcare company that will provide excellent care and give you peace of mind while assuring that your loved ones are safe, secure and continue to have a sense of independence. “