For anyone with aging parents, the question of getting help for your elders is likely to come up eventually. At some point, most families want to find someone to help a parent or grandparent remain safely at home. The effort to get a caregiver often starts out casually. You ask around. Someone refers you to a relative or friend of someone giving help to an elder. For aging parents who don’t resist, this leads to hiring an individual to show up at least a few hours every week to do chores or help your loved one.
It all may sound fine and it may work. For others, wanting a more formal approach with payroll taxes paid and agency oversight, the hiring is done through a “non-medical” home care agency. This means that someone has at least done a background check on the caregiver, and in other instances, the caregiver has actually had some training by the agency. Again it all may sound fine. It may appear to work. But here are some facts to be aware of:
- Caregivers are the second most common abusers of elders, behind only opportunistic family members. Stealing is easy when no one is watching.
- Unsupervised caregivers, hired casually, are frequently accountable to no one other than an impaired elder. Even when hired by an agency, supervision of their work may be infrequent, inadequate and require no daily accountability.
Let’s look at a typical hiring and typical work for a caregiver in an elder’s home. Imagine that the elder is a frail and forgetful female with a responsible daughter who lives at a distance. Help was needed because of that very frailty in the first place. The daughter gets a good impression of the prospect and the worker is hired to come in three days a week to help with bathing, cooking, shopping and laundry. The mom’s memory worsens over time and she forgets who is coming, and even what the worker is doing there. The daughter, busy with her own life, only sees that the bills are paid. She has no idea about the quality of work being done. She never asks. The caregiver does a few chores and then spends her time on her cell phone, social media, and watching the elder’s TV while the elder naps. That is, simply put, a ripoff. Getting paid for not working isn’t the idea here but it happens in too many unsupervised places.
What you can do to prevent this:
- Vet your aging parent’s caregiver or caregiver agency carefully. Ask questions about how they keep track of what is being done for your loved one. If there is no answer, ask them to create or use a form, checklist, or notetaking means that you can view from wherever you are. (In my own work, I create these forms so that families can log into a google doc or spreadsheet and see what’s up). This allows you, the responsible family member to ensure that your aging parent is getting what they are paying for.
- Never expect that an impaired elder is going to be able to adequately supervise a home care worker. By impaired I refer to memory loss, confusion, dementia, or other cognitive decline from anything. Someone else should be watching over what is happening with the worker.
- With any agency, you may hear that the caregivers are “not sophisticated with technology” or “we don’t do that” when you ask that they keep account of what they are getting paid to do. If they don’t have the means to set up record keeping remotely, you can do this for them. If it’s not your skill set, ask a tech-savvy person in your family to assist. Even middle school-aged kids are often able to do this easily. Create a form for daily note keeping and insist that the caregivers use it.
- If any person or agency you use for caregiving refuses to keep track of tasks and be accountable to you or the responsible person in your family, consider it a red flag. We find that in offering the record keeping form to a cooperative agency, the supervisor of the “not tech-savvy” worker will fill it out and help you keep track of what is happening.
MORE FOR YOU
The safety of aging parents and other loved ones can be better ensured when their caregivers are required to record what they are doing each visit. Don’t accept paper caregiver notes in a book you can’t see when you don’t live there. There is no doubt that workers do better work when they know they are being watched.