Hiring a home health aide to provide care for an elderly family member may do more harm than good, according to a new study that finds agencies in many states place unqualified caregivers – including some with criminal records – in homes of vulnerable seniors.
The national study, by Northwestern University researchers, has found some agencies recruit random strangers from Craigslist to care for older people with dementia. Some don't do national criminal background checks or drug testing, fudge the qualifications of caregivers and don't require any experience or provide training.
"People have a false sense of security when they hire a caregiver from an agency," said lead researcher Dr. Lee Lindquist, associate professor of medicine at Northwestern University Feinberg School of Medicine and a physician at Northwestern Memorial Hospital. "There are good agencies out there, but there are plenty of bad ones and consumers need to be aware that they may not be getting the safe, qualified caregiver they expect. It's dangerous for the elderly patient who may be cognitively impaired."
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For the study, published in the Journal of American Geriatrics Society, researchers posed as consumers and surveyed 180 agencies around the country about their hiring methods, screening measures, training practices, skill competencies assessments and supervision. They found only 55 percent did a federal background check, just one-third performed drug testing, and one-third tested for caregiver skill competency.
Based on their findings, the researchers recommend 10 questions to ask an agency prior to hiring a paid caregiver:
1. How do you recruit caregivers, and what are your hiring requirements?
2. What types of screenings (background checks, drug tests) are performed on caregivers you hire?
3. Are they certified in CPR or do they have any health-related training?
4. Are the caregivers insured and bonded?
5. What skills are expected of the caregiver you send to the home?
6. How do you assess what the caregiver is capable of doing?
7. Will you provide a substitute if a regular caregiver cannot provide the contracted services?
8. If there is dissatisfaction with a particular caregiver, will a substitute be provided?
9. Does the agency provide a supervisor to evaluate the quality of home care on a regular basis?
10. Does supervision occur over the telephone, through progress reports or in-person at the home of the older adult?
This study was funded by the National Institutes of Health.