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Hiring in-home caregivers: are you prepared?

by Carol Bradley Bursack, Editor-in-Chief

For many people, the economy is still tough going. The high unemployment we are still facing adds desperation to a mix of people who may be good hearted - or not - but who are aware of the gaps between the need for in-home care for elders and the money to pay for it. Home caregivers need to be careful about who they hire to help them with their caregiving.

I've heard of several cases where families, desperate for some elder care help, have hired ""freelance"" caregivers without looking into backgrounds or qualifications of the workers. In some cases, the result has been satisfactory. In others, the result has been tragic. Is this a chance you'd be willing to take?

My friend's sister, Virginia, felt as though she was between the proverbial rock and a hard place. She had taken a leave of absence from her job as a bank employee to be with her father after he had a stroke. Her father improved enough not to need a nursing home, but he still needed substantial care. Yet, Virginia knew she'd eventually lose her job if she didn't soon return.

Considering her job was not highly paid, she was concerned that nearly everything she made would have to go to pay for someone to come to the home and look after her father. It was during this time that she came across Anna.

Anna was a big hearted woman in her mid-forties. She'd had a hard life, but claimed she had spent the last years caring for elders in their homes. She produced some glowing references, so Virginia decided to give Anna a chance.

So far, so good. Anna is a great match with Virginia's father. They enjoy each other's company and Anna seems to be giving great care. Such good news, however, is not always the case.

Danger Disguised as Love

Marian, a different caregiver needing support, sent me an e-mail telling me her sad story. She wondered if I could alert other caregivers to the danger of being too trusting when hiring someone to care for a vulnerable elder.

Marian's story began during a stressful time when her mother's Alzheimer's seemed to be worsening, yet her mother refused to move to assisted living. Marian wasn't in a position to care for her mother daily, and money was tight. She put an ad in the newspaper stating that she wanted a part-time caregiver for her mother, who had dementia. She got several applicants, but one was particularly promising.

The woman, named Margaret, was in her late thirties. Like Anna, Margaret had a list of glowing references. Margaret said she'd worked in several private homes, and at one time had worked in a nursing home. She was neat, attractive and had a vibrant personality. She seemed to love elders. Marian hired her. She felt comfortable going off to her job as a sales clerk, thinking she'd found a great match for her mom.

At first it seemed she had. Marian's mother, who was developing the paranoia that often accompanies Alzheimer's, actually liked Margaret. Marian observed them as they did things together, and Marian was impressed. Margaret could even coax her mother into eating well.

Gradually, however, it became apparent that Marian's mother was losing possessions. When Marian looked for her grandmother's diamond pendant, she couldn't find it, and neither could her mother. Before too long, other random things disappeared. Then, one day, Margaret didn't show up for work. Marian left her job to run to her mother's aid. Margaret hadn't called, so there was no warning. The woman seemed to have just disappeared.

Within days, notices from her mother's bank were arriving, stating overdrafts. Since Marian did most of her mother's banking, she was surprised, yet she still felt maybe her mother had written checks and forgotten. Then she began to get calls from her mother's credit card companies - companies that held cards her mother hadn't used for months. The situation slowly clarified. Marian's mother was the victim of theft and perhaps worse, identity theft.

When the police were brought in on the case, they were unable to trace Margaret under the name she was using in this case, however through investigation, they were able to find a pattern that appeared to show Margaret was a serial offender, yet to be caught. This charming, ""caring"" woman was a crook on the run.

It cost Marian and her mother a lot of money, time and misery to get this mess straightened out. However, Marian was grateful that Margaret only took money. She could have done worse. She could have been physically abusive, as well. Lesson learned the hard way. Marian decided an in-home agency with licensed, bonded workers, who had been thoroughly and professionally background checked, was the smart way to go. She now hires a nationally franchised in-home care agency and is very pleased with the care.

Not All Independent Caregivers Are Bad

I want to stress that not all independent caregivers are a bad choice. In the article, ""Should You Employ a Private Caregiver?"" I discuss some of the pitfalls of becoming an employer (because that is what you are). Since writing that first article, I have become even more adamant about the fact that while independents can be wonderful people and employees, you, the employer, need to be very certain you know all about the person you hire, as well as legal implications should that person get hurt on the job, or have another issue. You need to know how to do a complete background check. You need to know how to check references and determine if they are real or trumped up, and you need to know in your heart if this is a real caregiver or a sham.

If you feel you've done all your homework and the right person happens to be independent, go for it. However, if you are not sure, hire a respected agency. If you don't like one particular agency worker, you can ask for another. If the agency caregiver gets sick, there should be backup. Consider it all, and then do what is right for you and your elder. Most of us need outside help somewhere along the way. We just need to make sure it's the best help we can find.