10 Questons to Ask Before Hiring a Caregiver

A troubling new national study finds many agencies recruit random strangers off Craigslist and place them in the homes of vulnerable elderly people with dementia, don’t do national criminal background checks or drug testing, lie about testing the qualifications of caregivers and don’t require any experience or provide real training.

The study conducted by Lee Lindquist, M.D., an associate professor of medicine at Northwestern University Feinberg School of Medicine, was published in the July 13 issue of the Journal of American Geriatrics Society.

For the study, researchers posed as consumers and surveyed 180 agencies around the country about their hiring methods, screening measures, training practices, skill competencies assessments and supervision. Without a federal background check someone could move from Pennsylania to Ohio and could have been convicted of abusing an elder adult or theft or rape and the agency would never know.

The following highlights some of the study's findings:

1. Only 55 percent of the agencies did a federal background check.
2. Only one-third of agencies interviewed said they did drug testing.
3. Few agencies (only one-third) test for caregiver skill competency. A common method of assessing skill competencies was “client feedback,” which was explained as expecting the senior or family member to alert the agency that their caregiver was doing a skill incorrectly.
4. Inconsistent supervision of the caregiver.

Agencies should send a supervisor to do a home visit to check on the caregivers more frequently initially and then at least once a month. But this only occurred with 30 percent of the agencies.
“Amazingly, some agencies considered supervision to be asking the caregiver how things were going over the phone or when the employee stopped in to get their paycheck,” Lindquist said.

With seniors wishing to remain in their own homes, paid caregivers fill an important role. “The public should demand higher standards, but in the short term, seniors and their families need to be aware what explicitly to look for when hiring a paid caregiver through an agency,” Lindquist said.

10 QUESTIONS TO ASK BEFORE HIRING A CAREGIVER

•  How do you recruit caregivers, and what are your hiring requirements?
• What types of screenings are performed on caregivers before you hire them? Criminal background check—federal or state? Drug screening? Other?
• Are they certified in CPR or do they have any health-related training?
• Are the caregivers insured and bonded through your agency?
• What competencies are expected of the caregiver you send to the home? (These could include lifting and transfers, homemaking skills, personal care skills such as bathing, dressing, toileting, training in behavioral management and cognitive support.)
• How do you assess what the caregiver is capable of doing?
• What is your policy on providing a substitute caregiver if a regular caregiver cannot provide the contracted services?
• If there is dissatisfaction with a particular caregiver, will a substitute be provided?
• Does the agency provide a supervisor to evaluate the quality of home care on a regular basis? How frequently?
• Does supervision occur over the telephone, through progress reports or in-person at the home of the older adult?

Remember an educated consumer is generally a satisfied consumer.