Adrianne Morris, 90, has been getting in-home care for the past decade.
“I’ve made a decision to die in my home,” she said. An aide comes to her apartment for a few hours every day. “She helps me do the laundry,” said Morris. “I have assistance with my shopping.”
But over the years, she’s learned that with the help, comes some risk. “My aide had access to all my PIN numbers because she did things for me,” said Morris.
In October of 2012, Morris discovered her bank account had been drained. Her non-certified, unregistered caregiver was charged with theft and forgery.
“I trusted her. I believed in her,” said Morris. “I loved her like a daughter. I knew all her family.”
Morris’s problems didn’t stop there. She said another aide tried to hide drugs in her house, and one stole her wedding dress that she hoped to be buried in. “It’s hard for me to trust people, you know. And I’m very careful,” she said. “I don’t let anyone go anywhere in my house. I’m afraid.”
“We have all heard these stories, but know they are the exception, not the rule. We know there are bad apples, but home care generally has a good track record, and it is improving. Home care is the most preferred method of long term care”, said Cathleen Carr, Executive Director of CertifiedCare, the PCA certification and registry company.
“We started CertifiedCare to help reduce elder abuse by giving PCAs the complete education they need for safe elder care. Having been a caregiver I know first hand how unprepared caregivers are for elder care, even the professional PCAs are clueless”, she said.
According to the Paraprofessional Healthcare Institute, the United States has more than 1.3 million direct care workers who provide hands on care to people who need it long term.
According to DHHS (Department of Health and Human Services), some home caregivers are Certified Nursing Assistants, or CNAs, who have to complete 180 hours of training and register with the state. They assist with a client’s care and treatment, under the supervision of a registered professional nurse.
Most, though are Personal Care Assistants, also known as Unlicensed Assistive Personnel, or UAPs. They show up to help with daily living tasks, like bathing, laundry and cooking and other activities of daily living.
“That is an area of home care where there’s less regulation because you don’t have the implications of medical licensing,” said Carr.
According to DHHS, UAPs in most states do not have to complete education or any type of training program. They do have to complete 2 hours of orientation if, and only if, they work for a personal care agency. They are not required to register with the state as individuals.
Even less regulated are aides hired privately by a consumer. The state doesn’t keep of track of them. Plus, the state can’t investigate complaints or have them removed for abuse, neglect or misappropriation of property. That responsibility falls to local law enforcement.
With more and more seniors choosing to stay at home instead of moving to nursing or assisted living facilities, there are important questions consumers need to ask before hiring in-home help.
You need to do your homework if you want to protect yourself”, said Dwayne Orsegeda, a law enforcement agent in New York. “CertifiedCare offers a 24/7 public registry of PCA / UAPs who have at least gotten comprehensive caregiver education and have been tested and certified by them”. He added, “Consumers are learning to ask that their PCA / UAP be certified and registered in a database like the one CertifiedCare has online”.
Because most PCAs are not certified and registered, Orsegeda says, since consumers are using an agency, or hiring on their own, there are questions they need to ask.
“It is easy to look up the company itself,” he said. “Are they registered with the state? What’s their track record with the Better Business Bureau? Are their PCAs / UAPs at least CertifiedCare certified? At least Google them and see if there are complaints.”
Next, he said, ask about drug testing and background checks. Under state law, all agencies are required to look at an applicant’s criminal history because certain convictions ban a person from doing direct care work. He also said that the increased use of Senior Care Auditors is helping people who live alone and otherwise have no one else to check on them AND their caregiver.
“The turnover can be high, and quite frankly, that’s another thing you want to ask when you’re looking at a home care company. ‘What’s the turnover?'” said Orsegeda. “I would say it’s not even unfair to ask, ‘What do you pay your people? Are you paying good wages?'”
Morris has a piece of advice, too. “They do not need to give access to their PIN numbers,” she said. “That’s a big thing.” She hopes the system will be improved before the baby boomers get to be her age. “People in this service are vulnerable,” said Morris.
Make sure your caregiver is tested and registered by CertifiedCare prior to hire or as a condition of continued employment.
CertifiedCare.org …where all types of caregivers for all types of elders benefit from complete elder care education.
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