Avoiding the Dreaded Caregiver “Gray Area”

Caregivers are the heart and lifeblood of every home health agency; they are only as good as their caregivers.

Caregivers are the front line and the soul of your loved one’s care. They perform the vital daily visits, provide assistance for those with disabilities, provide the personal care, cooking, take their clients to doctor appointments, and make certain that the client takes their medication as ordered. They keep the house neat and clean. They are the ones that need to change their personality to fit with the client.

Caregivers come in all shapes and ability. But each one is expected to do their job with the highest effectiveness as they were trained and to be honest, compassionate and respectful at all times.

Reputable Business Practices
The agency that sends the caregiver has done a background check which includes fingerprinting. They check the ability of the caregiver, pay their salary, employment taxes, workman’s comp. and liability insurance, disability insurance and give the caregiver an orientation to each new case.

A good agency will check on their caregivers often to make certain that the plan of treatment is carried out as ordered. Caregivers make a positive difference in a person’s life. Allowing, the patient to stay at home and age in place.  This should be a very positive experience.

Why State Licensed Matters
A State licensed Home Health Agencies offers the added peace of mind and quality of licensed nurse oversight. The subtle nuances of aging may be missed by the caregiver. Still, they often have a concerned impression or an instinct that there has been a change in the client’s condition that they discuss with a licensed nurse.

The caregiver and the nurse will team together to ensure the best treatment of the client. It may be the caregiver who first notices a change. The nurse will provide oversight to check the client for changes by doing vital signs, checking their medications and discuss any concerns that come up with the client’s physician.

Hazards of the Gray Market
When a patient’s family and or a patient hire a private caregiver, this is known as the “the gray” market. Without background checks or state licensing, these caregivers may be less expensive and do a good job.

Agencies that employ caregivers are legally required to pay payroll taxes and workman’s comp insurance. Legally, independently contracted caregivers cannot follow a specific daily regimen. If they do, they do NOT qualify as an independent contractor. That means, when they are released from providing services for you, they may file for unemployment. When the government discovers that unemployment insurance was not paid, the person in charge of the patient’s money will face the unfortunate situation of paying payroll taxes, fines and interest and there was nothing saved.

The perceived savings of the gray market is often mitigated by a lower quality of care, reduced accountability and reliability, and expensive ramifications in business practices.

  1. When an independent caregiver does not show up for their job, due to sickness or any other reason, the patient is often left without notice and, even worse, without help. Whereas, an agency will provide a substitute whenever one is needed.
  2. When a patient gives her caregiver a signed blank check to go and buy groceries and two days later the caregiver comes back to the clients’ home after writing a check for $5,000 that was spent at the casino, taking recourse is costly and difficult. Whereas, agency caregivers are bonded and insured giving you and your loved one peace of mind.
  3. Caregivers may send substitutes to work; no one knows where they came from or their qualifications.
  4. When a problem comes up with a caregiver, the patient and their family are ill-equipped with how to handle it and are often too embarrassed to tell the authorities that they have been robbed, molested, ignored, and deserted.
  5. Is this person trained in fall prevention and safety? Can this person cook the types of food that meets their personal preferences and dietary or medical specifications? Agency’s reputations rely on the affirmative answer to even the most complex caregiver questions.

Care of the frail elderly is a difficult job and best done by qualified people. Families should be just that: family. They should be visiting, bringing the kids, and enjoying life with them and relying on professionals to care for their loved one.  Both you and your loved one deserve the peace of mind instead of the worry about who is in their home, what kind of job is being done, are they watching for broken bones, wet undergarments that are not changed, bed sores, unexplained weight loss, increased depression. No one wants their loved one sitting in a chair with dirty clothes on, smelling of urine.

Aging is not simple. But there are choices that can be made with confidence. It takes courage to go through the many changes that come with a loved one’s aging. It’s difficult enough to experience what they have to endure. Hiring the best qualified caregiver for your loved one won’t make the situation perfect, but it offers the peace of mind that everything possible is being done for their utmost well-being. Don’t we all want that?

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