Elderly people who want to avoid nursing homes often employ in-home aids to help meet their day-to-day needs. However, in many cases, the in-home aid industry is unregulated, and advocates for the elderly say that this situation has led to a growing number of cases of elder abuse, neglect or fraud in which home caregivers take advantage of the elderly.
A district attorney in San Diego County, Calif. told The Wall Street Journal that he prosecuted at least 25 home caregivers in the past year, mostly for stealing from elderly clients. Another, from Lake County, Calif., told the Journal that about 80 percent of his office’s 74 prosecutions of elder abuse in the past year involved home aides.
In-home care has been touted as a way to keep older people happier and healthier, and at a lower cost, than they would be in a nursing home. According to The Wall Street Journal, it costs Medicaid program about $6,000 per person per year for home care, versus about $20,000 for care in a nursing home. About 1.6 million people are employed in home care, split about equally between those who provide basic health services, and those who provide housekeeping, cooking and nonmedical help.
Of the two types of aids, health aids are often certified nursing assistants who face licensing requirements and other regulations. However, most in-home elder abuse cases involve non-medical aids, who require no special licensing, and are loosely regulated.
According to The Wall Street Journal, in California, Florida, Connecticut and at least 19 other states, nonmedical aides don’t have to be licensed or pass a criminal background check to get a job. In other states where employment agencies are required to do some type of checks, applicants with criminal records can slip through the cracks, some research has found.
The problem goes deep. A recent study sponsored by the Centers for Medicare & Medicaid Services conducted at Michigan State University screened 214,167 people who held or sought jobs working with the elderly, including home care, in that state between April 2006 and November 2007. Of those, 5,462 had criminal histories that should have disqualified them. Michigan is one of the states that does require background checks of caregivers for the elderly, but as the study shows, that requirement clearly doesn’t go far enough.
Consumers seeking in-home help for an elderly loved should ask an employment agency exactly what a prospective caregiver has been screened for, and require at a minimum a state police criminal background check. Those hiring on their own can also request a background check from state police, and references should always be checked.
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