The Case Against Hiring Private Home Health Aides: Don’t Let The Fox In The Hen House| Leave a Comment
Let’s face it; it is very expensive to hire a home health aide to care for a loved one. It is not unusual to pay a licensed Home Health Care Agency or Registry between $16 and $25 per hour for a Certified Nursing Assistant or Home Care Aide. Assisted Living Facilities and Nursing Home fees are less than the cost of full-time (24 hours) around-the-clock care givers.
Understandably, most seniors want to avoid living in an Assisted Living Facility or Nursing Home for as long as possible. Some seniors actually ask their children to promise to “never put them in a nursing home”. Sadly, those same parents often do not have the financial resources to pay for home care to help their children keep this promise.
When seniors require home health care, the family or their advocate worry about the expense. They look for less expensive alternatives. Licensed, bonded and insured Home Health Agencies and Registries must charge competitive rates in order to assure that the caregivers are properly trained and pass the statewide background check. Licensed agencies are monitored by the government agencies who accredit them. In the Home Health Agency organization, a Director of Nurses provides direct supervision of the home health aides. The home health aide is accountable to be on time, to provide excellent service and to be honest. If the home health aide is ever found to be unreliable or dishonest, agency or registry can replace the aide quickly. All of these precautions are for the protection of the senior consumer who is usually vulnerable and may be living alone.
It is falsely assumed that a private home health aide who works for him or herself will be a less expensive alternative. Many private aides are referred to vulnerable, cost conscious families by well-meaning friends. A doctor, lawyer or professional advocate would likely NEVER refer an unlicensed, un-supervised home health care aide to a client. Un-supervised, unaffiliated home health aides are a major source of financial exploitation and abuse of the elderly. Many private aides have set up their own network of friends and family members to care for their clients, but the one thing they all have in common is that they are unsupervised. The only entity which can coordinate and refer home health care givers for a fee, is a state licensed Home Health Care Agency or Registry.
Concerned families come to our firm to learn about programs and strategies which can help manage the high the cost of facility care. Many of our clients come to us looking for placement in an assisted living facility or nursing home because they already tried hiring a private home care aide and now they have a terrible story to tell. A common complaint is about their private aide who is robbing them blind but they don’t want to let her go because their parent “loves her”. They tell me how the aide does not come to work regularly or disappears in the middle of the day, but commands a full salary in cash, under the table. One home health aide asked for the family to pay for her expensive car repairs stating that if they refused she would not be able to drive to work the next day. Over time, some families come to feel obligated to solve every personal problem for their private aide and money is always the solution to their problem. One family reported that the exorbitant loans and other unprofessional requests were okay because “mom has lots of money”. Why would anyone allow their parent to be taken advantage of, even if they could afford it? How could they let someone so unscrupulous get close to their parent?
The potential for abuse is not limited to financial exploitation. Frail seniors are at high risk for physical abuse and neglect. Private aides can become territorial and come to believe that the client’s home is their home too. They may let their friends and family take over the home. We were told of a client whose private aide stayed with her throughout the night. One night, the client awoke to find a strange man in her home fighting with her aide. This man was the boyfriend of the aide and during the argument he physically assaulted the aide and the client, who ultimately suffered fractures of both of her eye sockets.
There is an old but very true saying that ” You get what you pay for”. The risk of exploitation, neglect and abuse is never worth the few dollars less per hour that a private aide may charge. In fact, in some cases, the private aides charge their clients the same rates as the licensed agencies and registries.
All seniors who require home health care NEED an Advocate to supervise the home care. Being a true Advocate means protecting vulnerable seniors from those who would pray upon them and having the fortitude to fire anyone who is not working in their best interest. Even when hiring a licensed Agency or Registry, it is best to watch over the situation carefully. If you cannot provide this layer of supervision, hire a Professional Geriatric Care Manager to be your eyes and ears.