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Understanding The Potential Consequences Of Hiring An Unlicensed Non-Medical Home Caregiver

A friend and I were having a casual conversation regarding the costs of hiring a 24 hour caregiver. Her sister was having difficulty caring for a spouse with dementia. I told her that in the western suburbs of Chicago Illinois, the figure I was quoted was somewhere in the area of $230-$240 per day. Someone overheard me and said, “Oh no, you can get a live in for much cheaper than that. When I hired a caregiver for my parents, they only paid $120 per day.” My response was, “The arrangement you made for them was not through a licensed agency. Trust me, you probably talked to a staffing agency who found you the person that fit your needs. There is a big difference.”

If you are considering home health care for a loved one, the agency should be a member of the Home Care Association of America (formerly the National Private Duty Association). Without going into a lot of detail, the agencies who are members of the association In Illinois hold a license. They adhere to a code of ethics. A licensed agency, in opposition to an independent contractor or staffing agency (as the person I referenced was talking about), is responsible for the screening, training, and back round checks of the staff among other things. Some choose to test test for drug and alcohol use. If you choose to hire an unlicensed caregiver you will be assuming all the responsibilities of an employer, and may have no recourse if something goes wrong. What may appear as savings in the short- term may have long term repercussions as exemplified in the following Real Life Story.

Real Life Story
The client was a woman in her late 60’s. She had a diagnosis of a debilitating disease that left her bound to a wheelchair, and needed assistance with all of her activities of daily living (ADL). That is, eating, bathing, dressing, toileting, transferring, and walking. She needed total assistance from a sit to stand position, a feat that was well-accomplished by one caregiver. She lived in her own home with two full-time caregivers. One caregiver assisted her from the late afternoon into the evening, and supposedly held a nursing degree at one point in time. Yet, she was no longer licensed. The other was an unlicensed caregiver who assisted her from mid-morning until late afternoon. Thus, there was a gap in care from the late evening to the next morning. The caregiver who had the nursing credentials was being paid three times the amount of the unlicensed caregiver. Both caregivers were employed by her for over ten years.

Several weeks before I was hired, an attempt was made to move her to an assisted living community. She was admitted without an assessment (supposedly). They couldn’t handle her care adequately and it took several people to lift her. Due to her emotional attachment to the previous caregivers, she screamed ever time the staff members tried to lift her or give her a shower.

When the children noticed that their Mother’s personal expenses were exceeding $12,000 a month and saw some dubious banking transactions, they decided it was time to move her into a long-term care community.

The client told the me that she would only move on three stipulations:

She would have to bring the two caregivers to the community where she moved. Note, this automatically disqualified a move to a skilled nursing community. I vehemently opposed a move to independent living with the two caregivers and tried to convince her that she would benefit from the care, lower cost ($8,000 vs $12,000), and no time gap in her care. There had to be cooking equipment in the room. She had distinct location preferences in order to accommodate the caregivers.

I found two communities that would accommodate her request to keep the two caregivers. My main stumbling block was the fact that they were unlicensed. I thought the best approach was to place her at a continuing care community that had assisted living and a nursing home on the campus, and pray she would see the light in needing the higher level of care. She selected one of the communities, and planned to move with the two caregivers.

On the day of the move, I found out the kids chosen to move her to the skilled area of the community. The one caregiver (the one without the nursing degree) assisted with the move. The other caregiver remained at the house, but deluged the first caregiver with phone calls inquiring about when they were going to return. When the kids and the caregiver returned home, it had been emptied of all the furniture, including a huge pile of worthless junk in the basement. After the robbery was reported to the police, it was somehow determined that the caregiver, who never had a nursing degree, was operating under several alias names. It was also suspected that she was part of a band of gypsies who were responsible for a number of robberies in the area. Have I convinced you to use a non-medical home care agency who is a member of the Home Care Association Of America?

For all of your senior living needs,please contact Andrea Donovan Senior Living Advisors.