Can hiring non-agency caregivers put Alzheimer’s patients at risk?

The story below is about Mary (name has been changed) who was told by a neighbor she needed someone to help her at home. Mary had some diminished capacity and hired the “friend” that the neighbor suggested.  Unfortunately, the circumstances’ surrounding this case are not unusual and demonstrates the necessity of hiring a home care company that provides care management, bonded, insured and supervised caregivers.

Mary’s primary care physician became concerned for her well-being after an appointment in July of 2012.  Mary’s privately-hired caregiver exhibited controlling behavior over Mary during the appointment.  The physician expressed his concerns to Mary’s Trust Administrator, and after a brief investigation the Administrator realized that the caregiver was financially and emotionally taking advantage of Mary.  Acting quickly the Administrator contacted Kansas City Home Care and requested we find a bonded, insured and supervised caregiver to assist Mary with her daily activities of living.

Kansas City Home Care (KCHC) responded quickly and did a complimentary assessment of Mary’s daily living needs.  A mature and experienced caregiver was assigned to Mary’s case.  At first, Mary was frightened by the changes in her routine and said repeatedly that she missed her old caregiver.  However, due to the patience and understanding of the staff at KCHC, Mary accepted a new caregiving team by the end of the first week.

Kansas City Home Care has been providing daily care to Mary for three months.  Mary no longer exhibits paranoid-like symptoms when our caregiver or others are in her home.  In fact, she now looks forward to a daily visit by our caregiving staff. Mary has a history of high blood pressure and needs to be on a low sodium diet. Unfortunately, her diet had mainly consisted of canned soups and frozen dinners which are high in sodium. Mary has now been eating balanced low sodium meals and feels better and has gained some much needed weight!

Mary’s dementia-like symptoms have also improved and instead of forgetting that our caregiver is coming, Mary eagerly awaits a visit from “her friend” and looks forward to the activities that she and the caregiver have planned each day. Her overall mood has changed dramatically and she appears much less frightened and agitated than she was before we began services.

Mary’s Trust Administrator has commented on the improvements she sees in Mary as a result of our care.  About a month after KCHC began caring for Mary, her Trust Administrator went to visit her home unannounced and was greeted by the smell of homemade beef stew cooking in the kitchen.  The Administrator told the caregiver on shift that she didn’t know the last time Mary had a home cooked meal. During Mary’s recent appointment with her physician he commented several times that KCHC was taking good care of Mary.  He was very pleased to see the improvement in her mood, memory retention, and overall health.

Mary recently visited our office with her caregiver and was in a very good mood. Her color was good and she had just returned from the beauty parlor.  She was laughing and talking the entire time she visited our offices.  Our staff was happy to see how much Mary’s mood has improved and how much better she seems to feel. Seeing Mary smile and engage in conversation is a testimony to our corporate philosophy of “Clients First.” Making a difference in a client’s quality of life is our goal and obviously we have met our goal with Mary!

The use of privately-hired caregivers is not uncommon and there are situations where the arrangement works well for those needing home care.  But, in order for the arrangement to work well there must be someone other than the client who supervises the caregiver–a family member, a trusted friend or a care manager.  There can be many pitfalls to hiring someone privately and consumers must be careful.  The National Private Duty Association has an excellent paper on “Consumer and Worker Risks from the Use of Nurse Registries and Independent Contractor Companies” that discusses the issues surrounding employing private caregivers.  The position paper can be located at www.privatedutyhomecare.org.

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