Issue Date: April 13, 2008
How to hire a caregiver to help at home
As more of us care for our elders, we often employ aides. Read this essential advice before you interview prospects.
According to government statistics, approximately 25% of American families care for an elderly family member, friend or neighbor. As the average life expectancy continues to increase, it can only be assumed that this trend will continue (or even grow).
Be careful not to "burn out" caregivers.
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Even if you've never experienced it firsthand, you can imagine the hardship that becoming a caregiver places on a person or family. About half of those who become caregivers still must hold down a job outside the home, which makes it necessary to hire someone to stay with the loved one while you are at work. In addition to the financial strain and personal guilt associated with doing this, there is the potential problem of neglect or abuse at the hand of the hired caregiver. Although most folks hired to work with the chronically infirm do an admirable job providing for those in their care, it's still important to make sure that nothing problematic or underhanded is occurring in your absence.
Communicating frankly with a professional caregiver during an interview is a must. You should be explicit about the job's requirements so that expectations are clear. It's important that you don't rely on the caregiver for more than she was hired to do because you don't want to "burn out" your caregiver. And, just as you expect the caregiver to follow your rules, be respectful of her needs, as well. For example, don't require the caregiver to work seven days per week. She needs protected time, as well, and asking her to work daily without a break is not only illegal and unfair, but doing so also may compromise the quality of care she provides for your loved one.
Once she's on the job, it's important to keep the lines of communication open and to be alert for signs of neglect or abuse. (See below.) This is particularly important when the person receiving care is unable to communicate directly with you. The Department of Health and Human Services' National Family Caregiver Support Program has some good tips at aoa.gov/prof/aoaprog/caregiver/caregiver.asp.
If the person receiving care is exhibiting one or more of the telltale signs of abuse or neglect, you need to consider it a very real possibility. If the person receiving care can communicate verbally with you, question him about this when the caregiver is not present. If he is unable to communicate, consider monitoring the situation in your absence with a hidden camera, in compliance with your state laws. Whatever you do, don't ignore the signs of neglect or abuse. Waiting only increases the chance that a fall, injury or something else bad will happen.
If you suspect neglect or abuse, it's important to act. For starters, arrange to have someone else on hand at times when the caregiver is present. Next, meet with the care recipient's doctor. The doctor is in the best position to evaluate physical or emotional signs of neglect or abuse and can put you in touch with the appropriate social services should he feel the evidence warrants it. We each have a little voice inside telling us when something isn't quite right with a situation -- pay attention to it.
Tending to loved ones who are chronically ill is stressful enough. Don't add to this stress by leaving them in the care of someone who has lost your confidence.
Contributing Editor Tedd Mitchell, M.D., president of the renowned Cooper Clinic in Dallas, writes HealthSmart every week.
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8 signs of neglect or abuse by a caregiver
1. Personality changes in the one receiving care
2. Whimpering, crying or refusing to talk
3. Unexplained injuries (bruises, abrasions, burns, pressure sores, etc.)
4. Unexplained weight loss
5. An unkempt, disheveled appearance
6. Poor personal hygiene
7. Dirty or disorganized living space
8. Confusion, excessive sleeping (signs of inappropriate sedation)
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