Hiring Home Elder Care Aides: You Need to Know What I Learned
A few years before my dear aunt passed away at 98, she said she wanted to be able to live out her remaining years in her own apartment, so I hired aides to help her.
This article is a detailed explanation of how I managed her finances, hired caregiver aides, wrote a healthcare agreement, and dealt with elder care agencies.
I’ll explain how to handle each of the following items:
- Managing Finances of an Elderly Person
- Maintaining the Well-Being of an Aging Relative
- Plan Your Eldercare Needs Before Choosing an Aide
- Write an Eldercare Agreement Contract
- Interview Potential Aides
- Work with Eldercare Agencies
- Eldercare Agencies Are Not Loyal
- Dealing with an Abusive Health Care Aide
- Get Signed Power of Attorney (POA)
Managing Finances of an Elderly Person
Maintaining one's finances is vital to be sure not to waste money in the wrong places.
If you're not good at that, then it's best to hire a qualified person, such as a CPA, who can take charge of the essential items. If you already handle your own financial affairs, then you should be able to do this for your elderly family member too, as I had done for my aunt.
You need to keep track of items such as:
- Paying bills.
- Depositing checks.
- Managing health insurance.
- Filing important papers as needed.
- Arranging a budget to cover expenses.
I knew that last item was crucial to be sure her social security and pension payments would suffice so she’d be able to continue in her own home as long as she lived.
Maintaining the Well-Being of an Aging Relative
I couldn’t do it alone to maintain her quality of life. I needed to hire aides to take care of her around the clock.
The elder care aides helped her get around. They took her to the grocery store, to the beauty parlor, museums in the city, to the park on beautiful days, and to the doctor when she had appointments.
Aides are expensive. You’re lucky if you can work out deals for around $12 an hour. That is not live-in. They work their shift and go home.
Live-in aides are cheaper because you’re giving them room and board. You’re sharing your home with them. That's something you need to consider.
My aunt only had a one-bedroom apartment, so that was out of the question anyway.
Plan Your Eldercare Needs Before Choosing an Aide
Before choosing an aide, it's important to know what your elderly family member wishes to have and what needs should be met.
- Discuss what they feel they need.
- Suggest additional concerns that may be overlooked.
- Make a list of these needs and go over it to confirm if it's complete.
- Discuss what type of person they would be comfortable with having.
After you know what's needed, write an agreement that clarifies what work to perform.
Write an Eldercare Agreement Contract
A written agreement will make it clear what is expected of the aides, and it can be used as a contract when hiring.
In addition to specifying the work to be performed, the contract should make it clear that the aide is an Independent Contractor.
Here is what I wrote for that clause:
The Patient and the Independent Contractor agree that the Independent Contractor will perform the work as a Home Health Aide with the following Elder Care Responsibilities:
- Provide patient with help moving in and out of beds, baths, wheelchairs, or automobiles, such as for transportation to doctor appointments.
- Personal Care, such as dressing, grooming, and maintenance of hygiene.
- Administer medications as instructed per “Technical Direction” below.
- Preparing healthy meals, Local Errands & Shopping.
Interview Potential Aides
When interviewing an aide, get to know them and think about the issues that may cause difficulty if it's not a good match.
- Ask for references.
- Call the references to check their background.
- Do they understand the needs of the elderly?
- Are there cultural differences that need to be considered?
- Discuss food differences and habits that may not be compatible.
Work with Eldercare Agencies
Some agencies don't vet their aides well enough. They are just happy to take the money and place anyone. So you need to be aware of that. Don't trust whomever an agency sends to you without vetting them.
I did my due diligence by asking for references and doing Google searches to see if anything negative would show up.
On the Internet, you can also search for court judgments on companies and individuals. These are essential steps to take.
I hired two aids so each could cover 12 hours since she needed someone with her round the clock.
I thought I was all set, but I was wrong.
Eldercare Agencies Are Not Loyal
Don't let agencies boss you around. Let me tell you a daunting experience that I had. Early one day before dawn, one of the aides called me and asked why she was being fired.
I was shocked to hear that, and I told her that if anyone were doing any firing, it would be me. I told her to come in as usual. Then I called the agency.
It turned out the agency told her not to come back. They decided to send another aide that morning. I was furious, and I made my feelings known.
How can they switch people like that and expect an elderly woman to be comfortable with a total stranger once again? I told them, “To do that without warning is unacceptable! My aunt could have died from a heart attack!”
I found out later that the agency tried to fire the aide because they make more money by placing her with another client. That's because the first week with a new client is paid double—one payment to the aide and one payment to the agency.
By moving them around, they get more of these extra payments. Not all agencies get paid extra for the first week, but it is something to consider.
Dealing With an Abusive Health Care Aide
Sometimes things go wrong. Not all aides are trustworthy. You need to keep a constant eye on where the money is going and keep good records of questionable events.
Here's an example of an experience I had with abusive aides:
When my aunt's aides needed cash for groceries, they would take her to the bank to withdraw money. I noticed over time that the requests for money were steadily increasing.
They took advantage of her by telling her it’s because of inflation. The elderly tend to be gullible and believe anything.
My aunt couldn’t be eating so much and using so many of the staple items that were purchased. The aides must have been taking things home for themselves, so I decided to ask them to keep a record of the items they bought.
Other types of abuse can occur, as well. My aunt started complaining that one of the girls was yelling at her and losing her temper.
Keeping records and examining them is one thing, but any abuse should be dealt with quickly.
I had to fire two aides that were less than pleasing for my aunt. In one case the aide sued for being fired. I had to go to court to defend this case. I won, but it took a lot of time—all the more reason to keep good records.
Get a Signed Power of Attorney (POA)
There were several times that I hit brick walls when trying to help my aunt. One time I had to call customer service of her credit card to discuss a problem. They didn’t want to talk to me because they didn’t have my Power Of Attorney (POA) on file.
I had to handle litigation another time too, after firing one of the aides that abused her. You need to consult a business attorney if you get into this predicament. Healthcare aids are independent contractors and cannot be fired unless they fail to meet the terms of the contract. I won that case, but that’s another subject.
Having a "General" POA is useless because banks don’t accept it. I discovered that banks usually want one to file a POA using the banks own forms.
It's helpful to have an additional POA made from a standard form to use when needed. You can find many sites with a Google search where you can purchase legal forms and download a standard power of attorney form.
Include Litigation Rights on the POA:
The standard POA form has options to check-off that show which permissions you have. Make sure you include litigation rights. You never know when you might need that. It was required when I needed to defend my aunt in court for that lawsuit I mentioned earlier, brought on when I fired an aide.
Once you complete the form, you need to get it notarized. I had to bring my aunt to the bank in a wheelchair to get it notarized. If that’s what it takes, you need to do it.
Power of Attorney Expires Upon Death:
A Power of Attorney is only valid while the person is alive. It becomes null and void upon death. If you were expected to handle the estate, then you would have had to be assigned as executor in the will. That is something that needs to be done well in advance.
With all the legal issues that can arise with any of this, it’s crucial that you speak with a family attorney.
These can be the most challenging times for both the elderly and the family members who look after them.
When all the issues are taken care of properly, and with foresight, one can keep things going smoothly and assure that the elderly relative is comfortable and happy with less stress on you.
This content is accurate and true to the best of the author’s knowledge and is not meant to substitute for formal and individualized advice from a qualified professional.
© 2010 Glenn Stok