Personal Review Hiring In-Home Caregivers for an Elderly Relative
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 personal care aides to help her.
This article is a detailed explanation of how I managed her finances, hired caregivers, wrote a healthcare agreement, and dealt with elder care agencies.
I’ll explain how to handle each of the following items:
- Consider the Well-Being of Your Aging Relative
- Think About Managing Their Finances
- Plan Your Loved-One's Needs Before Choosing an Aide
- Write an Eldercare Agreement Contract
- Interview Potential Aides
- Stay Alert to Dishonest Agencies
- Remove Abusive Health Care Aides
- Get a Signed Power of Attorney (POA)
Consider the Well-Being of Your Aging Relative
I couldn’t do it alone to maintain her quality of life. I needed to hire in-home elder care aides to take care of her 24 hours a day. I hired two aides so each could cover a 12-hour shift.
They 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 in the client's home and then leave.
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.
Think About Managing Their Finances
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 loved-one 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 required,
- And arranging a budget to cover expenses.
I knew that the last item above 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.
Plan Your Loved-One's Needs Before Choosing an Aide
Before choosing an aide, it's essential to know what your love-one expects.
- Discuss what they feel they need.
- Suggest additional concerns that they may be overlooking.
- 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 you expect 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:
- Help the patient moving in and out of beds, baths, wheelchairs, or automobiles, such as for transportation to doctor appointments.
- Provide personal care, such as dressing, grooming, and maintenance of hygiene.
- Administer medications as instructed per “Technical Direction” below.
- Prepare healthy meals.
- Do local errands and shopping.
Interview Potential Personal Health Care Workers
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. Don't trust the agency.
- 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.
Stay Alert to Dishonest 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. These are essential steps to take.
- Do a Google search for reviews to see if anything negative shows up.
- Search for court judgments on the agencies and workers.
After you chose an agency and hired an aide, don't let them boss you around. The following experience of mine can happen to you.
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 her 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.
Remove Abusive Health Care Aides
Sometimes things go wrong. Not all health care workers 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 causing trouble. Then one of them 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 the 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 aides 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 bank's 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, it’s crucial that you speak with a family attorney.
These can be the most challenging times for both an elderly loved one, 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 your elderly relative is comfortable and happy. And 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.
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© 2010 Glenn Stok