In late 2006, 85-year-old Priscilla Stovall was killed in her Clovis, Calif., home. Her killer: the aide hired to help her around the house. Earlier this year, Kelly Jones, who had a prior criminal record, was convicted of involuntary manslaughter and sentenced to three years in prison for the death of Ms. Stovall. According to court documents Jones was on drugs when she gave Ms. Stovall a lethal overdose of morphine and methadone.
Killings by home-care providers remain rare, but they are only the most extreme examples of what prosecutors and advocates for the elderly say is a growing number of cases of abuse, neglect or fraud in which home caregivers take advantage of the elderly. This is prompting calls for better oversight of the ever-growing industry of home care. Currently, there are about 1.6 million people employed in home care, split about equally between those who provide basic health services, and those who provide housekeeping, cooking and non-medical help.
Health aides are often certified nursing assistants, who are generally licensed and regulated. But the bulk of the abuse cases involves caregivers hired to provide non-medical assistance. These caregivers, who aren’t required to receive specialized training, are only loosely overseen. Moreover in California, Florida, Connecticut and at least 19 other states, non-medical aides don’t have to be licensed or pass a criminal background check to get a job. As part of a seven-state pilot program sponsored by the Centers for Medicare & Medicaid Services, researchers at Michigan State University screened 214,167 people who held or sought jobs working with the elderly, including home care, between April 2006 and November 2007. Of those, 5,462 had criminal histories that should have disqualified them, says Lori Post, a professor who led the study.
In Ms. Stovall’s case, her son George is suing two home-care agencies for wrongful death, alleging they failed to check the background of Ms. Jones, the caregiver, before sending her into his mother’s home. Mr. Stovall says he was told by one of the agencies, Fresno Senior Care Inc., that Ms. Jones had been through “extensive background checks” and turned up clean. Obviously this was not the case.
In many states, non-medical caregivers don’t need licenses. “For a whole number of years they hadn’t been monitored or watched by anyone,” says Bill Bell, deputy director of regulation at the Illinois Department of Public Health. Starting in September, Illinois is requiring all home-care agencies to be licensed and screen their employees, after lawmakers received reports of theft and neglect by home aides. Indiana recently adopted similar rules. And in California a bill was drafted last year requiring licensing and background checks for non-medical home-care agencies. But many lawmakers rejected it mainly because it would have cost the state too much to run the licensing regime.
Caregivers have their own opinion on this situation as well. While they say they don’t mind being screened, they do not want to have to pay for it, according to Tyrone Freeman, president of California United Homecare Workers. He also says that old or minor crimes shouldn’t disqualify caregivers from the job. “That’s like creating a permanent underclass of individuals who’ve done something wrong at a young age.â€
Listed below are some tips from researchers and advocates for the elderly for those seeking to hire a caregiver.
- If you are hiring through an agency, ask exactly what the caregiver has been screened for. Most caregivers aren’t authorized to access the national criminal database run by the FBI. A state police check is usually the best option available.
- Using www.eldercare.gov, a website run by the U.S. Administration on Aging, you can locate services for the elderly in your area and contact state regulatory bodies.
- If you hire directly, without going through an agency, you are on your own. You can check references and still conduct a background check by contacting state police directly or going through a commercial firm that will do this for you.
- You can also check the name of your caregiver against state and national sex-offender registries. Available at www.fbi.gov/hq/cid/cac/registry.htm.
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