Relative to a front page article published on July 19, 2010 in the Cleveland Plain Dealer (Cleveland Woman Trying to Stop Mistreatment of the Disabled by Home Health Care Workers by Margaret Bernstein), I would first like to congratulate Edna Sutton on taking action to improve a system which sometimes fails the most vulnerable of our population. The development of a training program that not only teaches home health aides the basics of caregiving, but that also emphasizes sensitivity and personal empowerment, is to be commended.
It is true that some individuals, both men and women, turn to jobs in home health care agencies not because they are compassionate and drawn to helping others, but because they are desperate for work and the amount of training needed for such jobs can put them in the workplace in a matter of weeks. It is also true, as Ms Sutton has experienced, that some unscrupulous individuals enter the field of caregiving because they view our elderly and disabled as vulnerable, helpless, and easy targets for crime.
Ms. Sutton’s experiences exemplify the worst-case scenario in home health care. Though not a common occurrence, many social workers, nurses, care managers and supervisors who have worked in the home care arena have similar stories to tell about the exploitation, neglect, or abuse of an individual in their charge. And most, as soon as an unacceptable situation is brought to their attention, will immediately take action to address the situation and protect the elder or disabled person.
As I commented to Ms. Bernstein in my interview for the PD article, even the best of home care agencies can make a hiring mistake. What makes them the “best of agencies” is how they select, train and supervise their staff and especially how they handle reports of mistreatment of the clients in their charge. Due to the nature of their work, most home health aides provide services with minimal direct supervision. Therefore, to a great degree, it is the reports of the client and others with knowledge of the home situation that provide feedback to agency supervisors regarding the quality of services being provided by their staff. Clients have a responsibility to notify the home care agency when a home health aid is not performing to the acceptable standards of practice. If reports of poor performance are not made, it leaves the issues unaddressed and it allows the home health aide to continue the negative practices not only with the individual client, but with all of the other clients for whom that aide provides care.
To help avoid some of the potential risks involved in the receipt of care in the home, those who are considering hiring home care services should do their homework and ask questions of any provider being considered. Is the agency bonded or licensed? How long has the agency been in business? Are the care providers certified or “state-tested?” What kind of reference checks are done by the agency? How are the aides selected and trained? Are criminal background checks done on each worker? Are drug screenings done at the point of hire and randomly following employment? Will you be able to interview several potential aides and select the one with whom you feel most comfortable? What type of continuing education is required for each worker? How often are ‘quality checks’ done and what is done with the information obtained? How does the provider handle emergencies? How are complaints made directly to the agency handled? Are there reports, positive or negative, filed with local or state regulatory agencies or the Better Business Bureau?
The Ohio Developmental Disabilities Council offers a comprehensive guide for individuals and their families titled Taking Charge: A Hands-On Guide to Personal Assistance Services. This manual is designed to aid those who are setting up a “personal support system” and includes information on how to hire, how to manage, what to expect and how to protect oneself when in-home care is needed.
It remains my belief that the majority of home health aides in the workplace today are honest, caring, and hardworking individuals. We do we need schools such as Ms. Sutton’s to effectively train our in-home care providers and I hope that her school’s anticipated success can provide a model for others across the country. But we also need a better way to educate, empower, and guide our elderly and disabled and those who advocate for them. No one should have to endure the mistreatment that Ms. Sutton reports. No one.
– Posted by Terry Fries-Maloy