In-Home Caregiving Shift Raises Abuse, Neglect Concerns

The country’s frail elder and disabled residents are increasingly receiving care in their own home – as opposed to placement in nursing homes. olderwoman

This arrangement is often beneficial in that, when done right, it can provide a greater sense of autonomy and comfort than one might experience in an institutional setting. Beyond that, it saves the government money.

However, the problem is caregivers often aren’t adequately trained or thoroughly supervised. Some work for home health care agencies, while others are family members who are paid for their caregiving services by the state. In both cases, an investigation by Kaiser Health News revealed patients are at an increasing risk of abuse, neglect and maltreatment.

These caregivers receive an average of $10 hourly for their services. However, they are given enormous responsibilities and aren’t subject to the same kind of scrutiny as nursing homes. Because of this lack of oversight, patients may suffer years of neglect and abuse, leading to preventable injuries and sometimes even death.

In California, which was the focus of the Kaiser study, 73 percent of in-home caregivers are related to the patient. Few of these individuals are screened, and often the hiring process is left largely to the individual patient, who is given wide latitude. For example, a person convicted of felony robbery, assault or rape can be paid as a state caregiver if patient obtains a waiver. In California, there were nearly 1,000 such waivers issued over the course of four years.

Our Fort Myers nursing home neglect attorneys understand there is no technical bar absolutely preventing a person with a dangerous felony record or active drug addiction from caring for vulnerable patients. That’s a serious problem.

County and state officials are supposed to follow up with the patients at least once annually, but they are mainly concerned with documenting whether a client’s needs have changed and whether more or fewer billable hours are necessary. Sometimes, those visits last less than a half hour.

Recognizing this as a major issue, officials in Palm Beach County are considering implementing their own rules for home aides – most of whom are not regulated by state or federal government. Whereas nurses and nursing assistance work in nursing homes and are licensed and trained, in-home aides face nowhere near that level of regulation.

The Home Care Association of Florida estimates approximately 150,000 people in the state receive some level of in-home care.

The state does have some rules for companies that provide home health aide services. However, that does not include licensing or certification when the worker isn’t providing some degree of medical care.

Most companies do conduct background checks already, but independent hiring is fairly common, meaning the oversight is greatly diminished.

Palm Beach officials say they are asking the local sheriff’s office and county attorneys to work together to craft legislation. The proposal is still “a work in progress,” but officials say it could be introduced as early as the end of next year.

Officials say barring those with certain criminal backgrounds is a top priority. There is no word yet on whether increased oversight or reporting might be included in the language of the law.

If you have been injured, contact the Hollander Law Firm at 888-751-7777 for a free and confidential consultation. There is no fee unless we win.

Additional Resources:

Neglected to death: Little oversight for in-home caregivers can lead to abuse, Jan. 5, 2015, 89.3 KPCC

More Blog Entries:

Florida Hospitals Stung by Federal Penalties for Patient Injury, Jan. 21, 2015, Fort Myers Nursing Home Abuse Lawyer Blog