Private Caregivers
One of the most dangerous issues facing older Americans is the hiring of private caregivers. There are many conscientious private caregivers who, at worst, are only breaking state and federal laws, and not harming their clients, but, in my opinion, for every good private caregiver, there are at least three more bad caregivers.
Like a heartless bloodhound sniffing a track, assessing penalties and interest and liening property, the IRS will go after a person who works at a fast-food restaurant and makes only minimum wage, but the world of private caregiving is a black hole of untapped tax revenue. Private caregivers charge $15 per hour and up, yet not one cent is reported. Of course, these private caregivers are breaking the law; but worse yet, the person who employs the private caregiver may by charged by the IRS for not withholding taxes or reporting the income of that employee.
The question of worker’s compensation arises if a caregiver is hurt on the job. The clients usually assume that homeowner’s insurance will cover any injury, and are unpleasantly surprised to find that their insurances will not cover an in-home employee.
There exists the fact that private caregivers are not fingerprinted. A prospective client should understand that “background screening” is not the same thing, at all, as a fingerprint/background check. A prospective client should ask to see the state fingerprint clearance card of the private caregiver.
The worst thing about hiring a private caregiver is that he/she has no oversight and works without generally approved nursing or private duty standards and practice.
These issues are the upside of hiring a private caregiver. The downside is abuse, neglect and exploitation. Skillful private caregivers, in search of looting their client, are like skillful criminals of any type; they cleverly mark their target, wait for the right time, perpetrate their crime, and then disappear.
She was a dancer on Broadway in 1939. She had been classically trained in ballet, but found that she loved the Great White Way. People who have seen her reviews say that she was a rising star when she fell in love and married an Arizona rancher, and returned with him to the West. Unfortunately, her husband, Jack, was killed in an airplane crash three days after their first anniversary.
Nowadays, Helen is an eighty-seven-year-old with emotional and mental issues. Although quite wealthy, not so long ago she lived in a shanty in a bad part of town, thinking that this would defray would-be thieves. She is suspicious of everyone, especially those who would legitimately help her with no financial gain. Helen has no living relatives but an older brother with Alzheimer’s who lives out of state.
Delia took a room in a rundown motel two doors down the street from Helen. The day after she moved in, she knocked on Helen’s door early in the morning. “Hello,” said Delia, with a cheery smile, “I’m your new neighbor, and I understand you live alone, too.” She kept talking even though it was obvious Helen would not open the door wider than a crack. “Anyway,” Delia continued, “I’m going to walk downtown to the market, and I wondered if you needed anything?”
Helen did open the door wider, but only to slam it firmly in Delia’s face.
Two days later, and completely undaunted, Delia was back, this time bringing an oversized Hershey bar. “I thought you might like a little treat,” Delia cooed through the crack in the door. Once again Helen slammed the door, this time with an admonishment, “Eat it your damn self!”
Delia waited awhile, walking by Helen’s house a few times a day and waving when she saw the elderly woman at the window.
On a particularly warm day, Delia stopped at Helen’s house and set her own bag of groceries on the bottom step. When Helen cracked the door to her, Delia shoved a small brown bag through the crack at Helen. “Here, “ she smiled. “It’s Haagen Das. Eat it before it melts.”
Before Helen could answer, Delia picked up her groceries and walked quickly to the street. She must have been filled with self-satisfaction when she her behind her a faint “Thank you.” (I am sure she thought, “Bingo!”)
Every day for another two weeks, Delia walked by Helen’s house to town and then back again. One morning, on her way past Helen’s house, the elderly lady was standing behind the partially open front door. “Are you going to the market?” she asked Delia in a shaky, hardly-ever-used voice.
“I am, I am,” Delia smilingly replied. “I just have an efficiency kitchen with no way to store food, so I have to buy fresh every day.”
“Would you mind picking me up a loaf of that dark rye bread from the bakery?” Helen cautiously asked. “And if it wouldn’t be too much trouble, a pint of heavy cream.” She thrust a crumpled ten-dollar bill at Delia.
“No trouble at all,” said Delia. “I’ll drop it off on my way back to my house.”
Delia returned with the bread and the cream. She also brought the receipt and every penny of change that Helen had coming. Delia was on her way.
Within a week, Helen had called the market and cancelled their delivery service. She told the market that her “friend” would be picking up her groceries.
Delia always returned with the groceries and the right amount of change, and within a month, she was inside Helen’s house every day, cleaning and dusting the priceless antiques and the rare coin and stamp collections. Helen paid Delia a small salary.
Within a month, Delia had moved out of the motel and into the spare room at Helen’s house. A few weeks later, the old, rickety garage was opened up to reveal a vintage Cadillac in mint condition. Delia had her “brother” come over and tune up the car. The next day, with Delia driving, the two women went to the best restaurant in town for lunch. Helen, of course, paid the tab.
Helen slept late the next morning, thanks to a little something extra in her hot cocoa the night before. She rang for Delia to come and assist her out of bed, but Delia did not answer the bell. Helen called loudly for her, but still Delia did not come.
Afraid to leave her bed, and too weak from fear to get up without assistance, Helen called 911. “Send someone, please,” she sobbed into the phone. “I think something has happened to my friend. Someone may have hurt her!”
When the police arrived, the front door was standing open. Delia was not hurt – she was gone. Gone with her were the rare coins and stamps, the antique furniture and priceless china. Even the large cherry armoire was gone. So were the 1920s era Persian rugs in perfect condition. Everything of value had been removed, even Helen’s jewelry and wedding rings. The Cadillac was gone from the garage. Everything that Helen had to show for living a life of eighty-something years was gone, except for a few old movie star magazines and a 1951 copy of the Wall Street Journal.
The neighbor lady told police that she had seen an old van-type truck in front of Helen’s house about daybreak, and three people moving furniture - two men and Delia.
She hadn’t thought much of it, because Delia had told her that Helen had taken a nice apartment and was going to put things in storage and sell the old house.
Delia was never heard from again. There is much speculation that she is in Mexico with family, and no one thinks that she will ever come back to the U.S.
These days, Helen is in a care center provided by Medicaid funding. She seldom speaks,
and sits by the window in a rocking chair, humming some little tune from her past. She was a dancer on Broadway in 1939.
Private caregivers must have accountability. The way the system now works, private caregivers are practically immune from responsibility and accountability for their actions. They are also practically immune from prosecution for crimes committed against their clients.
Because private caregiving is such a huge enterprise from coast-to-coast, monitoring private caregivers would require its own governing board for accountability and oversight. Such a board could consist of a minimal number of employees, and, quite possibly, be staffed pro bono by advocates and volunteers.
Legislation must be enacted to make private caregiving a crime unless the caregiver is registered with the governing board which would be set up by the county, state or federal government. To apply for membership with the board, the caregiver would register with the board and present to them:
Fingerprint/background clearance from the state Department of Public Safety
The forms of picture identification
TB clearance from a physician or the local health department
A valid, self-employment tax document from the IRS
Current CPR/First Aide certification
Social Security card or Green Card
Verifiable references
Bonding
Professional Liability Insurance
Clients, themselves, would then have a resource for checking the credentials of individuals applying for private work with them. The IRS would have a large, untapped source of previously non-collectable income, and most importantly, potential clients would be afforded far more protection than they now have.
Legislation should also involve stiff penalties for those private caregivers working without the sanction of the governing board.
Some might think that all this would infringe on our freedoms of personal enterprise. In response, one must remember that these people are not mowing lawns, painting fences or fixing cars in the backyard. Private caregivers are in charge of a living, breathing human being, and that human being’s dignity, finances and, many times very life depend upon the responsible actions of a private caregiver.
Criminal caregivers do have a profile. They are usually repeat offenders, even if prior crimes did not result in an investigation or arrest. They find an isolated person to victimize, then proceed to further isolate the person. Women perpetrators will use a feminine approach to a female victim; i.e., “You’re like the mother I never had…You are my best friend!…You can’t trust anyone but me, etc.” Toward men, they will play the helpless female mistreated by the world, who just needs a little help. These criminals know how to make elderly men feel strong and “manly” again.
If you visit an elderly person and the caregiver eyes you suspiciously, you need to look more closely at that caregiver for abuse and exploitation. They resent anyone “cutting into their territory” even for a visit, and for some inexplicable reason, they have difficulty hiding their attitude. Suspect any evasion or any attempt to not leave you alone with their client. Observe and report.
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