According to a study funded by the National Institute of Agency called “Hiring and screening Practices of Agencies Supplying Paid Caregivers to Older Adults” by Lee A. Lindquist, MD, MPH, MBA, et al. The authors’ objective was to assess what screening practices agencies use in hiring caregivers and how caregiver competency is measured before assigning responsibilities in caring for older adults.
Four hundred and sixty home care agencies were contacted in seven states. 180 were eligible and completed interviews. Agencies were asked about their hiring methods, screening measures, training practices, skill competencies assessments, and supervision.
According to the survey
Table 2. Hiring Requirements of Paid Caregiver Agencies (N = 180) Requirement n (%)
Required experience 121 (67.2)
Specified duration of experience 55 (30.5)
Type—general (e.g., life experience) 55 (30.5)
Type—prior caregiver experience 33 (18.3)
Certified nursing assistant training required 12 (6.7)
Certified nursing assistant training preferred 34 (18.9)
Pass a written test 29 (16.1)
Agency created 17 (9.4)
Health related 6 (3.3)
State criminal background check 159 (91.9)
Federal criminal background check 96 (55.8)
Check references 112 (62.2)
English language 122 (67.8)
Driving record check 50 (28.4)
Drug screening before hiring 56 (31.1)
Drug screening randomly or for cause 15 (8.3)
Citizenship or visa verified 12 (6.7)
Copy of driver’s license 12 (6.7)
Only 12 agencies(6.7%) required the caregiver to be certified as a Certified Nursing Assistant before being hired.
The study concludes that using an agency to hire paid caregivers may give older adults and their families a false sense of security regarding the background and skill set of the caregiver.
Before contracting with an agency, it is imperative that ones asks the agency the following questions:
Table 4. Ten Questions to Ask Agencies Before Hiring a Paid Caregiver
1. How do you recruit caregivers, and what are your hiring requirements?
2. What types of screening are performed on caregivers before you hire them? Criminal background check—federal or state Drug screening
3. Are they certified in CPR or have any health-related training?
4. Are the caregivers insured and bonded through your agency?
5. What competencies are expected of the caregiver you send to the home? (e.g., lifting and transfers, homemaking skills, personal care skills (bathing, dressing, toileting), training in behavioral management, cognitive support)
6. How do you assess what the caregiver is capable of doing?
7. What is your policy on providing a substitute caregiver in the event a regular caregiver cannot provide the contracted services?
8. If there is dissatisfaction with a particular caregiver, can he or she be replaced “without cause”?
9. Does the agency provide a supervisor to evaluate the quality of home care on a regular basis? How frequently?
10. Does supervision occur over the telephone, through progress reports, or in person at the home of the older adult?
If it is at all convenient, It is highly recommended that family visit the offices of the agency.