Many Caregiver Agencies Fall Short, Study Finds

Only 55 percent of the surveyed agencies did a federal background check, and only one-third of them conduct drug testing of their employees, a Northwestern Medicine study found.

People who hire a caregiver from an agency to care for an elderly relative may wrongly assume the caregiver has undergone a thorough criminal background check and drug testing and was experienced and trained for the job, according to a study from Northwestern Medicine that has been published in the Journal of the American Geriatrics Society. The researchers found many agencies recruit workers online for placements in the homes of elderly people with dementia, don't do national criminal background checks or drug testing, and lie about their tests checking the caregivers' qualifications and the training they provide.

"People have a false sense of security when they hire a caregiver from an agency," said lead study author Dr. Lee Lindquist, MD, an associate professor of medicine at Northwestern University Feinberg School of Medicine and a physician at Northwestern Memorial Hospital. "There are good agencies out there, but there are plenty of bad ones and consumers need to be aware that they may not be getting the safe, qualified caregiver they expect. It's dangerous for the elderly patient who may be cognitively impaired."

The study was funded by a grant from the National Institute on Aging. It found only 55 percent of the agencies did a federal background check, and only one-third of them conducted employee drug testing. "Considering that seniors often take pain medications, including narcotics, this is risky," Lindquist said. "Some of the paid caregivers may be illicit drug users and could easily use or steal the seniors’ drugs to support their own habits."

Lindquist, a geriatrician, said some surveyed agencies concocted names of screening tests they claimed to use for applicants. "We had agencies say they used a 'National Scantron Test for Inappropriate Behavior' and an 'Assessment of Christian Morality Test,'" she said. "To our knowledge, these tests don't exist. If you're not a smart consumer, you won't recognize which agencies are being deceitful." This task is difficult because many agencies have impressive websites and marketing campaigns, she said in the Northwestern news release about the study. "It's a cauldron of potentially serious problems that could really hurt the senior," Lindquist said. "These agencies are a largely unregulated industry that is growing rapidly with high need as our population ages. This is big business with potentially large profit margins, and lots of people are jumping into it. Some of the paid caregivers are so unqualified it's scary and really puts the senior at risk."

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