Questions to Ask an In-Home Care Agency

Carol Bradley Bursack | Oct 20th 2017

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Choosing an individual or a company to come into our home, or that of a vulnerable loved one, to provide assistance with anything from cleaning to personal services is never easy. We are giving an unknown person access to not only our property but to the safety of our loved one who may need care while we are not able to supervise. Choosing the right person or company should be done methodically, and education can help you ask the right questions.

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An author shares his experience to help others

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Kurt Kazanowski, a hospice, homecare and senior care expert who is author of A Son’s Journey: Taking Care of Mom and Dad, says that there are 10 questions to ask the individual or agency with whom you are considering to enter into a contract. The following slides will lead you through Kurt’s questions with additional commentary from my personal experiences and that of other family caregivers.

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How long have they been providing service?

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Kazanowski says that people should ask how long the agency has been providing private duty home care. He adds that you should insist on meeting the care worker who will be reporting to your home and get at least three references from patients for whom this person has provided care. I agree. I would add that emergencies happen, and if you are working with an agency, you may not always get the same caregivers, so vet the agency well in order to trust their judgement.

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Make a written plan

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“Is a written, customized care plan developed in consultation with the client and family members, and is the plan updated as changes occur?” This question, posed by Kazanowski, is important because the caregiver needs to know exactly what is expected of him or her. But it’s also vital so that the agency and the caregiver know that the family caregiver in charge will be keeping tabs on what

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What about emergencies?

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Kazanowski says that we should ask how emergencies are handled after normal business hours. This is important. As a family caregiver, I’m well aware that emergencies have a way of happening during the evening, at night or on weekends. If you hire an agency to provide a caregiver outside of normal business hours, make certain that the caregivers the agency sends are authorized to handle medical and other emergencies without needing contact the office for assistance.

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How closely does the agency supervise caregivers?

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Kazanowski says that we should ask if the “agency closely supervises the quality of care, including maintenance of a daily journal in the client’s home and non-scheduled supervisory visits.” This is important from both aspects. We want to know that the in-home caregiver has good supervision and can ask questions when necessary. A written journal is the way professionals hand off their shift so that everyone knows what has been done and when.

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Do professionals stop by for random checks?

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“Does the agency employ a nurse, social worker or other qualified professionals to make regular visits to the client’s home?” This is an ideal situation and it should be part of every contract, but reality tells me that it’s not done often by many agencies. Nevertheless, you should ask this question. It’s possible that the agency does make these visits, but even if they don’t they will get the message that someone, maybe you, will be checking up on how things are managed.

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Patient statement of rights

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Kazanowski says that you should ask if the agency provides a written document that states the rights of the patient, and the responsibilities of the client, and explains the company’s privacy policy and code of ethics. From my experience this is standard procedure but certainly ask before you sign up if you are not offered such a document. It’s essential that you have this information in writing, signed by the agency head.

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Thorough employee screen essential

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Does the agency triple-screen their caregiver employees carefully, including use of reference checks, driving records and criminal background investigations? This may be one of the most obvious questions, but all background checks aren’t equal. Make certain that the agency does a paid, deep background check into the personal and professional life of the caregivers sent out to homes.

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Ongoing training for staff

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Mandating ongoing training to update skills should be part of the agency policy. Kazanowski considers this important, as do I. As a family caregiver, I went through a virtual Alzheimer’s training program that forever changed my life. In my opinion, every caregiver should have similar training, if available, and many other updated classes are also needed. Such training underscores skills and the need for compassionate, person-centered care.

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Payroll- and employee-related matters

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One reason to go through an agency rather than hire an independent caregiver is that you can eliminate a large amount of paperwork. Kazanowski says to ask if the agency manages all payroll and employee-related matters and if it adheres to state and federal guidelines in its employment practices, such as withholding appropriate taxes and providing workers’ compensation and other benefits. You don’t want to have legal issue to cope with on top of all of your other concerns.

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Supplemental staff

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Kazanowski’s final question on the list has multiple parts. He says to ask if the agency also uses independent contractors and if so, who employs the person and what type of background checks do they do on these contractors. Also, he says to ask who pays the mandated taxes and withholding for these people. In my opinion, the agency should handle all of these issues. That is the reason that you are going through an agency rather than handling this independently.

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The takeaway

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Lining up in-home help for your vulnerable loved one is stressful. One of the biggest complaints that I hear from people is that caregivers don’t show up and the family has to scramble to fill in. Finding out how an agency provides staff when the regular caregiver can’t make it is vital. It’s your right to ask questions of an agency that you hire, so do so. Be friendly, but make it plain that you need answers.