Geriatric Care Managers Should Know


I was reading a recent blog post from another agency, Seattle area based Capability Homecare.  The article was about how the owners got into this business of senior care.  As for many of us, the story was about their own family experience, much as it was for us at Support For Home.

What leads me to write this post, however, was a comment written in response to the agency’s article, by a Geriatric Care Manager.  The comment, in full, read:

Many of us specializing in geriatric care entered the specialty due to a personal experience like yours.  But sadly, as a geriatric care manager (masters clinical social worker) I am not seeing the quality of caregivers you describe as your staff.  Caregivers are not trained, lack respect and responsibility, and often sleep on the job.  I try to place private, trained experienced caregivers today rather than agency staffing.  I hope your caregivers are as you describe and truly do provide care and service.

Frankly, I find this comment fairly amazing.  I understand the frustration underlying the comment.  In elder care, all of us are frustrated when we see disreputable home care companies or “referral  agencies” who take no responsibility for the people they send out.  However, giving up and giving in is not what I would expect from a Geriatric Care Manager.  My own response to the GCM’s comments is below:

As a GCM, I would say you are definitely looking at the wrong agencies.  In our case, most of our employees are Certified Nurse Assistants (state certification), with very thorough background checks, skills and experience.  Finding some bad agencies — indeed, they are out there — does not justify exposing your clients and their families to workers compensation claims, unemployment taxes, payroll tax problems, liability insurance concerns (home owner’s insurance does not apply to domestic workers) and the absence of dishonesty bond coverage.  Look harder for good agencies.  Your clients deserve that.

Putting your clients and their families in the role of caregiver employer is a poor strategy, and that is what happens the vast majority of time with “private” caregivers.  Taxes do not get paid; the family is exposed to all kinds of liability issues.  We have heard this not just from colleagues, but from California state officials.  At Support For Home, we have actually had clients call us to begin providing home care after disasters with private caregivers.  In one case, a new client said, “I have a hearing with the Employment Development Department tomorrow.  What do I say?!”  Unfortunately, there was no good answer.

So, whether you need home care or someone you love does – or you are a GCM – you owe it to yourself, your loved one or your client to do the “home work” necessary to ensure the best possible care.

Best wishes, Bert

6 responses to “Geriatric Care Managers Should Know

  1. Thank you for explaining the risks of hiring a caregiver privately. By outlining the specific problems, hopefully families can understand why using an agency is a better (and safer) option.

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    • Thank you, Megan. I truly believe using an employer agency is the better, safer option, as it was when my folks needed home care. Now it is up to agencies such as yours and ours to maintain and raise the bar of quality and integrity. It’s good to have colleagues who get it! Bert

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  3. Bert, you are right on point with this article. I also would like to add that GCM’s trying to staff their own employees can be quite trying for clients as well. For the most part they lack the resources to replace call out and complete extensive screening on potential employees.

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  4. I absolutely agree. GCMs are ethically supposed to manage overall needs and find high quality service providers, not provide home care or other services themselves. It is a conflict of interest, just as it would be for a private fiduciary. If we, as home care providers, do not measure up, do not refer to us and let the world know!
    Best wishes, Bert

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