Objectives
To assess what screening practices agencies use in hiring caregivers and how caregiver competency is measured prior to assigning older adult responsibilities.
Design
One-to-one phone interviewers where interviewers posed as prospective clients seeking a caregiver for an older adult relative.
Setting
Cross-sectional cohort of agencies supplying paid caregivers to older adults in Illinois, California, Florida, Colorado, Arizona, Wisconsin, and Indiana.
Participants
462 home care agencies were contacted, of which 84 were no longer in service, 165 offered only nursing care, and 33 were excluded. 180 agencies completed interviews.
Measurements
Agencies were surveyed about their hiring methods, screening measures, training practices, skill competencies assessments, and supervision. Open ended responses were qualitatively analyzed by two coders.
Results
To recruit caregivers, agencies primarily used print and internet (e.g. Craigslist.com) advertising (n=69, 39.2%) and word-of-mouth referrals (n=49, 27.8%). In hiring, agencies required prior “life experiences” (n=121, 68.8%) of which less (n=33, 27.2%) were specific to care giving. Screening measures included federal criminal background checks (n=96, 55.8%) and drug testing (n= 56, 31.8%). Agencies stated that the paid caregiver could perform medication reminding (n=169, 96.0%).Skill competency was assessed by caregiver self-report (n=103, 58.5%), testing (n=62, 35.2%), and client feedback (n=62, 35.2%). General caregiver training length ranged from 0–7 days. Supervision ranged from none to weekly and included home visits, phone calls, and caregivers visiting the central office.
Conclusion
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.