Senior Exploitation: Home Care Agency Caregivers vs. Private Caregivers

As the owner of a licensed, insured & bonded Home Care Agency, an industry which is highly regulated in Texas, there are extensive safeguards to protect vulnerable seniors from abuse, neglect and exploitation. Extensive experience in the senior services business has taught me that no one is shielded from elder exploitation.

The old adage of “you get what you pay for” certainly rings true.

When you sign up with a licensed Home Care Agency you are getting peace of mind.  If theft, abuse, neglect, or exploitation of a senior occurs, the Home Care Agency is required by law, to notify the Texas Department of Child and Adult Protective Services and the Department of Aging and Disability Services within 24 hours of the event.

We have all become aware of the recent increase in exploitation or theft perpetrated by private caregivers.

Often the private caregivers are hired by the family, at a cheaper hourly rate than through a licensed Home Care Agency.   However, safeguards that could potentially prevent exploitation are circumvented, thus leaving the senior vulnerable.  A Home Care Agency is required to perform appropriate background checks of criminal history, the Misconduct Registry, previous employer references and an assessment of caregiver competency.  The Home Care Agency provides an orientation for all caregivers and there is direct supervision by an Agency Supervisor.  The Agency is also required to investigate any complaints.

However, when the caregiver is hired privately, the senior becomes the employer with all the legal responsibilities including payment of all federal and state taxes.

Frequently no criminal history or other background checks are performed.  Supervision in the home is minimal or nonexistent.  Gradually, the senior develops a close bond, becomes more dependent and trusting of the caregiver who is viewed “as one of the family.” As the senior’s emotional attachment and dependence increases, they decide to demonstrate their gratitude by offering inappropriate amounts of money or valuable items.  The caregiver is now viewed as family, and not an employee.  Consequently, the caregiver may develop a sense of entitlement or they see the opportunity to exploit the senior without ramification as there is no supervision.  So, “that large bank account” may be viewed as more money than the senior will ever need, or the other family members should inherit, and the opportunistic mind gravitates to illegal or exploitative behaviors.

Here are some suggestions I recommend to prevent exploitation:

  • Encourage the senior to have one of the family become a financial power of attorney (POA) or, at minimum, become an authorized signer on all bank accounts.
  • Avoid sending banking information to the home through the mail.  Set up online banking that is password protected.
  • Alert the bank to type a “caution note’ under the senior’s account, directing a family member to be notified if money above a certain amount is withdrawn or large amounts of money are being transferred from various bank accounts.  Directives requiring two (2) signatures when significant amounts of money are withdrawn is also recommended.
  • Set up payment of bills on auto-pay to minimize writing of checks.
  • Provide the caregiver with a gift card that has been preloaded with an appropriate amount of money that can be used for all household expenditures.  All receipts need to be submitted to the appropriate family member.
  • Remove or lock up household valuables or jewelry.

If a senior has been exploited and valuable items or money has gone missing, these are some immediate actions you need to execute:

  • First call the Police and file a report, if you suspect there has been a theft.
  • If it is a suspicious situation of exploitation you may contact the Texas Department of Child and Protective Services to file a report.
  • I strongly suggest contacting a lawyer specializing in Elder Law through the Texas Chapter of the National Academy of Elder Law Attorneys or the National Association of Elder Law Attorneys (NAELA).  These Attorneys have the experience to facilitate implementing quick legal action to halt or reverse any serious senior exploitation.

Helen Trowsdale, President of AA Care Services, is a nurse administrator with over 30 years of experience as a BSN, psychiatric nurse, and geriatric care manager with adults as well as pediatrics in hospitals, private duty home health care agencies, and residential home health care. Her team of caregivers are dedicated to serving their clients with home care in San Antonio, New Braunfels, Austin, and Dallas; providing clients with consistent, quality care while minimizing the number of caregivers in the home. Learn more about AA Care Services.

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