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Be wary of caregiver's offer to work outside agency

By JAN WARNER
Published August 29, 2006

Editor's note: We are printing this letter from a reader, with minor edits, because we believe the reader has hit the proverbial nail on the head of the home health care issue. Excellent tips on being wary of changing a home health care arrangement are included.

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To take better care of my father, who has dementia, my mother hired a home-care assistant through a regional hospital that serves as my parents' medical care provider. The woman has been most helpful, professional and friendly; however, after three weeks on the job, when Mom said she was considering increasing the number of home-care visits each week, the woman suggested that rather than continue to hire her through the hospital, Mom could save money by paying her directly to come in on her own time.

She told Mom it would be a "win-win" situation because Mom would be paying less, while the provider would receive more than the hospital was paying her per hour.

Mom asked my opinion, and I gave it to her by making a list that we went over. I thought it might be helpful to your readers if you print it:

* I warned Mom that in addition to opening herself up to liability, I was sure there were tax and labor laws to consider. For example, if she hired the home-care assistant directly and that woman got hurt on the job, she might be able to sue Mom and Dad for her medical expenses.

* The fact that this provider would be working "off schedule" for direct pay suggests to me that her availability may become unreliable. To avoid conflicts with her regular work schedule, she might not be available at preferred times of the day or days of the week.

* My sisters and I view this behavior as a breach of ethics, which leads us to believe that since this woman would be willing to take work away from her employer, she is not to be trusted.

This concern is redoubled because our parents live in a rural area, about 10 miles from the nearest town. What happens if Mom and Dad become dependent on her and she begins raising the price of her services or does something else that causes my folks to get someone new who won't be informed about the whole situation? The last thing Mom and Dad need right now is additional stress caused by home-care assistants who become dominant in the relationship.

My mother, I assume like many seniors, tells me that she is not interested in me "parenting her" and has decided that she will not stop using this woman. However, Mom IS worried about the liability issues and will keep the woman on through the hospital service.

I think I have gone as far as I can without ruining my relationship with my mother. Still, I have concerns about how convincing that caregiver can be because she has my mother's attention and support. I live several hours away by car, so I can't keep an eye on things as much as I'd like.

Now that I have done it, I'd like to know if you think I am off base with my analysis. Do I have valid concerns? Are there additional concerns I should be aware of?

Jan Warner is a member of the National Academy of Elder Law Attorneys and has been practicing law for more than 30 years.

Jan Collins is editor of the "Business and Economic Review," published by the University of South Carolina. You can learn more information about elder care law and write to the authors at www.nextsteps.net.

United Features

[Last modified August 28, 2006, 18:59:12]