Sunday, June 26, 2011

Creating a New Standard For Senior Home Care in Arizona

We (my husband, his brother, his brother’s wife and myself) spent the past week with our consultants for our new in home senior care business. I learned so much. I have been caring for seniors for more than 12 years in my capacity as a dental assistant and as a dental student now. As well as helping with end of life care when my uncle had terminal brain cancer when I was in high school. I thought I knew a lot about the challenges our elders face but I found out this week that I have only touched the very tip of an extremely large iceberg. I think my most shocking revelation is that since Arizona has no licensure requirements for in home care, anyone can open one and there are no regulations making sure that they are doing things to any type of standard. As a group we found this to be unacceptable. We hired a consulting firm out of Georgia because as a state Georgia has the strictest licensure requirements in the country and we decided that we wanted to exceed those requirements in an effort to force our competition here in Arizona to do better! I hope that this entry finds its way to someone who is researching in home services for a loved one and that they will be more educated in choosing a company. There are approximately 500 companies in Arizona offering in home services for seniors and disabled individuals, some are wonderful and some are not. It is very important to do your homework! In our research we found that many of the more prominent companies do not train their staff at all, they rely on the prior experience of the staff member. We found this week as we held a mandatory 8 hour training session with our first bench of employees that although they were all experienced, many lacked basic training. One of our new hires actually thanked me for having a company that trained the employees. She said that she is used to being interviewed one day and sent out to someone’s home the next with no idea of what was expected of her. We also learned that most companies do not do thorough multistate background checks. This is not good enough. Although expensive, it is critical to do the most thorough background check possible because we are being trusted by some of the most vulnerable individuals in our society. I would not send anyone into the home of a client that I would not trust with my own children or my grandmother. We developed a list of questions to ask when considering an in home services company. I am going to post them here because I feel that it is really important that people are aware of them. This is a critical decision for a family to make, please take the extra time to be sure you are making the best decision you can. We are also offering free training seminars for family caregivers, because although you love the person you are caring for, you may not be equipped with all of the skills necessary to properly care for them. We would rather help you learn, than have someone not cared for properly.
Important questions to ask any agency you are considering:

1.Is the agency licensed by the State?
Although Arizona does not require a state license to own a home care agency, the company you choose should meet the most stringent licensing requirements across the country that help protect and provide for the clients.

2. Are the agency’s caregivers bonded    and insured?
 The company you choose should have professional and general liability, bonding and Worker’s Compensation coverage in case of a mishap.  Some firms have only minimal coverage and some none at all.

3. How extensive are the agency’s criminal and background checks?
You want only the most ethical, skilled and compassionate caregivers in your home.  It is important that the agency not only run a check on the last place a person worked, but complete a complex multi-state check on all the places they have lived, their driving records and reference checks from previous supervisors.

4.How qualified are the agency’s caregivers?
Often times, an agency will simply hire someone without much experience and even less credentials.  Reputable agencies have requirements for levels of experience, certification and annual training. Select a firm that requires companion caregivers to be thoroughly trained through a recognized program.  Although Certified Nursing Assistants are state certified, they need to be trained in the agency’s policies, procedures and standards along with the diseases of the aged.  Reputable agencies must have a licensed RN on staff for supervision to insure that proper protocol is being followed in the care of the client.

5.Will the same caregiver come to the client’s home on a regular basis?
It is difficult to receive good care if different caregivers show up every week.  A good home care provider will insist on continuity of care and carefully match each client with the proper caregiver.

6.How would a complaint or question about service be handled?
A reputable agency will provide you with a detailed process for dealing with complaints or service questions.  All clients should be given the agency contact person and phone number to resolve any concerns that may arise.   

7.What procedure is in place to handle emergencies?
Emergencies can happen and a quality agency will have policies, procedures and plans in place to deal with emergencies if they do occur.  Its employees will be thoroughly trained in how to respond to any serious situation.

8. Can the agency provide printed materials describing service rates and fees?
An agency that provides detailed, carefully considered materials for your review, more than likely, has gone the extra mile in other aspects of its business.  These should include rates, minimal hourly requirements, billing cycles and any required deposits.

9. Is the client’s course of care documented with specific tasks to be carried out by the caregiver and is the client’s family involved in the creation of this plan?
A reputable agency will create an individualized plan of care for each new client.  It should be carefully and professionally developed with the client and family members.  The care plan should be written and a copy left with the client.  The plan should list specific duties, work hours/days, and the name and phone number of the supervisor in charge.  The care plan should be evaluated, updated and revised as the client’s needs change.

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