Sunday, September 21, 2008

Elder Care: Caregiver Abuse

Those who need to depend on caregivers are justified in worrying about the trustworthiness of the person they're letting into their home. Iti's a given that an elderly person who needs a caregiver is in a dependent state. If they weren't, they wouldn't need a caregiver. All the aspects of aging that create dependency--hard of hearing, don't see well anymore, take naps a lot, can't remember very well, lonely--contrive to create a situation that is ripe for exploitation. So, yes, there's a lot to worry about.

But that's not what I want to address now. Rather, I want to give some exposure to the all too frequent abuse of caregivers by their clients. The work of a caregiver is not (yet) a degreed profession , unless you're at the nurse level of caregiving. Thus it is open to anyone who is willing to do the hard work. In some respects, the caregiver is part of what I consider an underground industry. Caregiving per se isn't regulated. There's no certification required to be a caregiver, and those who need the caregiver often are in somewhat desperate circumstances themselves...desperate for help, desperate for relief, or even just desperate for company.

Look further and you see the client and caregiver isolated in the client's home, typically without supervision. Ues, for those so inclinced this offers a perfect opportunity for a caregiver to take advantage of their client. It also makes it easy for clients to become abusive with their caregiver who likely is very dependent on their hourly wage and not in a position to walk away from the job.

We want the caregiver to be caring, kind, to drive carefully, to remember instructions and to use their best instincts in the care of our parents. We want them to help our parent with errans, take them to doctor appointments, and not steal. Yet we're not willing or able to pay much to our caregivers. An agency sending a caregiver to my parent's apartment may pay them $8-$10 per hour. If I hire an independent caregiver, the rate may be $11-$13, depending on the number of hours I want them to come in. By comparison, there's the auto mechanic, for which your local repair shop may charge $60-$120 an hour. Considering who it is we're making caregivers responsible for and the attention we're asking them to pay their work, the job is, in my view, poorly paid.

In my experience, a caregiver often is someone who's working 2-3 jobs and really needs the money. This puts them in a position that their clients also find easy to exploit. I've heard stories of caregivers whose clients scream at them in the most rude and brutal manner, who require the caregiver to reserve time for them for weeks, but don't pay them for holding the time open, and many other thoughtless and disrespectful actions that I find appalling.

There are many caregivers who take great pride in their work, who are eager to learn new skills to improve their performance and who grow to be deeply fond of their clients. As would any other worker in personal services, caregivers thrive on kindness and concern for their well-being, and repay tenfold when they are treated with dignity and respect. And doesn't that sound just like the way we want them to treat our parents?

Here's what I urge anyone who already has or is considering engaging a caregiver to do:

1. Go overboard in treating them as professionals.

2. Pay them a bit more than the going rate, even just 50 cents more. And pay mileage for when they drive your folks around, and also if you ask them to work for less than 4 hours.

3. Get to know them as people, their lives, their other jobs, their families, their worries.

4. Be considerate of their needs so you can expect them to be considerate of yours.


Anonymous said...

Thank you so much for this article. I am a caregiver and I work in a nursing home. We cater to people with money and they tend to threaten us caregivers when we don't put them first, even though we are not private sitters. The families can be creul and ungrateful even though we are performing a task that they wouldn't be caught dead doing. Cleaning feces from their parents buttocks.

Anonymous said...

I just left a job due to extreme emotional/verbal abuse from my client's daughter. Yes, I need the income but when the abuse began affecting my own health I decided to walk. Very hard decision, even though I knew it was what I had to do. Thankfully I have the emotional support of my husband, family and friends. I am starting to feel like myself again and have finally slept well for the first time in weeks. I stayed much longer than I should have but decided she could find another caregiver for her mom, my husband and family can't find another me. Yep, it was THAT bad.

Anonymous said...

What about a person who is a relative and feels trapped in the caregiving? When can that person say, "Enough! I can't handle this!"

Dina said...

RE. Crying "Enough is Enough": I know that if I'm burned out, resentful and bitter, I'm not the best caregiver. But if I try (it's hard!) to think rationally about it, I can realize that this doesn't have to be a Black or White, All or Nothing situation. Basically, what burns me out is that caregiving is so much a one way street. It's a situation with 99% give and very little return in the traditional sense. What I do is look for one or two things that'll make me feel like I'm taking back something for myself, instead of continuing to give every ounce and spare minute as I have been. I don't know what your situation is so can't say whether or not this is feasible for you. If it's even half an hour to yourself to watch a favorite TV show, meet a friend for coffee, go for a walk, sit and do NOTHING, that'll make a difference.

Hope this helps...........