I think that in America the image of “long-term care” usually includes a nursing home or assisted living facility. And while it’s true that we’ve become more comfortable with the idea of placing elderly loved one’s in facilities outside the home, it’s far from the norm.
Staying Home: Caregivers & Home Health Aides
In 2012, the National Center for Health Statistics placed the total number of nursing homes at 15,700. On any given day, approximately 1,383,700 residents lived in a nursing home and another 713,300 lived in residential care communities or assisted living facilities. Together, that’s just over 2 million Americans in residential long-term care. But at last estimate, 13.1% of the American population had reached, or surpassed, the age of 65, around 41 million people.
Obviously, many seniors don’t require the ongoing medical services and consistent observation that all long-term care options offer. But out of the estimated 8.4 million seniors who do each year, only about 25% are admitted to nursing homes. The overwhelming majority, 57.1%, or 4,724,500 elderly Americans, choose to remain at home and receive ongoing medical care from a home healthcare provider.
What Are Home Health Aides?
There are many different types of home caregivers, and listing all the synonymous names and describing their minute distinctions would be impractical. Generally, the type of caregivers who assist elderly patients with the daily activities of living are considered “unlicensed,” like personal care assistants and home health aides. In most states, including New York, home health aides are only required to receive 75 hours of training before they can become certified.
Home health aides usually work under the direction of Registered Nurses, “licensed” health care professionals who, along with a team of doctors, will create a plan of care that covers your loved one’s medical and lifestyle needs. The home health aide will then carry out this plan from day to day, administering necessary prescriptions and serving as a companion. Bathing, dressing, movement, toileting, and eating – home caregivers usually assist in all of these tasks.
Are They Abusers?
Yes, they can be, although elder abuse and neglect is far more likely to be committed by a family member than people unrelated to the senior.
In the only large-scale study performed on the prevalence of elder abuse in New York State, a staggering disparity was found between the amount of elder abuse that seniors describe when asked, and the number formally reported to governmental agencies. Only 1 out of 24 instances of elder abuse were referred to social services, law enforcement or legal authorities.
A similar disparity was found in regard to abuse at the hands of home health aides. Within the set of documented cases, elder abuse that had been reported to a state agency, only 0.65% of abusers were “paid home assistants,” or home caregivers. But in self-reported cases, 12% involved abusive or neglectful paid home care aides.
- 43.4% involved neglect in the daily activities of living
- 54.7% involved major financial exploitation
- 1.8% involved physical abuse
A study conducted in 2008 found that 12% of men suffered physical abuse at the hands of a “personal assistance service provider,” a subset of home health caregivers who work solely with disabled seniors.
Can They Be Held Accountable?
Although “unlicensed,” home health aides are held to a high standard of care, much like nurses and even physicians.
This standard prohibits deviating from your loved one’s care plan, as well as all forms of elder abuse and neglect. Because home caregivers routinely handle and administer medications and maintain medical equipment, their negligence may fall under medical malpractice laws. Other forms of neglect, like undernourishment or dehydration, would most likely be tried as civil tort lawsuits.
You may also be able to sue a home caregiver’s agency if you hired them through a distinct company.