[Critique Group 1] Leonard's comments on Cleora's piece

[tuchyner5 at aol.com]

Cleora sub for July 21

2088 words

Help Wanted

by C. S. Boyd

 

Twenty plus years ago, I started using care givers. With myfailing eyesight and some mobility restrictions, I needed help with house workand reading my mail. I asked my visually impaired friends what they did. Somehad family members they could depend on. A couple of my male friends werehiring students from a local college. This was a good source since thesestudents needed flexible hours, and were capable of doing the more exactingwork they required. However, as a female, I didn't feel this would be a safeway for me to find helpers. I decided, instead, to use a home health careagency knowing that they were required by law to do background checks on thepeople they sent into other people’s

 homes.

 

See correction above.

 

At first, I used someone once a month, then a couple oftimes a month, and now three times a week. Around nine years ago I noticed adramatic decline in the quality of care givers I was receiving. 

 

To date, I have used five different agencies. Nine if youcount the number of times the agency I was using either sold out to or wastaken over by another agency.

 

The Owners of the good agencies I've used started theirbusiness because of frustration they experienced when they went looking for acare giver for a family member. When they started their business, they hiredpeople they would be willing to have taking care of their own loved one. Overtime, as the business grew, they turned more of the responsibility over toothers. These people were chosen with the same care they used to select caregivers, but these people, while good people, didn't share the commitment andpassion the owner did and didn't have the instinct for selecting quality caregivers. As the owner became less involved with the business, While they stillwanted to provide quality care for their clients, the service degraded into thesame kind of business they had sought to replace. In other cases, the agencywas bought out by another agency and office personnel were replaced, or givendifferent operating instructions for conducting business. Again, The end result!

was that the business became the same as the ones they hadsought to replace.

 

Let's face it. People who need help are often cranky,frustrated by their own inability to take care of their own needs, sometimes inphysical discomfort, and may be inclined to take all this out on their caregiver whether they mean to or not. People are needed that have the confidence,compassion, maturity, and self-esteem to be willing to do the task the way thecare receiver wants it done, and accept that the person they are helping knowsbest how something will work for them. People are needed who can provide carewith the understanding and compassion that instills confidence and trust in thecare giver.

 

For this reason, a care giver has to be a very specialperson. They need to be someone who understands and provides good care withouttaking advantage of the person or abusing the person they are caring for. Theyneed a high enough self-esteem that they don't become offended when the personthey are caring for wants them to do the task in a particular way.

 

Government regulation is not enough to insure quality care.It is as important to check out the agency as it is for the agency to check outtheir care givers. There are a few things that can be done to try to weed outthe agencies that may not have quality people in their pool.

 

1. What is the agencies mission statement?

 

Some I've seen:

 

Your Home, Your Way.

To Us, It's Personal

 

The mission statement conveys what the company owner wantsyou to believe they will provide. In most cases this is the true feeling of theowner. However, it doesn't necessarily indicate that the people working for himhave been successful in hiring people that will fulfill the promise.

 

They all claim to match compassionate, reliable care giverswith each person’s personality and needs. 

 

Same error.

 

2. How does their help wanted ad read?

 

The ad for people may say something like"you’re compassion and heart can truly make a difference in thelives of aging adults." They will say they need people who are inspired tohelp others.

 

The first question to ask, is how well the agency fulfilsthese high sounding words.

 

How to you ascertain this?

 

 

Does the ad also say: "No experience necessary, we willtrain."

 

Training likely consists of anything from a 30 minutelecture on how to sign in and out of the shift, general information about whatto do if the client doesn't answer the door, and things they are not allowed todo. Some agencies take up to a week to provide more detailed training in thetypes of duties the job may entail.

 

How do you find out what their training consists of?

 

If this is a person on their first job as a care giver, theylikely have no idea what to expect. If you don't mind taking raw material andyou have the time and energy to provide someone on the job training while youpay them by the hour, this could be your opportunity to train someone exactlythe way you want. Some flaws in this plan are the same as for the employergiving a young person their first job opportunity. Finding a person willing tolearn, and that has the right disposition for the job. You may find that thisnew hire is going to realize this isn't what they want to do at all, and youwill never see them again. They may also think that little trinket on yourmantle is cute and you will never miss it. Some will resent you telling themhow you want them to do something, and refuse to do it your way.

 

So why not get someone that responds to your own add  and train them?

 

Check the agencies help wanted ad. If they are looking forpeople with three to five or above years experience, this gives a better chanceof finding a good fit.

 

Good idea.

 

3. Do they charge for filing a long Term Care insuranceclaim?

 

 

If you have a Long Term Care policy that has been activated,most likely you cannot file the claim. It has to come from the agency. Don'tlet the agency tell you that they have a fee for filing the claim, and that youcan avoid the charge by filing it yourself. This works for your medicalinsurance where the doctor's office provides you with a SUPER that has all themedical codes and all you have to do is fill out the claim form, attach theSUPER and send it in for reimbursement. To file the LTC claim yourself, you aregoing to need to be able to document the care givers clock in and out time,prove that the ADLs were done, and that the care giver was a qualified person.This information is available only through the agency. If you have a sharpfamily member or friend willing to do the work, or you are able to spend thetime and hassle you can try it. Check with your insurance to find out what theyrequire. My insurance wants a list of tasks done on the shift including the t!

ime the ADLs were done. The time must be within the shifttime. This must be done for each day service is provided and signed by both meand the care giver. You may be able to get the agency to provide you a report,but in my case, each day has to be signed by both me and the care giver. Theinvoice the agency sends you showing the dates of service and amount of timefor each day is not enough. The insurance company needs proof that the servicewas actually provided by a qualified person within the shift time. You canunderstand this. They have to be sure you and your neighbor or family memberdidn't make up some stuff, sign it, and send it in for reimbursement. For thisreason, I don't think it is reasonable for an agency to charge for filing theclaim. 

 

What does a long term insurance pay for. 

This sounds very important. 

Don’t assume your reader knows what you are talking about. 

This one doesn’t  

It sounds very complicated.

 

I have only dealt with one agency that wanted to charge forfiling the claim. This agency did not have quality care givers and it was ahassle every month to have to find out what was wrong and get them to resubmitthe claim sometimes as often as five times before they got it right so I couldget my reimbursement.

 

“The messeage I get is that what ever they do, 

you have to pay for it. 

It must be filed with a insurance company. 

But you don’t get cooperation with  providers to do that. It 

sounds like something you should have a guarantee  aboutbefore hiring them.

 

4. How do they expect to be paid 

 

Most companies will tell you that you are responsible forthe bill regardless of if you have long term insurance or are paying out ofpocket. I have found a couple that will try to have the insurance company sendthe payment directly to them, and the client is only responsible for payingwhat is not covered by the policy like mileage charges, charges for filing theLTC claim, and any other fees the agency may charge. I personally, prefer tohave the insurance reimburse me. 

I think your fighting  a war you cannot win.

5. What is their afterhours policy?

 

The government requires that an agency cover the phones24/7. Different agencies handle this in one of three ways that I know of. Theremay be other ways, but the ones I've encountered are.

 

The main number may be either answered 24/7 or forwarded toan answering service. They may have an afterhours number to a cell phone thatis taken with whoever is on call.

 

Try calling the agency of interest after regular business hours.

If an answering service answers, the agency may be alright,but put them at the bottom of your list and keep looking.

Good advice.

 

Some answering services are very good, so this shouldn'tscratch the person off completely, but it isn't a good sign.

 

If you get voice mail. Again, the person on call may betalking to another client and couldn't pick up the line. Or, most likely in myexperience, they are busy with some personal activity and just don't answer.One way to ferret this out, if you are very interested in the agency everyother way, leave a message. If the call is returned promptly, keep them on thelist. If more than 30 minutes passes without a call back, scratch them off.

Good advice.

 

The main number is actually answered 24/7 by a person thatis actually at work and can answer your questions even though it is not regularbusiness hours. This is the best and I have only talked to one that does this.Similar to this is when the owner or other office staff answers, and canaddress client needs, but wants you to call back during regular hours todiscuss services.

 

5. How thorough is their check?

 

Do they just do the minimum required by the state? 

 

I tried to get specifics on what checks are required by mystate, but was unable to get that information. In talking to various agenciesI've used, I'm pretty sure a criminal background check and a check with DPS arerequired, I think there is a third check but I don't know what that is. Someagencies will also check the national record, but I don't think this isrequired on the state level. Some agencies also do a drug test on a regularbasis, and I'm told there are as many as five possible checks. The more checksthe agency does, the better. I've had a little experience with abusive people.In my experience, these people do not change. They only walk the straight andnarrow as long as they know someone is watching.

 

I am still learning, and add new things to my list as myneeds change and I discover more things I need to be aware of. These agenciesare audited periodically. Supposedly they don't know ahead of time when this isgoing to happen. The auditors will look over the agencies records and pick upto 10 clients at random to visit and interview to check on the services beingprovided. I'm not sure how good this audit is. I was aware of a couple ofissues with some of the agencies I have used, and was surprised when I learnedthey had been audited and got a satisfactory report. Hopefully, this willprovide the reader some guidance in doing the best possible job to acquire helpfor yourself or your loved one.

 

 

 
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