Patrice Kadlec needed someone to help take care of her elderly father in his Oak Park home, and she needed someone fast. Kadlec works full time, and her father, who has Parkinson'sdiseaseand related dementia, was being discharged from the hospital the next day after treatment for bladder cancer.
Kadlec scanned a long list of service providers she had received from a local organization that helps senior citizens. With panic setting in, she picked one.
Nearly a year later, she has changed agencies three times. She encountered a paid caregiver who begged for money, a worker who left her father in soiled adult diapers all day and another who was argumentative to the point of being scary.
"I was panic-stricken a lot of the time wondering what was taking place in my absence," Kadlec said.
People who hire caregivers for elderly family members might assume that agencies conduct drug testing and thorough criminal background checks, and that prospective employees have been painstakingly vetted to make sure they are experienced, competent and trained for the job.
But that is not always the case, according to a recent Northwestern University study that found many agencies do a poor job of making sure caregivers are safe, reliable and capable.
Among the study's findings: Some agencies recruit workers from Craigslist and place them in the homes of older people with dementia without checking for criminal convictions or assessing whether they are qualified. Many agencies don't do national criminal background checks or drug testing. And some agencies lie about testing caregivers' qualifications, don't require experience in the job and don't provide training.
"Our results brought forth some alarming issues among agencies that hire caregivers," said lead author Dr. Lee Lindquist, a geriatrician and associate professor of medicine at Northwestern University Feinberg School of Medicine. "There are good agencies and bad agencies, and consumers need to be educated about what to look for."
The study looked at five states with large populations of older adults — Illinois, California, Arizona, Florida and Wisconsin — plus two other states, Indiana and Colorado. Lindquist said she did not break out the results by state, but Illinois ranks in the middle in terms of legal requirements.
Melaney Arnold, a spokeswoman for the Illinois Department of Public Health, which licenses agencies that supply paid caregivers, said the state stays on top of potential problems.
"Illinois has some of the more stringent regulations for home-services agencies among the states," she said. "Illinois laws require home-services agencies to be licensed by (the department) and to provide criminal-history background checks for all employees. Home-services workers must pass a competency evaluation provided by the agency, successfully complete a training program and complete a minimum of eight hours of training each year."
The state health department said it bars people from working as caregivers if they are convicted of certain crimes that show up on an Illinois State Police background check, unless they apply for a waiver and it's approved.
Yet criminal background checks don't always pick up all the information that consumers might want to know about a potential caregiver. For example, although theft is on the state's list of disqualifying offenses, a theft conviction would not show up on an Illinois police check if it was a Class C misdemeanor or the person was sentenced to supervision. If the conditions of supervision are met, the court can dismiss the charges.
Paid caregivers include a large category of workers such as personal care attendants, private duty attendants, home care aides, direct care workers and sitters. In Illinois, training must cover patient confidentiality, basic hygiene and basic infection-control practices, recognition of emergencies and proper response, and personal care skills for clients, including bathing, shaving, dressing, feeding and remembering to take medication, among other tasks.
The National Private Duty Association, which represents more than 1,300 home care companies, acknowledged that some agencies don't do a good job but took issue with the study, criticizing it for painting all agencies with the same brush.
"The study's findings are not representative of the hiring, training and supervisory practices of the members of the NPDA who adhere to high standards and industry best practices," the organization said in a written statement.
Its member agencies employ, train, bond, insure and supervise their caregivers, who provide a variety of care, including homemaker services, companionship and home health care, the statement said.
Lindquist said the purpose of the study wasn't to vilify all agencies, because they serve a critical role.
"What we're trying to say is, don't go with the agency with the pretty website or a good story," she said. "You need to vet the website and what they tell you (over the phone) and look into it more."
Michael Doepke, who owns Home Helpers HomeCare in Hinsdale with his wife, Mary, said his agency goes beyond what state law requires. For example, Illinois requires only a criminal background check through the state police database, but Doepke said his agency also does a national check. The agency also does routine and random drug testing, he said.