What to look out for when employing carers in my home or for my loved one.
Carers can be of great help when you or your loved one can no longer complete daily tasks independently. Getting the right help timeously can ensure you remain independent for much longer as they can take over strenuous tasks and ensure safe mobilization, reducing your risk of falling. They can also ensure emergency personnel are contacted if you have a change in condition. In short, they can enable you to live in the comfort of your home with just the right amount of help.
That being said, having carers in your home comes at a risk and an even greater one when you/ your loved one is cognitively compromised. Registered home based care agencies can mitigate some of these risks by ensuring transparency, communicating with your next of kin when needed, using professionals to conduct thorough assessments to set up an individualised care plan and having reporting systems in place that is monitored to flag any health risks or address challenges that may arise.
Carers need to have undergone a training programme accredited by the South African Qualifications Authority (SAQA). They also need to register with the Department of Social Development by filling out Form 7 of the Older Persons Act. Unfortunately this is not a well regulated profession in South Africa and these registers are not kept up to date. You can request proof of caregiver qualification (which should be redone every 2 years) but you won’t know if they were previously dismissed for poor conduct. Therefore thorough reference checks are essential.
Things to consider when employing a private carer:
- Do they have a clear credit and criminal check?
- Do they have a recent, positive reference?
- How will they know what your loved one needs help with? If that changes, and they need more help, will the carer be able to notice this and work proactively?
- How will they know what is the safest way to mobilize or transfer your loved one? Some transfer methods can do more harm than good.
- How will they deal with your loved one if they are refusing to wash or change clothing? What if it becomes a hygienic concern?
- Will the carer know when to seek medical help?
- Will they know how to manage specific medical conditions? (Like elevating your legs, increasing fluids to prevent hydration, pressure care monitoring)
- How will the medication be managed? It’s not in a carer’s scope to administer medication. Agencies usually insist on blisterpack medication from the pharmacy which is already packed out in days of the week and can be monitored.
- Who will do the shopping? (It is very irresponsible to give a bank card to a carer to do shopping)
- Will they provide sufficient cognitive, social and physical stimulation to maintain functioning?
- How will they keep records of services and who will monitor this? (Frequency of washes, record of medication given, food intake, noting irregular bowel movements, noting strange behaviour that could be an indication of a UTI, noting pain)
Considerations when managing an employee:
- What replacement is there when the carer is absent?
- If the person they are caring for is a high fall risk, who will step in when the carer is on a smoke-break or on lunch?
- Will the carers bring their own food or are meals provided? If they help themselves to meals, how is this monitored?
- Will they accept gifts? (Confused elderly often offer money or objects making them vulnerable to exploitation)
- What will you do if something goes missing in the home?
The elderly are a vulnerable population and sometimes require support to ensure they are not being exploited. A social worker can be contacted to assist with a holistic assessment to identify and manage potential risks at home.