How to protect infirm loved ones


A 90-YEAR-OLD woman in New Jersey is beaten and robbed by a home-health aide, who turns out to be a drug addict.

In New York, a home-health aide steals jewelry and cash from a string of frail clients.

Again in New York, a live-in aide is charged with stealing the life savings of her 94-year-old Alzheimer's patient -- going so far as to sell her house.

When we need home care, or our elderly parents do, who, exactly, are we inviting in?

About 7 million older people received help at home during some part of 1996 (the most recent data), according to Barbara Haupt, at the National Center for Health Statistics.

The great majority of aides appear to be giving honest service. But for crooks, the elderly disabled are easy prey, especially when they live alone with no relatives nearby.

Still, disasters are generally preventable, says Thomas Cassidy, a former investigator for the New York state attorney general's office, and author of Elder Care: What to Look For, What to Look Out For! (New Horizon Press; $13.95 in paperback). To start with, you need to check the applicant thoroughly. If you use an agency, check it, too. Abusers slip through when families are under pressure and move too fast. Behind a friendly, intelligent face might lie a practiced thief.

If you're using an agency, ask if it's licensed as a home-care provider, not just as a business, says Bill Dombi, vice president of the National Association of Home Care in Washington. Also ask if it is accredited by Medicare or a nursing or home-health association.

Be sure the agency runs a criminal check on the people it recommends -- both full-time aides and the fill-in workers it might send when your aide gets sick.

If you're hiring independently, call your state's Office for the Aging to find out if, and how, you can do a criminal check yourself, Cassidy says. (For the phone number of the office, call the Eldercare Locator, 800-677-1116.) Consider hiring a private investigator.

Always ask the applicant for multiple references, and call every one of them.

Whether you work through an agency or through word-of-mouth, do your first interview by phone, without revealing where you live, Cassidy says. Find out what training the aide has had and what he or she is prepared to do (housework? errands? feeding and bathing? routine medical care?).

Check the references yourself, even if an agency has done it before you.

If your state licenses home-care workers (ask the Office for the Aging), get the applicant's license number and confirm it. That screens out a lot of frauds.

If everything checks out, meet the applicant in a neutral spot, Cassidy says. Get a picture ID -- say, a driver's license -- to be sure the name and face match up.

An aide hired through a home-care agency might cost $12 to $15 an hour for homemakers and $14 to $25 for aides who help with bathing and dressing.

Independent hires can cost significantly less, Janet O'Keeffe, a senior analyst with the American Association of Retired Persons, told my associate, Dori Perrucci. But the vetting will be entirely in your hands.

Don't tempt a home-care worker with easy access to money. Jewelry and other valuables should be stored in a safe-deposit box or a relative's house.

If the patient no longer handles his or her money, and you're in charge, route all the bills and bank statements to your address. Don't leave a checkbook or credit cards in the house. Also, remove financial records that reveal assets and the patient's Social Security number.

Check every bill and bank statement as soon as it arrives, to be sure there's no fraud. Cassidy knows of an aide who ran up $30,000 in expenses over eight months, because no one was looking.

Give the aide cash for food and living expenses, and make it clear that you want receipts. Alternatively, you could set up a bank account for the aide, and make a deposit every week or two.

If you yourself are the patient, and are handling your own affairs, keep your financial records, checkbook and credit cards locked up. Don't let the aide use your card or write checks on your behalf.

"No matter how nice they seem, you should treat them as strangers," Cassidy says.

A relative or neighbor should make frequent, unscheduled visits to the house, to see how things are going. Don't slack off as the months or years go by, Cassidy warns. That's when abuses may begin.

Pub Date: 2/15/99

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