Tag Archives: Training

Common Problems with Private Duty In-Home Care Agencies

While the private duty industry has just released a report indicating that their turnover rate has reached an all-time high of 82% according to the 2018 Home Care Benchmarking Study by market research firm Home Care Pulse, a review of the common problems of the home health private duty care agencies is in order. Traditionally, hiring a private duty in-home care agency was seen as the only avenue for people looking to care for those with elderly parents who need assistance.  Through out the history of private-pay, private-duty care, working with caregiving agencies is often a daunting task that can be difficult for both elderly parents and their adult children. Part of the problem is that to date, getting a reliable, dependable, affordable caregiver is usually an exception rather than the rule and this situation is only getting worse.

For adult children looking to hire a caregiver or private duty agency to care for the elderly parents, there are many pitfalls that get covered up by private duty agencies. Most people believe that an agency is going to get a matched caregiver to you or your parent’s needs and pay them a decent wage, when in fact most agencies just field the next available caregiver in roster. They are more about making money than servicing the clients.  In case after case we hear about how caregivers at agencies often do not show up, are sleeping on the job, are not trained, or more seriously, sometimes abuse their charges.

In order to save individuals frustration and regrets, it is beneficial to review some of the most common problems with private duty in-home care agencies and how to avoid them. Below is a listing of the top client complaints concerning private duty home care agencies.

  • Lack of consistency of caregiver
  • Caregivers not showing up or consistently late
  • Communication Problems Between Client and the Agency
  • Insufficient Caregiver Training
  • Caregivers focused on technology not the client
  • Unwanted caregiver behavior
  • Cultural differences / not accounting for cultural needs

The most common problem with private duty home care is that either caregivers do not show up, or there is a new caregiver showing up ever other week.  These issues have been a chronic and persistent problem in private duty home care since its inception. While the industry has known about this situation for some time, the problem persists due in a large part to the inadequate pay afforded caregivers, and the fact that agencies tend to hire anyone who applies for the open job, instead of doing a real match to a client’s needs and the caregiver’s personality and skills. The bottom line is that agencies are more concerned with maximizing their profits rather than really taking care of a client’s needs.

Another common problem lies with poor communication from the private duty care agency and/or their caregivers. While you believe hiring a caregiving in-home care agency will give you some relief for people looking to take care of parents who are no longer able to adequately take care of themselves, it is amazing how even acknowledging that the basic activities of daily living (ADLs) are being performed do not get communicated to those who might be paying for those services. This is even more compounded if special needs are involved, or if the elderly client needs to be taken to the doctor or requires some form of clinical therapy.

On top of not paying caregivers adequately, another challenge for the industry is the fact that there is insufficient training for caregivers. In some instances, caregivers are not allowed to provide services in the home due in a large part to the Stare restricting what services a private duty agency can offer. On the other hand, it goes back to in home private pay care agencies just trying to get billings, knowing adult children are desperate to get care for their needy parents and are unable to personally attend to that need. Sadly, even basic skills such as cooking and cleaning, may go lacking with many of the caregivers private duty agencies hire, and should be questioned and evaluated before hiring a potential caregiver.

Technology can be a great tool for delivering care, but at the same time, many caregivers are distracted with their phones, social media and the internet in general, and this distracts them from performing their caregiving duties. While you may not like it, it is very difficult for home care agencies to police their caregivers on the use of their smart phones as a distraction to caregiving.

While the best-case scenario is when a caregiver feels like they are part of the family, it is vitally important to maintain some boundaries with the caregiver. This is especially true if they start to display some irresponsible behaviors. Occasionally, everybody is late, but with private duty home care agencies, this tends to be a chronic condition, and when you start to see a caregiver not show up for care, or have a substitute being called in frequently, it is time to reevaluate the use of this agency. The problem gets worse if the caregiver seems nice, but in actuality is just taking advantage of the situation. Remember, you are relying on a 3rd party to bring someone you do not know of have not vetted or chosen into your home. Too often people make the assumption that a private duty agency takes as much care as they would in choosing a caregiver, but most of the time, that is not the case.

Finally, there are the differences in cultures, likes and dislikes. Some of these are straightforward like language and ethnicity, but others deal with diets, foods, music, cleanliness, and religion. It is important that you address possible language and cultural barriers first. There are some cultural differences between hygiene and eating habits that may pose a surprise problem later on. Laying out expectations from the beginning can eliminate these problems. Working with private duty in-home can be difficult, but it does not have to be. There are new alternatives being offered, like Well Beyond Care, that allows people to how hire your own caregiver and steer clear of the frustrations of working with private duty and at the same time saving a substantial amount of money and letting you choose your own perfect caregiver.  Well Beyond Care teaches families and individuals how to find and manage affordable non-medical in-home care, while solving the chronic problems of caregiver truancy and turnover. The platform combines the power of the internet with the personal touch of nurses to offer families a pathway to transitional care, allowing our elderly parents to safely age-in-place. This solution lowers stress in hiring a caregiver and saves families tens of thousands of dollars per year in care costs.

About Well Beyond Care
Well Beyond Care is the only company that teaches families and individuals how to find and manage affordable non-medical in-home care, while solving the chronic problems of caregiver truancy and turnover through the web application, WellBeyondCare.com. The Company’s platform combines the power of the internet with the personal touch of nurses to offer families a pathway to transitional care, allowing our elderly parents to safely age-in-place. Their solution lowers stress in hiring a caregiver and saves families tens of thousands of dollars per year in care costs.

Private Duty Services for All!

Reprinted by permission from Elisabeth Hogue, Esq.; (877) 871-4062; ElizabethHogue@ElizabethHogue.net

In order to be appropriate for home care services of all types, patients must be able to care for themselves or have primary caregivers who can meet patients’ needs in between visits from professional staff from home care providers. This requirement is necessary in order to meet the eligibility of many payors, to avoid risk of legal liability and to help ensure quality of care.

Patients’ family members or others may be willing to serve as primary caregivers on a voluntary basis. If not, providers should offer patients and/or their family members the option to pay privately for primary caregivers. These services may be referred to as private duty or non-medical services.

The option to pay for private duty home care services should be offered to all patients who cannot care for themselves and who have no voluntary primary caregivers. Patients who can care for themselves or have voluntary primary caregivers may also wish to contract for additional assistance, so providers should offer this option to all patients who may benefit from these services.

Specifically, this means that:

  • Hospital discharge planners/case managers should offer private duty services to all patients who may benefit from them and assist patients to arrange for such services post-discharge as part of the discharge planning process.
  • Other types of institutional providers; such as skilled nursing facilities (SNFs), Long Term Acute Care Hospitals (LTACHs), and independent rehabilitation facilities (IRFs); should also offer patients who are being discharged the option to arrange for assistance from private duty agencies and should arrange for such services post-discharge.
  • Assisted living facilities (ALFs) should offer private duty services to all of their patients who may benefit from such services.
  • Home health agencies should offer patients the option to private pay for services if primary caregivers are no longer available to provide assistance and if patients no longer meet the eligibility requirements of payor sources.
  • Home health agencies, hospices and home medical equipment (HME) companies should educate patients about private duty services even though patients may have voluntary caregivers and help patients and their families arrange for these services.

Providers may be reluctant to offer these services to patients and their families because of their cost. They may also erroneously conclude that patients and their families cannot afford them. Providers should not jump to conclusions about who can afford these services. Instead, private duty home care services should be offered to all patients and their family members who may benefit from them.

A home health agency, for example, decided that a patient no longer met the eligibility requirements of the Medicare Program. The staff of the agency was reluctant to offer the patient the option to private pay for additional services prior to discharge because the patient lived in a “shack” and drove an old, beat-up truck. They did so anyway. To the staff’s surprise, upon receipt of the offer, the patient got out of bed, extracted a wad of cash from under the mattress and told the staff that there was plenty more money to pay for private duty services!

Private duty care has a very important role to play in the provision of home care services. This type of care should be offered to all patients whenever it seems that patients may benefit from it.

About Well Beyond Care
Well Beyond Care is the only company that teaches families and individuals how to find and manage affordable non-medical in-home care, while solving the chronic problems of caregiver truancy and turnover through the web application, Well Beyond Care. The Company’s platform combines the power of the internet with the personal touch of nurses to offer families a pathway to transitional care, allowing our elderly parents to safely age-in-place. Their solution lowers stress in hiring a caregiver and saves families tens of thousands of dollars per year in care costs.