|
|
Home Care Trends and IssuesWith the population of both New Jersey and the United States aging rapidly, undoubtedly there will be those who will require some level of personal care assistance. In fact, according to the Department of Health & Human Services, 8,000 people will turn 65 years of age daily in 2011 equating to 49 million people in the U.S. 65 or older. By 2025, that figure will reach 72 million. 5.3 million are already 85 or older.
Not suprisingly, about 90% of Seniors surveyed by AARP want to remain in their own homes as long as possible. Afterall, why wouldn't anyone want to remain in their own homes?
Unfortunately, as our country ages longer and longer with advances in medical diagnostics and treatments, some will be unable to stay at home without assistance. Nursing Homes and Assisted Livings used to be the primary solution to the problem of those requiring assistance with Activies of Daily Living (ADL's). The cost of Nursing Homes (about $69, 715/year) and Assisted Livings ($36, 372 per year) made getting assistance out of financial reach of many Seniors (Source: MetLife Market Survey of Nursing Home & Assisted Living Costs). Private Duty Home Care can be a much more affordable option while providing many of the same, and in some instances more personal care and assistance. In fact, the average cost for 20 hours of in-home care per week is only about $1500 per month or $18,000 per year; this is HALF of Assisted Living costs and almost 75% cheaper than Nursing Home care!
The arising problem, is that while home care services are an attractive and affordable solution to getting the care that is needed, there are two avenues consumers tend to choose; First, they choose a licensed, bonded and insured home care agency, or, second, they opt for unsupervised (but slightly cheaper) privately hired help. It is the second category that those who care about our Seniors are most concerned about.
The Risks of Hiring Private Help in New Jersey:
Without realizing it, inexpensive hired personal care can expose the consumer to a host of issues that can not only create legal and tax consequenses, but even deplorable acts such as abuse, neglect and fraud. Below are some common concerns that needs to be imparted prior to hiring a private care giver in NJ.
1. Taxes: As most of us know, both the Federal Government and the State of NJ require that those who collect a paycheck file income taxes. This also includes payments be made to Social Security, Medicare, FICA, Unemployment and Disability in NJ. Unknown to the consumer, failure to pay these items to the respective government entities can easily result in stiff fines as well as possible criminal penalties. Additionally, unless all payments are made to each governing agency, the private caregiver may not be afforded the benefits of Social Security, Unemployment, etc. Being a Consumer / Employer (which is what this scenario would be) means having a solid working knowledge about payroll taxes, deductions, bookeeping, labor laws and other areas that can easily cause severe problems if not done 100% properly.
2. Insurance / Injuries: One of the main disadvantages of hiring a caregiver privately are the lack of adequate liability insurance and workers compensation protection. Homeowner insurance policies are not designed to protect “employees” (remember, if a caregiver is hired privately there is an employer-employee relationship that exists) in a private home setting. Therefore, should your private caregiver become injured in your home while working for you, substantial financial issues can arise; not the least of which can be extensive medical bills for diagnostic testing, hospital evaluations and the potential for long term treatment / therapy. One of the most common caregiver injuries are back injuries which tend to be very costly and can go on for several months to years to be properly treated. Medical bills would be assigned to the employer (which is the consumer in this case) with totals that can easily go over $50,000 - $100,000 for a catastrophic injury such as a ruptured disc or worse.
3. Abuse / Neglect: One of the least pleasant topics to review, is that of client abuse and/or neglect. While the vast majority of private caregivers are well-meaning, pleasant and good natured people working hard to make a living, there are those few who operate with motives that are less than honest. In fact, there are those who purposely avoid working through licensed agencies, and the reasons are usually pretty consistent. A private caregiver operating independently doesn’t need to worry about being drug tested, having a criminal background check run, doesn’t need any State issued license or certification nor do they even necessarily need to produce valid identification! After all, who will be checking? This places the consumer at SIGNIFICANT RISK for all varieties of fraudulent activities, theft, and yes, even abuse (financial, verbal, physical, mental) as there is NO ONE supervising the caregiver! Again, while it may seem cheaper initially to hire someone outside the scope of a Licensed Agency in NJ, the fact is, Licenses, Certifications, and Regulations all exist for one purpose; TO PROTECT THE CONSUMER! Trying to operate outside the scope of the safety measures put in place by the State of NJ is like playing with gasoline and fire; the risk is great that something catastrophic can happen. Why is that? Lack of appropriate supervision.
4. Proper and Authorized Supervision: Caregivers who are privately hired in NJ may in fact be operating illegally. If any of the following items are being performed in the home setting, it is a violation of State law to do so without the DIRECT SUPERVISION of a Registered Professional Nurse (RN); cooking, bathing, dressing, toileting, assisting with medications, anything other than “hands-off” companionship! In NJ, a Licensed RN must assess a potential client and provide a written plan of care which is the caregiver’s instructions on what each client needs to be properly and safely cared for. Privately hired caregivers follow no such care plan. There are no Licensed Healthcare Professionals (again, in NJ it will be a RN) overseeing the client’s health and well-being. If there is a change in condition, there will be no one to report this to, and there is no guarantee that appropriate treatment plans or emergent care actions are taken. There is no “safety net” for the private caregiver to discuss issues with. Nor is there the expertise of a Healthcare Professional to work through difficult issues or to detect possible “caregiver burnout” which places a client at risk of abuse and/or neglect. In short, NJ has very strict rules for homecare agencies to follow, and they exist for the safety of every client. Only an RN (not an LPN, C.N.A., CHHHA) can develop a plan of care and instruct / educate caregivers on proper care techniques.
The items above outline the dangers of attempting to circumvent the safety measures NJ has in place for those seeking to remain at home with a caregiver. It can be a very rewarding experience when done properly. The cost savings of attempting to go around these safety measures are negligible, and in fact, could easily cost a consumer hundreds of thousands more (due to injury, theft, criminal / civil penalties) and above all, PLACES THE CONSUMER AT RISK! Most, if not all people, would never consider going to a Doctor that didn’t have a license to practice Medicine; why would you want to place yourself at risk by doing the same with a caregiver that may have a criminal history, unknown citizenship status, all while lacking the proper insurance, tax and labor law knowledge just to save a few dollars? Protect yourself and the caregivers that are there for you by using a reputable, licensed, bonded and insured Home Health / Health Care Service Firm. Your life and that of those you love are worth it!
"There's No Place Like Home..."
NJ Licence #: HP0098600
Providing Home Care Services in the Following Areas:
Toms River, Manahawkin, Mantolokin, Howell, Lakewood, Brick, Jackson, Manchester, Point Pleasant, Freehold
Ocean, Monmouth, Atlantic Counties