Thinking of Hiring a Home Caregiver or Agency? Please - do your homework first! by MADAME X, a first rate caregiver.

At some point in your life, you may have a need to retain a Home Caregiver to take care of someone you love. This article was written to ask you to make sure you do your 'homework' on the agency - or person you are going to have watching over and taking care of your loved one - because, as someone who knows about the pitfalls firsthand, I can tell you personally that you cannot always judge a book by its cover and you must be very cautious and savvy when choosing the Agency or Caregiver who will be taking care of your loved one. If you want to see how horrific a caregiver can be, read "T IS FOR TRESPASS" by Sue Grafton. Any library will have it. Also in that book, you see inexpensive methods for researching the caregiver's past. Every family with a senior should have that book!

The information I have gleaned concerns I would say about 60 to 70% of the 'Caregivers' (I use the term loosely in this case) of which I have first-hand knowledge. Don't assume you will get a Caregiver with integrity and good character. You must insist on seeing paperwork in which the Agency has performed a 'background check'. Don't just take their word for it. This might at least eliminate some toxic people who have less than honorable backgrounds.

However, not even a background check will reveal to you certain characteristics of that Caregiver, such as manipulative Caregivers, or separate them from the ethical ones who are good-intentioned and have a conscience when it comes to Caregiving. Trust me when I tell you - Caregivers, when they have 'issues', 'behavioral disorders' or their own agendas will resent the hard-working Caregivers because they show up the toxic ones by doing the right thing, time after time and not being slackers.

In some instances, this leads to the toxic 'Caregivers' trying to sabotage the well-intentioned Caregivers, because they view them as a 'threat'. Sometimes the sabotage is so subtle and/or done behind the scenes that it is difficult to tap into and be aware of. I have heard from a Caregiver's own mouth where some Caregivers actually methodically plant seeds (brainwash) with their unsuspecting Clients - in order to have the power to manipulate them. Whether it intimidates or brainwashes the Client - or both - you certainly don't want that type of person in your loved one's home. For them, it's all about 'control'.

The toxic Caregivers might be people who have lived a hard life - grew up in adverse conditions, and really learned the ropes of survival. Maybe they're still living in adverse conditions. A lot of them (but not all) have very little education and went to the School of Hard Knocks. Some are very adept at manipulating people and situations. I have witnessed it first-hand. Some are unscrupulous in their machinations - and the elderly, possibly ailing Client - whether intimidated or brainwashed or both -.does not -- will not - reveal anything (at least accurately) to their loved ones that is going on within the house - maybe fearing some type of backlash. They are intimidated. They don't want to rock the boat - maybe even for the simple reason that they are afraid they will be put into a nursing home if certain things came to light - and that is usually what they fear the most.

I truly believe in some cases I've seen the 'Stockholm Syndrome' where the elderly Client allies themself with the toxic Caregiver or Caregivers because they are the stronger, controlling affiliation within the household - the Client starts to 'like' who they like and 'dislike' who they dislike (i.e. Patty Hearst Syndrome, a victim empathizing with their captor(s))- in order to 'survive'.

I can tell you unequivocably that out of all the Caregivers I've known, I would only recommend maybe three or four of them for the care of anyone I knew and cared about. That is pretty dismal considering that I have met and co-mingled 'with' maybe 15 or 16 different 'Caregivers' in several different states. You would be shocked to know that some of those toxic 'Caregivers' have very reputable, upstanding jobs in their communities. What I've come to learn unfortunately is that the bottom line is the majority of Caregivers that I've come across mostly just care about themselves and figure out how to expend the least amount of effort while expecting, sometimes almost demanding other (good apple) Caregivers to do their work for them. Oh yes, and I'm sure it's more common than anyone realizes.

Some Caregivers hold down more than one job - some full time, some part time, and when they arrive at their second job, which unfortunately happens to be their second assignment (Client) at the end of the day, they are quite often tired and frazzled (spent) - I've seen it firsthand - and they won't always be in the greatest of moods. Some even burden the Client with their personal problems. This is so unprofessional and such an injustice done to the Client who is paying good money for their services.

Your loved one could be at the mercy of a smoothly deceptive Caregiver (some of which might even have criminal backgrounds) such as a few I've known -- and have cleverly mastered the art of manipulating things or the Client to suit their own agenda, and since you are unsuspecting and not remotely aware of it, might unfortunately never pick up on it. You, the consumer, depend on the Agency doing the background checks - but don't ASSUME that they are - and don't take their word for it - insist on SEEING the reports. Be advised, once a toxic Caregiver gets a foothold in the home (and WINS the Client's ALLEGIANCE), their undermining and controlling behavior can wreak havoc and cause a multitude of problems.

I have come to learn that no one is exempt from getting involved with a Caregiver who has a checkered past - criminal backgrounds, problems with alcohol, questionable morals - that could ultimately affect your loved one. Some that I've known have actually revealed they had criminal pasts to me. I do believe, however, that after a certain amount of years has gone by, their criminal past may no longer show up on a background check. I think background checks only trace back ten years. Of course, some people do change and lead positive, productive lives - but I think there are many more that don't actually ever change their core behavior and reform or become rehabilitated.

This is not only sad but outrageous - and unfortunately true in some cases. I'm sure there are good Caregivers out there - I have met a handful - but they are few and far between. Maybe because there is a shortage of Caregivers - some agencies or supervisors will look the other way when they know they possibly have a bad seed. Sometimes it's all about the Almighty Dollar. I have also discovered with some agencies that they choose quantity over quality. Some Agency or Agencies may even disregard the fact that they have been forewarned about certain Caregivers' bad behavior and still continue to place them into a Client's home despite being advised and apprised of said behavior. You would have to surmise that the welfare of the Client was not their No. 1 priority. You also have to wonder why they would jeopardize their company and their company's 'reputation' - not to mention risking legal problems and entanglements.

What is the world coming to when the bad apple Caregiver is kept on and placed in new Clients' homes because she managed to get the agency owner's allegiance (defying all rational thinking) while wreaking havoc with a well-intentioned, conscientious Caregiver (with whom she apparently felt was showing her up simply by performing her duties well). If this sounds petty to you, I can assure you this is considered a serious issue, especially by any hard-working, good intentioned Caregivers who have been overlooked for new assignments in Clients' homes in favor of the toxic (unethical and irresponsible) 'Caregivers' being given preferential consideration.

Usually the day shift Caregiver has the most responsibility - driving the Client to appointments, i.e., doctors, beauty salon, shopping - general errands; then coming home preparing lunch and/or dinner, keeping bathrooms clean and keeping current with general housekeeping; putting groceries away; hostessing any company dropping by; laundry; Being a sort of 'gatekeeper'.

I have been aware of some Caregivers who come onto their shift and adopt an attitude if there is one little item or task that the Caregiver they are relieving may not have had time to do or just overlooked because of a hectic day - that means - Heaven forbid, that little task might fall to them when normally they've most likely become spoiled because the night shift is usually much easier - in the case of a fairly healthy Client not much is expected after dinner except helping the Client with a shower, maybe throwing in a wash, and giving the Client good companionship until he or she goes to sleep.

Yes, I have been advised of or privy to such undermining and backbiting that was allowed to flourish within a Client's household without any action taken against one or two toxic 'caregivers' - where visitors to the household were witness to this controlling, negative influence within the household. One of these so-called 'caregivers' was actually seen time and again outside the Client's home talking and blatantly flirting with a married neighbor - while leaving the elderly Client alone in the home. Even though many people saw and knew about her unethical and unprofessional behavior, she was somehow given a free pass to do as she pleased. She somehow managed to ingratiate herself with the Owner of the Agency. And, that particular 'Caregiver' took full advantage of that preferential treatment of her. Remember what I've said earlier, these types of people, or psychopaths, are master manipulators - bending or creating situations to suit THEIR particular needs, not the Client(s). They are experts at doing this.

Some visitors to Clients' homes have reported they witnessed these types of toxic Caregivers - who, in front of the Client - have acted unprofessionally by maliciously maligning another Caregiver working in the same household. Toxic 'Caregivers' promote interpersonal conflicts within the Client's household. I don't have to tell you that this ultimately not only affects the Client, but taints the atmosphere and possibly the relationship between the Client and the well-intentioned (ethical) Caregiver causing tension and strife. At some point the Client feels the need to be loyal to one Caregiver over another. The Client will choose to align themself with the Caregiver (toxic) that most intimidates them. Don't forget - as we get older we become more fearful. Fear is a powerful motivator. As I mentioned earlier, ala The 'Stockholm Syndrome'.

Getting back to one of these toxic 'Caregivers'. There were times this 'Caregiver' showed up at the Client's house 2 hours early for her shift - without any prior approval from either the Agency or the Client. She apparently was in the neighborhood and had nowhere else to go, didn't want to kill two hours, didn't want to go home, so chose to come to work early and ask the night shift gal to just disappear which of course cut the other girl's income. She would drink at work, eat an entire chocolate cake which the diabetic patient had to watch and act in an uncaring and unstable manner at times in front of the Client, who said nothing about it (maybe out of fear of reprisal). There were witnesses to the antics of that Caregiver yet nothing was done about it, and from what I'm told, as mentioned previously, that same Caregiver is still working for the same agency!

Just because they call themselves 'Caregivers' does not mean some of them cannot be guilty of unscrupulous behavior. There is good and bad in ALL walks of life. But, there is no room for a bad apple in a Client's household. There is a book called 'Psychopaths Among Us'. That about sums it up in a nutshell. This may all sound harsh - but I assure you I am much wiser now than I was say four years ago on this subject. You could say I have some battle scars.

Some remarks from Dr. Robert Hare, author of 'Without Conscience: The Disturbing World of the Psychopaths Among Us' -"...hundreds (of psychopaths) live and work and prey among us - your boss, boyfriend, your mother..." could be what he calls a 'subclinical psychopath' - someone who leaves a path of destruction and pain without a single pang of conscience. "They're your neighbor, your boss, your blind date." "Psychopaths love chaos and hate rules" (Remember this last sentence in particular). He goes on to say - "know your own weaknesses because the psychopath will find them and use them" (http://www.hare.org/links/saturday.html).

Here are some helpful tips from someone who is in-the-'know':

a)Drive by the home of your loved one unannounced - check things out sporadically; (you might find that your weekend or evening Caregiver is outside chatting with (or worse, flirting) with a neighbor - maybe for extended periods of time - instead of doing his or her job being inside the house Caregiving your loved one;

b)Carefully walk around the entire home - you may find that the Caregiver has invited someone or more than one person into the home without permission - especially on weekend shifts;
While there, check any and all refrigerators (don't forget the garage) for alcohol (beer); they should not be drinking while on the job (or even just prior to coming to the job)

c)See if the Agency involved will give sporadic breath-alyzer testing;

d)Check grocery receipts - try to monitor in case food is going out of the house; (even if you do the shopping that is no guarantee that food is not disappearing). That French cheese that isn't in the fridge, though it's on the bill? Where did it go? And as the patient cannot eat fatty cheeses, why was it bought?

E) INVENTORY the home, that is paintings, antiques, chatzkes. Photograph shelves. Let the caregiver see these photos. Do the same with books. Some books from the fifties are worth hundreds of dollars. Caregivers know this. Antique sewing patterns are 15$ each. Find out your caregivers Email Addie and see if it shows up on EBAY.

If this sounds snoopy or melodramatic, for what is at stake, it is better to be safe than sorry. A caregiver who cheats in small ways cheats in big ones. Please realize that your elderly love one is not necessarily going to reveal to you things that may be going on in hers or his household - even if he/she may want to.

With these tips you may hopefully spot problematic Caregivers before they get a foothold in your loved one's home - or worse, heart (much easier for manipulating) or wallet.

There should be a 'Watchdog' service, that can act like a P.I. for investigation of caregivers for families who might want the extra added precaution for their loved one(s) For the time being, the watch dog is you. Do not assume that the Agency you've hired will play 'watchdog' for you and your loved one. Remember, they are in the business of making money.  This was written by a professional caregiver, one of the kinds that you should hope you get, but won't always find. Madame X

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