Updated July 2018, originally posted on Quora during August 2017.
Ultimately, you can’t prevent someone from making a choice to abuse. You can lessen the chance that it is one of your caregivers and increase the chance that they will notice and report someone else’s abuse by having an engaged, educated, well-supported caregiving workforce who feel trusted and able to communicate concerns with their admin team.
Awareness – Do your employees know what constitutes elder abuse? If they can’t define the types of elder abuse then they are in danger of perpetrating or perpetuating it. Education is key to abuse prevention culture.
Reporting – Do your employees know what to do when they suspect elder abuse? What is the company process and what should they expect after a report? Consider educating caregivers about the powers of the public guardian and the abuse prevention resources & hotlines available locally.
Conscience – Do you hire people who are self-directed and act on a strong sense of principle? For a remote workforce as independent as home caregivers, being picky about this trait pays off. When the caregiver could cut a corner to make their job easier, especially with someone difficult or because the administrators made an error that causes your entire day of one hour visits to be behind by an hour; conscience is what keeps them focused on doing right by each and every person they are with.
Other focused perspective – Are your employees needs being met? If their needs are being met then they are empowered to look beyond themselves to others. When caregivers are underpaid, rushed too far and otherwise mishandled then their sense of purpose in caregiving can be lost or damaged. If the caregiver is not being cared for by their employer it generally drives resentment and encourages them to prioritize themselves in cases where their needs and a clients might conflict.
Aim for a culture that encourages communication. Almost no client sees only one caregiver if they have multiple regular weekly services. With several caregivers seeing most clients, if a condition change occurs there should be multiple reports. It’s crucial that caregivers understand that they need to report concerns the first time every time. If they are waiting to observe a concern more than once before reporting then it may be a week or more before they raise a concern to their office.
Most of the time when a caregiver makes a report indicating abuse they will not be privy to the outcomes relating to their contribution. Reinforcing the value and important of this feedback is key. A key complaint from many caregivers is not being heard and feeling that their voices are valued. This is a failure of culture and feedback loops where people don’t feel safe & supported to communicate openly and know that they will be heard and valued. Over time this builds into a culture of apathy, mis-trust and feedback fatigue. You will see caregivers taking measures into their own hands in order to meet client needs instead of reporting to the office.
If caregivers are unengaged, burnt out, rushed between clients, unsupported or otherwise given cause not to engage and report what they see or suspect about a client condition then your risk of unreported elder abuse & neglect increases. Whether that abuse is at the hands of family or another home care worker is another matter.
Clients are more likely to be abused by their family members than their professional caregivers. Caregivers are more likely to be abused by their clients and client’s family members than the other way around. Caregivers are disproportionately females, minorities and immigrants. Many put up with regular abuse or are disadvantaged by clients, client’s family or their employers. Stories about elderly clients who are abused by a “caregiver” draw more media attention than caregivers being routinely abused and harassed. Neither are acceptable.
TLDR – Care for your caregivers and they will care for your clients. Neglect your caregivers and they will neglect their clients.