Many Agencies Place Unqualified Caregivers in Homes of Elderly without Background Checks or Drug Testing

A new national study from the Northwestern University Feinberg School of Medicine has found that many agencies that place caregivers in the homes of vulnerable elderly people do not perform national criminal background checks or drug testing and do not require any experience or provide any real training or supervision, according to a news article available on the Northwestern University Feinberg School of Medicine website at

For the study – which will be published in the July 13 issue of the Journal of American Geriatrics Society – researchers surveyed 180 agencies in the U.S. about hiring methods, screening measures, training practices, skill competencies assessments, and supervision while posing as consumers and found:

  • Only 55 percent of the agencies interviewed said they performed a federal background check.
  • Only one-third of agencies interviewed said they conducted drug testing.
  • Only one-third of agencies interviewed said they tested for caregiver skill competency, mostly through “client feedback” or “self-reports” where the caregivers describe their own skills.
  • Only 30 percent of the agencies interviewed said they sent supervisors on home visits to check on caregivers frequently initially and then at least once a month.
  • Some of the agencies interviewed recruited random strangers off Craigslist and placed them in the homes of elderly people.

“People have a false sense of security when they hire a caregiver from an agency,” lead study author Lee Lindquist, MD, MPH, an associate professor of medicine at Northwestern University Feinberg School of Medicine and a physician at Northwestern Memorial Hospital, stated in the news article. “There are good agencies out there, but there are plenty of bad ones, and consumers need to be aware that they may not be getting the safe, qualified caregiver they expect.”

Lindquist, a geriatrician who also said that “some of the paid caregivers are so unqualified it’s scary,” advises people hiring a paid caregiver through an agency to ask the agency the following ten questions:

  • How do you recruit caregivers, and what are your hiring requirements?
  • What types of screenings are performed on caregivers before you hire them? Criminal background check—federal or state? Drug screening? Other?
  • Are they certified in CPR or do they have any health-related training?
  • Are the caregivers insured and bonded through your agency?
  • What competencies are expected of the caregiver you send to the home? (These could include lifting and transfers, homemaking skills, personal care skills such as bathing, dressing, toileting, training in behavioral management, and cognitive support.)
  • How do you assess what the caregiver is capable of doing?
  • What is your policy on providing a substitute caregiver if a regular caregiver cannot provide the contracted services?
  • If there is dissatisfaction with a particular caregiver, will a substitute be provided?
  • Does the agency provide a supervisor to evaluate the quality of home care on a regular basis? How frequently?
  • Does supervision occur over the telephone, through progress reports or in-person at the home of the older adult?

This study – which was funded by a grant from the National Institute on Aging (NIA) of the National Institutes of Health – comes at a time when the U.S. population is aging rapidly and many Americans are faced with arranging care for their elderly parents and relatives. The NIA estimates that as many as seven million Americans are long-distance caregivers for their aging parents who live an hour or more away. If a trusted relative or friend is not available, many long-distance caregivers attempt to find a paid caregiver they can trust.

The need for trusted and qualified caregivers in rising fast and is expected to grow over the next four decades as part of a “silver tsunami” where the number of people age 65 and older will double between 2010 and 2050. However, choosing a caregiver can be a real challenge – including how to properly conduct a caregiver background check on candidates. Choosing a background screening provider requires the same level of care used in selecting any professional service since all screening companies are not the same. Since the health and well-being of loved ones may depend on it, the focus should be choosing the most qualified screening provider.

ESR Screened Caregiver – is a service from background check firm Employment Screening Resources (ESR) that specializes in background screening services for both employers of caregivers and caregivers to protect vulnerable elderly populations from bad hiring decisions of unqualified or dangerous workers. For more information on screening caregivers, view the presentation ‘What Is The Best Way To Screen a Potential Caregiver?’ at:

For more information about background checks, visit Employment Screening Resources (ESR) – ‘The Background Check Authority’ and nationwide background screening firm accredited by the National Association of Professional Background Screeners (NAPBS®) – at, call ESR at 415.898.0044, or email

Related ESR News Blogs:

Caregiver Background Checks Rising as Millions of US Adults Care for Aging Parents (Posted January 27, 2012)

News Investigation Finds Background Checks Needed before Hiring Home Health Caregivers (Posted November 1, 2011)

ESR Screened Caregiver Website Offers Background Check Services for Household Employers of Caregivers (Posted October 19, 2011)

Tags: Caregiver Background Check, caregivers, Home Health Care, in-home caregiver

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Employment Screening Resources (ESR) – ‘The Background Check AuthoritySM’– provides accurate and actionable information, empowering employers to make informed safe hiring decisions for the benefit for our clients, their employees, and the public. ESR literally wrote the book on background screening with “The Safe Hiring Manual” by Founder and CEO Lester Rosen. ESR is accredited by The National Association of Professional Background Screeners (NAPBS), a distinction held by a small percentage of screening firms. By choosing an accredited screening firm like ESR, employers know they have selected an agency that meets the highest industry standards. For more information about Employment Screening Resources (ESR), visit, call 415.898.0044 or 888.999.4474 (Toll Free), or email

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