1 in 3 caregivers of the elderly may not be trained or screened

By Cara Murez

Health Day reporter

THURSDAY, June 24, 2021 (HealthDay News) – A new report raises questions about the education and qualifications of many senior caregivers in the United States.

The study by the RAND Corporation, a nonprofit research organization, found that nearly a third of Americans who arranged for paid care of a frail elderly adult or dementia hired someone from outside a regulated organization.

Known as “gray market” care, these paid providers are not linked to the beneficiary and potentially unselected and untrained.

“Gray market care accounts for a substantial proportion of paid long-term care for the elderly and can fill gaps in access to care,” said study author Regina Shih, senior policy researcher at RAND. “A better understanding of the use of gray market caregivers for older Americans is important to meeting the needs of the country’s aging population.”

In August 2017, researchers interviewed more than 1,000 participants of the RAND American Life Panel, a nationally representative group of adults who are routinely interviewed on the Internet. The survey asked participants if they had sought care for an elderly person and where their official caregiver worked.

About 28% had organized long-term aging care for themselves or someone they love. Among respondents who organized paid care, including those who combined paid and unpaid care, 31% hired a gray market provider. Of those who were gray market consumers, 65% also organized or provided unpaid care themselves.

Many seniors who need help do not qualify for long-term Medicaid-sponsored services and supports, and may be unable or unwilling to pay out of pocket to hire nurses or helpers through a home health agency. , the researchers said.

The study also found that people with dementia who need long-term care and live in rural areas may have more difficulty accessing or paying for regulated providers at home and in the community than those living in rural areas. urban areas. They were nearly five times more likely to hire gray market care.

Home health care agencies typically perform criminal background checks, verify education or training, and maintain clinical records, under regulations that vary by state. Workers are also generally covered by disability and liability insurance, which protects both consumers and suppliers if someone is injured on the job.


“Without the agency’s oversight, the quality of care provided by gray market caregivers is unknown, and the potential for exploitation or abuse – both by the care recipient or the care provider – has not been systematically studied, “Shih said in a RAND statement. Release.

The demand for home and personal assistance is expected to increase by 36% from 2019 to 2029 due to the rapid aging of the US population.

The results were recently published in the Journal of Applied Gerontology.

More information

The United States Centers for Disease Control and Prevention offers more information on care for the elderly.

SOURCE: RAND Corporation, press release, June 21, 2021

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