Elvis believed that “we can’t go on together, with suspicious minds.” While that might be a great approach to songs and relationships, it is a bad approach to managing anything involving vulnerable senior citizens. Suspicious minds are always an asset!
It is unfortunate, but true, that as people age they become more dependent on others for their care. Often they make unwise decisions about financial matters, and as dementia sets in they can’t be counted on to attend to even their most basic needs. Fortunately there are caring people in the Long Term Care industry who merge their desire to help these vulnerable seniors with a solid business plan. The Long Term Care provider gives the seniors a margin of safety and enables independent living for those who might not be able to live independently otherwise.
Although it isn’t apparent from watching an episode of Cops on TV, criminals are not always as dumb as they look. They recognize that old people often have amassed sizeable savings and can be easily conned. Posing as housekeepers or health care workers, they steal the elderly blind. Sometimes, when the elders can’t be duped into parting with their money, a more violent side emerges. Threatening physical violence against the elders, or their families, criminals know that seniors can often be forced to part with all that which is precious. It is for these reasons that suspicion is a good thing when interviewing new employees in the long term care industry.
Once, when I worked in a hospital, I hired an employee on the advice of a supervisor who really liked the girl. The new employee set off alarm bells when I interviewed her. I couldn’t point to any one thing that the woman did, but something in my gut told me that the woman could not be trusted. Over the years, I have learned to listen to my gut because the woman turned out to be a pathological liar. She routinely charted that she gave treatments that she did not give. Firing a pathological liar is hard, particularly when they have donned camouflage and made it past their probationary period. The experience taught me a valuable lesson. As Ronald Reagan said: trust but verify.
As managers, and particularly as clinicians, those in long term care must go the extra mile to protect the elderly. Most facilities check references, but references have become almost useless as companies refuse to provide qualitative data about employees for fear of litigation. Some agencies will only verify employment, and eligibility for rehire. Many will not state the reason for an employee’s discharge. Still others refuse to report fired employees to state boards for fear of being sued. For this reason simply doing a reference check that verifies employment is not enough. A smart employer will insist on getting some information from someone that deals with the employee’s performance and quality.
Still, it is not enough to just check references, particularly where state law requires a background check. Sometimes it isn’t even enough to do a background check based on name and social security number. Criminals often give false names and social security numbers so as not to show up on the state and federal databases where they are already barred from working in Long Term Care. So they borrow a cousin’s identity, or steal someone else’s identity because being able to work in long term care provides them with a ready pool of potential victims. For this reason, when getting a reference on a new hire, get a physical description too. If a former employer tells you Sally Jones is five foot tall, and your new employee is six foot two, you need to investigate further. If anything sounds suspicious, again, investigate further. Do not place a worker in unsupervised contact with the elderly if they do not come up clean on a full background investigation and thorough reference check.
It is also a good idea to place new employees with more seasoned employees who can evaluate the care and conduct of new hires. When management walks out of the facility at the end of the day, attitudes and demeanor often change. If that happens, management should know. If residents report thefts after a new employee is hired, care should be taken to isolate the new employee and carefully investigate the thefts. Any employee caught breaking the law must be referred for prosecution, and reported to the appropriate state agencies to protect other patients and residents.
Criminals are also very often skilled manipulators. They will offer all kinds of stories to explain long gaps in employment history or other “coincidences.” Every story should be checked out. When criminals have unfettered access to elderly residents, bad things are sure to happen. Recently two Chatham County North Carolina residents hired a housekeeper to do the cleaning in their Assisted Living Facility apartment. The housekeeper cleaned for them a few times and then demanded more money. When the couple refused, the housekeeper beat them to death, and very nearly killed the daughter of one of the couple who came to investigate after not being able to contact her mother. After the housekeeper’s arrest the news media reported that five years earlier a judge had barred the woman from ever working with the elderly again after she stole $5,000 from a 90 year old man in Durham. Had the Assisted Living Facility required a background check of all persons contracted by the residents it is likely that the criminal history and disposition toward violence would have been caught, and the residents protected.
Whenever a facility has a suspicion about a new hire, that new hire should not be placed in unsupervised contact with residents until their background check has been verified and their references have been checked carefully. And if anything suspicious turns up, the new hire should be removed from the facility until the issue is cleared up.