Q: My elderly father is frail and has difficulty doing much for himself, especially since my mother died last year. It is becoming clear that I need to hire someone to check on him regularly and help with day-to-day activities because I work six days a week.

I am looking for a companion for Dad because he does not want to leave home. I need someone to run errands, do basic housekeeping, shopping, help dad get to his regular doctor appointments. I'm concerned, though, about the many horror stories of private caregivers taking advantage of their customers. I'm terrified of putting dad in harm's way. Can you give me some advice on selecting a trustworthy service?

A: You are wise to be cautious about whom you hire. Even though you may be monitoring the care, it's necessary that you find a service that has preventative measures to guard against elder abuse built into their care program. If you hire someone on your own, they will probably become employees, meaning you will have to pay Social Security, etc., which is a headache. In addition there will be no oversight, which is a recipe for disaster. And if the caregiver does not show up, you will have more problems than you can imagine.

There are a number of national and local providers of non-medical companionship and homecare services for the elderly. You should check out the safeguard systems of each company so you can be comfortable with the service and your father can accept the aging process gradually and with confidence, while allowing for independence at home. 

Here are some key checks and balances that should serve as a preventive medicine against elder abuse "second set of eyes" in at-home care situations:

A) Criminal and reference checks are standard. Caregivers should be checked out thoroughly to make sure they have a clean criminal record, and that they are reliable and trustworthy. The company should also require at least six references, each of whom should be contacted and questioned.

B) A written record of care is critical. Caregivers should be required to record exactly what they did and what they observed during each visit. And, this information should be available to family members. Records should be kept in the client's home. In addition to the ongoing log kept by the caregivers, the company should have all emergency numbers and vital information about the client's personal preferences and routines.

C) A "second set of eyes" helps ensure safety and accountability. Abuse is much less likely to occur if someone in authority is checking on the client and caregiver. The company should make both announced and unannounced visits to speak with the clients and caregivers, review the log and observe the situation to see that everything is going well.

By thoroughly researching each homecare service and making sure they take such precautions, you can greatly reduce the chances of any problems with your father's care.

In addition, we suggest that all of your father's funds be under your control to avoid temptation, so see a competent lawyer to help you with a power of attorney or trust.

Jan Warner is a member of the National Academy of Elder Law Attorneys and has been practicing law for more than 30 years. Jan Collins is editor of the Business and Economic Review published by the University of South Carolina and a special correspondent for The Economist. You can learn more information about elder care law and write to the authors on www.nextsteps.net.

Copyright 2009, Jan L. Warner. Dist. by Newspaper Enterprise Assn.