What I wish we’d known about homecare agencies

by Lindsay Imai Hong

Gooney with her daughter, granddaughter (me), and first great-grandchild in 2010.

When my grandmother, who we called “Gooney,” turned 95, she had limited mobility from some nerve damage in her leg and she was getting more frail from old age. Our family decided it was time to hire homecare workers to support her with her eating and bathing.

Gooney was not always easy to get along with, especially if you couldn’t appreciate her raunchy sense of humor, or you weren’t willing to bend the family rules a bit and give in to her regular requests for chocolate. That said, the women we hired were really patient with her and did their jobs with both commitment and a love that I know my grandmother felt. Many of them took the time to get to know what Gooney loved (chocolate, trips outside, her cat and crossword puzzles) as well as what she didn’t like (being cold and being told what to do).

They not only supported her with tasks of daily living, they also became so in tune with her pain levels that they would advocate with the doctors about her pain medication and diet.

One homecare attendant, Lena, was one of Gooney’s favorites. As a mother of very young children, Lena eventually had to stop working for my grandmother because the low wages were not adequate to compensate for her long commute. Lena’s departure was difficult for Gooney, as she had gotten quite attached to her. It was also difficult for the woman who replaced Lena, since she never could quite measure up. While Lena couldn’t work for my grandmother, she did stay in touch with her, and she even came to Gooney’s funeral service.

I share this story to speak to the hard work and commitment of homecare workers and to the importance of homecare work. And I think, mine is a common experience. We hired Lena and the other homecare workers through an agency that had come recommended to us. Once we became close with some of the workers, we learned that they were getting less than half of the hourly rate that our family was paying. We had incorrectly assumed that the high hourly rates and positive reputation translated into fair wages and treatment.

My mom, who was one of the employers for my grandmother, explained that she felt as if they were in a real bind: They wanted to pay Lena and the other workers more, and yet they also really depended on the reliability and ease of operation that the agency provided. Furthermore, Gooney had become really attached to Lena and Irene and many of the other women who worked for her, so changing agencies didn’t seem to be an option either. Knowing what we know now, about the real spectrum of agencies, we’d do more research about the pay and working conditions before selecting a homecare agency.

Many of us hire through agencies because we can’t afford the time it takes to hire and employ independent homecare attendants.

The need for homecare can be sudden, such as when an aging relative has an accident, like a fall, and suddenly needs help with tasks that they didn’t just the day before. We depend on the agency to provide us with quality homecare, and workers do their best when they are well rested, well paid and feel respected on the job. But unfortunately not all homecare agencies are equal.

If you find yourself looking to hire homecare workers, there are a number of questions you can ask a prospective agency to make sure the agency is going to provide safe and reliable service and that the agency treats homecare workers as well as they’ll be treating you or whomever they’re supporting. You are totally within your right to ask about worker conditions (like if they cap how many shifts they take on), what wages an agency pays, and make sure that they follow overtime and minimum wage laws. And ask how they screen and train the workers they employ.

Good care is fair care. Agencies that would send overworked, underpaid, exhausted homecare workers are not looking out for us or our loved ones and aren’t doing right by the people who do this vital work. For a more detailed checklist that explains what you should ask (and why!), click here.

Lindsay Imai Hong is Gooney’s granddaughter and Hand in Hand’s California Lead Organizer. Learn more about the California Bay Area chapter at www.domesticemployers.org.