Released: March 01, 2007

New options, risks for elder home care

Source: Jane Gross, New York Times (Free Registration)

Dr. Diane E. Meier, a geriatrician at Mount Sinai Medical Center in New York, is an expert on end-of-life care. So when her elderly parents needed long-term help at home with bathing, dressing and cooking after her father’s stroke, she knew where to find assistance.

It was not through agencies in Manhattan that provide home health aides who are bonded, insured and certified. A year of custodial care from such an agency would cost her family $150,000, and in short order exhaust its savings because aides are not covered by government assistance unless patients are poor or fresh from a hospital stay.

Instead Dr. Meier turned to “a little list” of aides from the so-called gray market, an over-the-back-fence network of women. They are usually untrained, unscreened and unsupervised, but more affordable without an agency’s fee, less constrained by regulations and hired through personal recommendation.

With 4.2 million Americans currently over 85 — a number expected to grow to 5.9 million by 2014 and then accelerate with the baby boom generation — the exploding need for long-term care is remaking the home-care industry, driving more of it underground.

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