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By Sheli Monacchio

According to The Institute on Aging, in the year 1900 only 100,000 Americans reached the age of 85. By 2050, the 85+ year-old age group will reach 19 million, which is 5 percent of the total population. These numbers are scary when you look at the amount of qualified individuals there are to care for these folks as they age.

Wages are increasing, which means costs will have to rise in many industries. Some families do not have the funds to pay for a licensed, bonded Certified Home Health Aide. Families are taking the word from friends about “this great aide we had for my mom when she needed it.” The problem with “this great aide” is she may not be licensed or skilled for that matter; we are her employer and by law, required to deduct taxes and workman’s compensation from her wages. There is no background check, so we don’t even know who we have in our home and if they have previous reports of abuse or theft on their license. Homeowner’s insurance is not enough to protect us if an aide falls on our property being that we are considered their employer. We must be aware of the risks when we go to apply for Government benefits such as Veteran’s Aide and Attendance which now has a three- year look back and Medicaid which has a five year look back. With look backs like this, we will have to present statements of all transactions in order to receive these benefits. How can we successfully “prove” where our health care out of pocket expenses are going when someone is not claiming the income? We need to look at the big picture of what you get through a licensed, bonded, accredited agency. Including Certified Home Health Aides with active licensure and supervision by an RN which is the regulation. We will have an opportunity to have a substitute aide to come assist our loved one if the current aide falls ill or has car trouble and we will have a legal record of payments that were paid in out-of-pocket costs with a tax statement at the end of the year.

The financial advantages are what makes the grey market intriguing to a family, but the other risks involved are just not worth those few dollars an hour or per day we may be saving. Not only are there risks to families and the individuals who are receiving care, there are also risks to aides joining the grey market as opposed to working for a licensed agency or long term care setting such as Assisted Livings or Skilled Nursing Facilities. With no supervision and policies and procedures, the Home Health Aide or Certified Nursing Assistant also risks not learning the regulation changes and will risk losing their license or the chance of renewing their license (if they have one). They will directly be held liable for things that may not even be their fault in the home.

If you are thinking about hiring assistance for yourself or a family member, remember to look for a licensed, bonded, accredited agency to avoid potential care issues and legal issues in the future.

Caring Connections of New Jersey is a non- profit organization whose primary mission is to educate seniors and their families on the options that are available in their local community. Visit our website at or call (609) 960-2265 for assistance.