By Kshalini Nonis

Choosing a professional carer is one of the most critical decisions a family can make. It requires a balance of rigorous vetting and emotional intuition to ensure the safety and well-being of an older adult.

There have been many instances when carers have taken advantage of the patients by robbing them of their belongings, having no empathy or patience and preying on them. Many are the stories of carers who have coaxed or tricked older adults to part with their belongings or stolen jewellery and other valuables coaxing them to 'clean their cupbards.' Or in the case of the elderly who lives with carers who handle their cash, who take advantage of their forgetfullness. 

Q  In your opinion what are the factors that must be considered when choosing a carer for the elderly from Professional organisations, websites and referrals?
There are a few  key factors, but make sure you  look beyond the marketing.
*Does the agency provide specialised training in specific conditions like dementia, post-stroke recovery, or palliative care?
*Does the organisation provide an overseer or nursing supervisor who visits periodically to audit 
the care?
*Does the same institute have doctors, consultants who could provide care for the older person or communicate with the doctors, so all are aware of the care plan and challenges in caring.  This is particularly important especially when immediate family members are not able to do close supervision.
*Ensure they have a “buffer” staff. If your primary carer falls ill, the agency must guarantee a seamless replacement. 
*Reputable agencies should clearly state their fee structures, and the legal status of their employees.

Q.What are the questions that must be asked at the interview?
The interview should reveal both technical competence and temperament:

• Can you describe a time a patient refused medication or food? How did you handle it?
• What are the signs of a fall or  a stroke that would trigger an emergency call?
• How do you manage your own stress during a difficult shift?
• What do you enjoy most about working with the elderly? (Look for genuine passion vs. just seeking a job)

Q. How do you check their credentials?
Never take a CV at face value.
*Request original copies of NVQ (National Vocational Qualification) or nursing assistant certifications.
 *Always request a copy of their National Identity Card (NIC).
*If they are from a professional body, call the office to confirm they are currently in ‘good standing’ and not under disciplinary review.

Q. What about testimonials from people with whom the carer has worked for previously?
References can confirm ‘soft skills’ that certificates cannot:
 Did they arrive on time?
 Were they patient during difficult moods?
 Did they maintain boundaries with family members?

Q.How do you prevent the carer taking advantage of a patient?
*Keep a log of high-value items and jewellery. Ideally, keep these in a locked safe or move them to a different location.
*Never give a carer access to ATM cards or PINs. If they must buy groceries, use a dedicated ‘petty cash’ book where every receipt is taped and balanced weekly.
*CCTV: Discreetly placed cameras in common areas are now a standard safety measure, provided the carer is informed (for legal transparency).

Q. How do you ensure that the patient gets the correct diet and Medication?
*Maintain a book. The carer must record what the patient ate, the quantity, and the exact time medications were administered.
*Use a pill dispenser labelled by day and time. This allows family members to see at a glance if a dose was missed. 
* Provide a written menu based on medical advice .

Q .What are the main qualities of a carer? 
* A carer should function as a companion.
*Have the  ability to see the person behind the disease.  
*In elder care, being ‘10 minutes late’ can mean a missed life-saving dose of medication.
 *Constant care can be intrusive. A carer with a calm, cheerful presence reduces the patient’s anxiety and resistance to care. 
*They must be strong enough to assist with ‘transfers’ (moving from bed to chair) and bathing without risking a fall for either party.
*Caring for a person with high needs is physically exhausting; a carer must have the energy to remain alert throughout their shift.
*Miscommunication in healthcare can be dangerous.
*They have to  respect the patient’s religious or lifestyle habits.
*Always try to start with a 3-to-7-day trial period to observe the ‘chemistry’ between the carer and 
the elderly person before signing  
long-term.