Struggling to follow doctor's orders: Paid caregivers may lack the skills to take on health-related tasks in senior's homes

The study will be published in the Journal of General Internal Medicine.

In a first-of-its-kind study, nearly 100 paid, non-family caregivers were recruited in the Chicago area and their health literacy levels and the health-related responsibilities were assessed, said Lee Lindquist, M.D., assistant professor of geriatrics at Northwestern University Feinberg School of Medicine and physician at Northwestern Memorial Hospital.

"We found that nearly 86 percent of the caregivers perform health-related tasks," said Lindquist, lead author of the study. "Most of the caregivers are women, about 50 years old. Many are foreign born or have a limited education. The jobs typically pay just under $9.00 per hour, but nearly one-third of the caregivers earn less than minimum wage."

Lindquist found that despite pay, country of birth or education level, 60 percent of all the caregivers made errors when doling medication into a pillbox. This is an alarming statistic, because patients who don't take certain medications as prescribed could end up in the hospital, Lindquist said.

"Many of these caregivers are good people who don't want to disappoint and don't want to lose their jobs," Lindquist said. "So they take on health-related responsibilities, such as giving out medications and accompanying clients to the doctor for appointments. Most physicians and family members do not realize that while the caregiver is nodding and saying 'yes', she might not really understand what is being said."

Right now there isn't a standard test family members or employment agencies can use to gauge a caregiver's ability to understand and follow health-related information, Lindquist said.

"Currently we are developing tests consumers can use to evaluate caregiver skills as well as studying the screening processes caregiver agencies use," Lindquist said. "But, if you really want to know if the caregiver is doing a good job and is taking care of the health needs of your senior, start by going into the home, observing them doing the tasks, and asking more questions."

The Barney Family Foundation funded this study.