Home care is an option which allows older people to continue to live at home and preserve their autonomy. But the home setting can open the door to vulnerability and potential abuse, neglect and exploitation. It is critical for family members to follow careful hiring practices and do complete background checks before hiring someone to care for a loved one at home.

Although many people who apply for home jobs are qualified and caring individuals, many others are criminals who prey on the elderly and infirm. Some of the problematic areas include theft, substance abuse, and elder abuse and neglect.

Theft can range from petty theft to felonious stealing to support an addiction or higher lifestyle.

Substance abuse will cause absenteeism and the potential for abuse and exploitation. The co-dependency of an addicted person and someone who is frail can only lead to problems.

Elder abuse has been kept secret for many years. Despite some media attention, it still has not received the public sympathy of similar crimes, such as child abuse and spousal abuse. Some states maintain registries of complaints filed against individuals for physical, emotional, psychological or financial abuse against the elderly. Connecticut is not among them.

There is no guarantee, not even from an agency, that a caregiver will not harm an elder person. That's why a thorough check is critical before hiring someone for home care. Get proof of the full name, birth date, driver's license number, Social Security number and current address.

You can request that the candidate sign a general release form. This should include release of the medical history, credit information, motor vehicle records and police records. Fees may be attached to any of the above record searches. Check in advance to determine procedures and fees because they vary by state and community.

Be sure to check motor vehicle records if the job includes driving the elder individual. Check for lapsed or revoked licenses and moving violations. Take a test ride with the potential caregiver.

You might have the individual fill out a Statement of Health as well.

If you require that the candidate have a physical examination and lab tests, you should be responsible for all costs, i.e. tuberculosis test, flu shots, etc. The frail elder person may have an impaired immune system and be vulnerable to infections, such as pneumonia.

Local police detectives emphasize a thorough reference check, regardless of whether or not an agency is involved. Call previous employers. What was the outcome of previous employment? Why was it terminated? In addition, police recommend the following:

1. Be sure that the individual being considered for employment in the home is bonded, regardless of whether that person is being hired through an agency or not. Then be sure to check directly with the bonding company to confirm that the person is, in fact, bonded.
2. Call the Better Business Bureau. Are there any complaints on file?
3. Call the local police station where the individual lives. Are the police aware of any problems?
4. Call town hall and/or social services in that town. Have they heard of the individual? Have there been any reports negative or positive?
5. Do a detailed interview. Be sure that you're "on the same page" and that the personalities of the individuals are compatible.

Finally, as noted in previous "New Wrinkles" columns, be sure that you have a written and signed contract with the home caregiver, which specifies all responsibilities and payment arrangements.

In short, take precautions. Do your homework and talk to people. The more checking you do, the more assured you will be that you will be hiring someone you trust with your loved one and their personal property.