Elderly spousal abuse?

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For the past five years I have worked for an elderly couple as a housekeeper. The wife is disabled and the husband has late stage Alzheimer's. About six months ago I started seeing changes in his normal routine. The first time I knew something was wrong was when I arrived he was still in bed late in the afternoon. Then after he had lunch he slumped over in his chair and fell asleep and was unresponsive to what was going on around him. That same day his wife admitted to me she had given him some of her meds the night before to calm him down after he woke her up believing someone had hit him in the back with a board. She believed he had fallen again. When I asked her if she had taken him to the doctor she said no. She has since had hip replacement surgery and now has a personal aid come to stay with her in the afternoon and two nurses come daily to check on her. When I arrived last time to clean, my clients husband was still in bed sitting on the edge of the bed doubled over with a pillow in his lap as if he was in pain. He was wearing a t shirt and no diaper. He is incontinent and normally always wears a diaper. His bathroom was covered in feces as has been the case for the last 4 months every time I would arrive to clean. His wife was upstairs laughing and socializing with her aid and nurses while he sat downstairs alone in his room. I alerted her nurses and her aid about his condition. They all said they were only there for her care but they did go talk to him to see if he was alright. I had a long talk with them in another room after they checked on him about how his wife had been leaving him alone prior to her surgery with no phone and no emergency call button and to the fact that she kept saying she would get him help but never did and to the fact that she has POA and to the fact that the money they have is his since her constant excuse for not doing anything to get him help was no money. He needs assistance with all of his personal care. That same day her aid told me that my client admitted to her she had given him some of her valium. The aid said one of the nurses were told and just shrugged and seemed indifferent. My clients husband does not wait on himself does not prepare his own food and does not take his medication until she gives it to him. I have found several of his pills on the floor around where he sits. Although I have seen him on a few occasions before his Alzheimer's became so advanced, have a surly and sarcastic personality so did she. I have seen her talk bad about and mock people on several occasions. She has said that she believes his bad behavior now is intentional and spiteful at least half of the time. I think he's beyond that capability at this point. His daughters live out of state and they do not ever visit him so that does indicate he may have been an awful parent. So I don't know what more I can or should do or how much farther I should get involved in this. I have thought about contacting APS but I know even if I do it anonymously my client will figure it out that it was me and I will lose her as a client. I know I cant continue to watch the man slowly dying with no one around him that cares. He is definitely not dying with dignity. I have no idea how bad of a person he may or may not have been when he was younger I just know that regardless it just seems wrong the way he is being neglected and ignored. what are your suggestions?


Call APS. I expect that once they move into an appropriate level of care you will lose them as a client any way, it is the nature of your business that clients come and go so you shouldn't use that as a deciding factor. I was also a cleaner and had one client that was in obvious decline and I struggled with whether I should say something to her daughter... she had a fall and the decision was taken out of my hands.
If you are a paid caretaker aren't you a mandated reporter? Call APS to protect your own position.
Agree with Vegas, you are a mandatory reporter of elder abuse. You are staring it right in the face. If you do not report it you could be brought up on criminal charges. If that happens you will never be able to get a job in the field again.
Once I was no longer a medical assistant, I looked up mandated reporter to see if I still was one. I sure felt this burden to care that much about others. What I found online was, basically, we are all mandated reporters and should not look the other way.
Contact his family first.
Don't know if everyone is actually a mandated reporter but members of the medical profession definitely are and the wife's nurses could loose their licenses.
I am doubtful about a housecleaner but as a caring person which you obviously are you should definitely call APS.
Why would you want such a woman as your client. If she is so heartless towards her own husband she can just as easily turn on you.
My advice would be to tell this client you are no longer available, get any pay due and immediately call APS
I'm not a mandatory reporter but cant in good conscience continue to ignore the neglect. Somehow his family must have been contacted because I found out through a mutual acquaintance they are supposed to be coming in to see him but not for several more days. My client knows they will be coming in so she has plenty of time to get things presentable as well as him. I will not be enabling her to do that. She will get him help but it will be just long enough to pass the family inspection then as soon as the pressure is off and everyone returns home and all of her nurses are gone, I suspect things will return to the neglected state they were in. I'm hoping his family will see beyond her façade and make sure they will be contacted if his wife stops his care after they go home. About her possibly turning on me that is one of the reasons I have hesitated to report this and I don't want the focus to become about her instead of about him and getting him the help he needs.

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