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LivetoHelp Asked October 2013

I am a pro. caregiver who discovered my clients family member's evidence of drug abuse. Would you call elder services?

I feel like I am in a bind, and do not know what to do. The senior I work with is wonderful! My client lives with one other family member, who at times has very erratic behavior. Today while I was picking up I saw a cut up straw, a credit card and white chunks where the only other person (not my client goes.) I am pretty sure it was oxycodone. My client had recent back surgery and only takes Advil. I am concerned the the medicine might be my clients. I also overheard the family member last week confirm a credit card over the phone in my clients name. I am really not sure what to do, or how to approach my superiors. I would appreciate some guidance and advice, I think the credit card thing is fishy, would you alert elder services?

Stressed52 Oct 2013
I might report it to the agency I work for but in the meantime I would be taking pictures with my cell phone and that white powder left on the table, take a piece of tape and lift some of it just in case it is needed as evidence.

I would feel that my responsibility was to the person i was caring for, but in doing that I would feel that I needed to protect them from a bad influence. If nothing else I would document and turn that evidence over to the proper authorities if needed. I don't know how you can prove anything about the credit card unless you saw what was being charged and knew they were running up an excessive bill,

Eddie Oct 2013
Easy Kaz, easy. I'm a mental health/substance abuse counselor by profession; and Live is in one of those darned if you do and darned if you don't situations. The credit card was probably being used to cut cocaine; or to cut opiates/opioids in pill form (e.g. oxycodone, vicodin, etc., whose effects -- if the amount is right -- often mimic heroin when snorted).

Indirectly, ask your client if s/he has had a Rx for opiates/opioids (e.g. oxy, vicodin, Percocet, etc.) filled lately, and if so who picked it up and where the medication is. On another day, strike a conversation with your client about credit cards. Perhaps s/he will mention having misplaced one recently. Choose another day and start a conversation with the family member about bodily pain. S/he might reveal something.

Right now, what you have is conjecture that can be construed as overzealous gossip. Gather some facts before you report the situation to your superiors, and don't forget the kinship between your client and the other person. I'm sure they talk when you're not there.

I'm not suggesting you look the other way, but be careful where and how you tread on this. The world of caregiving is a small ghetto, and word gets around fast.

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ThereIsNoTry Oct 2013
Unless there is a clear immediate danger, a professional should always find a second opinion, in this case their employer, before making accusations or involving themselves in their patient's private life. Right now there is only a vague suspicion. The cut up straw etc is a likely scenario for drug abuse, but the but using the patient's credit card would depend on their relationship.
Asking the patient about it might be quite upsetting and I recommend against that.
So please report it to your employer. You can't really ask the patient without arousing suspicions and that should be done by someone who can handle the ramifications if it is true or if the suggestion causes distress, and you must hope for the best but assume the worst. Only your employer knows what should be done in this situation and if your employer suggests nothing should be done and your instincts disagree, come back and let us know. You are doing a good job. Kazaa, go find someone else to bully.

pamstegma Oct 2013
Do not pickup after the addict. Snap a picture with your cell phone and send it to your supervisor. Ask your boss what to do next. Protect yourself so the addict can't turn around and say it was you.

wheeliesurfer Oct 2013
I would:
1. Notify the agency that you suspect your clients roommate/family member/caregiver is using illegal drugs or Rx drugs recreationally. Notify them of the date you were there, what you were doing, what part of the house you were in, and what you witnessed (straw, card, white powder/chunks).

2. Notify your client of what you witnessed. Ask your client if they have any Rx meds that are scheduled (class III or class II). Also ask your patient if they are willing to keep their medication in a lockbox to aide in the prevention of theft.

3. Purchase lockbox (if necessary due to patient being home bound) and lock meds inside. Hide lock box in a place it is easily accessed but not in immediate line of sight. Get a weekly pill case if your patient doesn't want to get into the lock box every day to get into the pill bottles. Put all scheduled medications in this pill case. If they have scheduled AM and HS meds, get two weekly cases (different colors help) for each of the med times. For PRN meds you can get a third weekly case, or if your client can remember which pills are which you can get an altoids tin or something to leave just enough prn meds for the week out. The weekly case for PRN meds help too if your client can't remember if he/she took them or not. If they are prone to forgetting when/if they took meds, having the empty slot or a lower number of pills in the slot is a good memory boost.

4. If you catch the other household member stealing narcs from your client or witness him using narcs (Rx or street drugs) call 911 and report the use/abuse of narcs. Your client may need temporary placement, but it will likely be better than living in a house with a drug user/abuser who may or may not have stolen your clients meds.

Good luck as you proceed. Def find out what your agencies policy is on this type of situation. Let us know what happens or ask any other questions you may come up with.

Wheelie :-)

Eyerishlass Oct 2013
Hand this problem off to your company and wait for them to advise you on what to do, if anything. Your employers need to be the ones to take action, not you.

kazzaa Oct 2013
Well ferris we have very different laws here and hitting a child is abuse and is reported to the police so they have a record for any future complaints. I understand what you are saying but if this adult is abusing his parents credit card and taking drugs in his home then the elder cant be safe and well cared for and may be taken advantage of. I had to kick out my own SIL and call the police as she was stealing money and other thngs from my poor mother WHO paid to get her into this country in the first place of course my brother didnt believe a word and has been hostile to me since but even my mum noticed her taking things. It just hits a nerve with me as i hate to see the vunerable being taken advantage of and it happens so much its unreal and usually by family members. Never hurts to make a call and report anything a bit suss. Also the kids I mentioned who were being hit by the father were 18mths and 3yrs old?

ferris1 Oct 2013
Whoa kazzaa. Let's not confused children with adults who have the right to engage in illegal activity. As a former Child Protective Services case manager, hitting a child does not warrant the agency's intervention, unless there is bruising, bloody, broken bones, etc. There is new research out that says hitting can be done if all else fails, as a judge in CA just allowed it for a couple with a teenager. This "pro" might be new, be at the lower rung of the "pros" and or just does not know where to turn. I am glad I have been in the position with clients to have seen a lot of what goes on in homes, and people have a right to do illegal behaviors if they are adults. If the client is being given the illegal drug, then that is a different story, and the client might have given the person who lives there permission to use their card. DO NOT ASSUME you know all the circumstances. Again, my advice is to ask the client and see what he/she says. Do it in a non-confrontational way so you do not get replaced. Just say you had some concerns for their (client's) welfare and wanted to check with them to make sure they knew about the circumstances. You cannot police the whole world.

kazzaa Oct 2013
Sorry did you say you were a PRO?? im confused. You see I was a PRO nanny and when "my client" was hitting his kids I contacted the child protection services I didn't waste time on some forum asking very UNPROFESSIONAL questions.

vitallifesenior Oct 2013
Your primary responsibility is your patient. You need to follow the chain of command in the company you work for and what your company policy is. It may not be your place to make the call. However, you may be caring for a vulnerable senior whom may need further assistance with addressing this problem. Seek out help from your administration. The ethical choice in the matter is to notify the administration of your company so that you can sleep at night knowing you did the right thing.

gladimhere Oct 2013
I agree you should check your employer's policy. I would think that the majority of these companies have a responsibility to report things like this to the proper authorities. If the company suspected a problem, and did not make appropriate report this could cause liability issues for them and possibility you.

snowgrey Oct 2013
Dear 'Livetohelp'- If you are true to your screen name, then help is what you'll do, right?
My thought is before you bring a government agency in on this, I would consider another path that would prevent from creating needless drama. Whatever needs to be done to keep your client safe and environment healthy, is the first concern.

You state the 'person of interest' in this matter behaves erratically. And certainly, it is not a good environment for the convelesing senior to be around. Who knows what a drug addicted family member could be capable of.( I'd like to say that depending on the extent of addiction this person is under, would depend on action taken, but in all good conscience I cannot.) Any consumption can cause problems, and should be addressed as soon as possible to avoid complications.
Good luck and may God guide you, dear.
This actually is a bad situation. But shouldn't be a hard call... You know what is right and what is wrong.

ferris1 Oct 2013
Having been there and had a patient who was an alcoholic, I contacted his daughter and told her I did not feel like buying any more booze for him. She then admitted he had a drinking problem. My client and I had a talk and his daughter then bought the alcohol. So, I would talk with your client, tell him/her about the credit card issue, what you saw, and maybe there is a logical explanation. Do not rush to judgment. Consult your employer with the same information and how they want you to proceed. Since the family member is not your responsibility, they are not in your contract. You are not there to police the family member who I am assuming is an adult who wishes to do drugs.

Calicaregiver Oct 2013
I think you should behave like your client is aware, and mentally capacity tend to discuss with them first. Too many Caregivers, and others that inter-act with seniors treat them like they are not even in the room. Unless, they don't understand what you are telling them, I think it should be addressed within the family first before involving outside services that may very likely land the senior in a home.

AKAlicious Oct 2013
You're in a difficult situation. I would first find out what your company's policy is re elder abuse so you can make sure to act in accordance with their guidelines, if you work for a company. But ultimately, this seems on the surface like elder abuse (or at the very least, drug abuse). Something t consider--I am a signatory on my mother's credit card and use it all the time to buy stuff for her household (e.g. toilet paper, grab bars, whatever else she needs, etc.), so the purchase _may_ have been proper if this is also their arrangement. Does your client have a POA, and is it the other family member or someone else? If someone else is POA you can bring the issues to their attention and it may resolve things more easily/quickly. If the other family member is POA, I would look to some outside senior reporting service to look into this.

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