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If a patient claims they live alone, are home care agents who do the assessment allowed to go into other rooms and open drawers and closets?


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Thinking this over, I recall that the VNA was the only home care agency that didn't inspect rooms. The nurse and therapists looked at the primary routes from door to bedroom, kitchen and bathroom, but didn't snoop.

It's so sad that the VNA went private in this area, and that literally killed the agency. In retrospect, I think one of the franchises may have bought the best agency we've ever used, and deliberately allowed the service to deteriorate (which it did, drastically) to eliminate the competition.

Holiday and CWillie, your comments are amusing, and accurate! I should have asked for a search warrant!

Seriously, though, I do understand the need to examine pathways, but some take it too far. And others, such as the one from the agency I fired after about 10 days, saw it as a social opportunity - Dad and I thought she'd never leave. She was the most unprofessional nurse I'd ever encountered.
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They shouldn't do things like go through drawers or even search every single room but it's a safe bet there noting general conditions such how clean, safe ie trip hazards etc, signs of abuse or neglect or does the patient seem to have help if they can't help themselves. We had a therapist who insisted on going down the basement under the guise of seeing how the patient handled stairs but they already observed them go upstairs to second floor. The basement was not as neat as the rest of the house and they got a look at other things like tools in the house.
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I agree with everyone's comments, even the police aren't allowed to search without a warrant!
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Gardenartist—This supposed therapist is not a police officer and has no right to rummage through say, the caregiver’s things. I would report her. Or rearrange your furniture even!
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Maybe they do a quick look at the room(s) but no real need to open closets or drawers.
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"They don't think out of the box". Well said, JoAnn, well said! That's so very true; they're just not that experienced, not as much as the hands on care folks are.
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Social Workers...no, I wouldn't have given them any income info either. I only had one I liked. One wanted to know why I didn't put a ramp up for Mom. Tried to explain that I lived in a split level and the door she used had 3 steps going up to get outside. I explained the stairs were underground in a "well". No way a ramp would help. If she ever got to the wheelchair stage, she wouldn't be able to live with me. My house is all stairs. She never understood. Last SW told me Mom was being moved and showed me the bed. I said it was too close to the a/c window unit that she got cold very easily. Went to see her the next day and she was in front of the a/c unit. I went to the SW and complained. She came and saw it was more at the foot of the bed so no problem. Yes it was, Mom had neuropathy in her ankles so her feet got like ice. The SW turned the vent up and then said the woman in the room all day likes it cold. Then why not move her to where the a/c was! They don't think out of the box.
I agree that someone else need to be with the elderly person when being accessed. Elderly think they can do more than they can.
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No, a Homecare agency does not need to go thru drawers. You are not under obligation to carry out their suggestions, they are just that, suggestions. This woman was going beyond her job description and I would bring it to someone's attention. At my former job the head nurse would tell her nurses, this is the person's home and as such you cannot impose your ideas onto them. Suggest only. Their job is to make sure the home is safe. But when you told her why the bed was there and why the chair was where it was, that should have satisfied her. My Dad got rid of a therapist from a Homecare agency because she was so overbearing. My Mom agreed. She came in acting like she was a sargent.
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LcG, when my Dad, who lived alone, wanted to hire caregivers from an Agency, a Rep from the Agency came out and I was also there. She had a long list of questions which were in relationship to the type of care my Dad needed.

I gave the Rep a tour of the house, and she was glad that grab bars had already been installed in the main bathroom. And showed her there was a metal cabinet pantry in the basement as storage space in the kitchen was limited.

I am pretty sure the regularly scheduled day time caregivers did more digging around to help them remember where everything was, like extra bed linens, towels, paper towels, toilet paper, can goods, cereal, bread, etc. And Dad's closet and dresser. Those caregivers who were fix-it handy learned their way around Dad's workshop :)
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I'm not at all comfortable with the idea of an elderly person, on her own, meeting with a stranger in her home and the stranger taking it on herself to rootle around among the older person's possessions.

Looking at it from the agency's point of view, though: they do need to know what sort of home environment they will be taking care of their client in, as well as where supplies are stored. But they must ask permission before they go into any rooms, and especially if they are opening closets and drawers, and they should explain what they are looking at and why.

LcG, are you able to say what happened in this instance?
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Some of the searching is helpful; sometimes it's a CYA approach as the therapist wouldn't want to be blamed for missing something that could contribute to an injury, especially while she was there.

The best staff we ever had was through the Visiting Nurses Assn. Private home care agencies were generally good the first time (except for one that I fired before the second week was over).

I did have trouble with two social workers, who insisted that they had to come the first week. I wouldn't let them; there were already a nurse, PT, OT and SP coming; they were the important ones.

One of the social workers insisted she needed access to financial records so SHE could assess what services to recommend. I repeatedly refused; I'd already been through assessments before and I knew what was available. She wanted to explain Medicaid; I knew Dad wasn't qualified for it. So why waste my time?

She repeatedly demanded to see Dad's financial records; I repeatedly refused. Eventually she threatened me, announcing that if APS was ever called, she would make it clear that I refused to allow her to come for a visit. Given that I already had the medical team, her threats had no merit, but she was WAY out of line.
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This is an interesting, and good question. My experience has been that the nurse, who makes the initial assessment, does do a cursory overview check of various rooms, specifically those in which the client will be navigating, bathing, eating and sleeping. When I've been there, I make a point of keeping them out of any other rooms as they're not relevant to ADLs.

However, I did notice that one particularly aggressive OT became too nosey. She announced that she needed to use the bathroom. Never before has that happened, but I assumed she really did need to use it. However, I was in the adjoining room and could hear, and the only thing she did was flush the toilet, apparently pretending to need to do so while checking out the bathroom. (She wasn't in there long enough to accomplish anything except snooping.)

There is a legitimate need to check bathrooms though, b/c of the fall danger. And sometimes therapists will recommend different devices for toileting - the heavy wing devices, a pole, commode, etc.

She was also aggressive in other ways. She was the only one who did what she considered a thorough assessment of the living room and bedroom, irritating both my father and me with her domineering attitude.

She advised us to turn the bed around (no easy feat), she moved one of the chairs in the living room, and dictated a list of other changes she wanted to happen. These weren't just suggestions; they were literally demands.

What she ignored even I though told her was that the bed had been in that position for over 60 years, and when my father did sleep on the opposite side (only once some time ago) as she now recommended, he wasn't used to the new configuration and fell out of bed.

And she also ignored the fact that we had positioned the chair in the living room close to the door so that he could lean on it or fall into it if he had to. Moving it meant that if he fell, instead of falling into the chair, he'd hit the side of it.

Dresser drawers were specifically left open b/c he had difficulty grasping the handles and opening the drawers.

Dad had configured the house in a way that accommodated his needs; she couldn't see that.

She strongly advised that her changes should be made even after I explained why they weren't realistic.

I should have asked for a replacement, but she had treated Dad before and was good. This time was different. Beyond that, she was a good therapist.


As to your question, I can understand that someone would want to check the arrangement of clothes in drawers, to see if they could easily be accessed. Same issue with closets. What I would also consider is if there are any areas where someone could lean against a wall, or chair, while opening drawers or closets.

But it sounds as though this person might have been a little bit aggressive or at least didn't have the foresight to explain her actions.

Was she a nurse or therapist?
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