I care for a mother daughter duo. Daughter has special needs, but is high functioning. Nom has Parkinson's. She's in a wheelchair, extensive one-assist. I care for them from 8am-8pm, but they are alone at night. Mom recently almost fell in the bathroom. If I had not been there she would have fallen face first into the glass shower door. She wouldn't even have been able to protect her face or break her fall since both her hands were pulling up her depends. Months before this I came in at 8am one morning and found on the floor by her bed.. she missed the edge if the bed sitting down after a bathroom trip. She was sitting on the wood floor like that from 4am until 8 when I arrived. I have asked if she would have a grab bar installed, she said no. I asked her to order more absorbent overnight depends so she's not making multiple trips alone at night to the bathroom, she said no. I have asked her to wear life-alert at night, she said no. I've asked if we can schedule overnight care, she said no. As a long-time caregiver I know she needs the help round the clock. My question is if something happens at night while the girls are alone can the family, or anyone for that matter, come after me? I want to respect boundaries and rights but also protect myself, my license, and keep the ladies safe. Also her POA and Proxy are both her other daughter that lives 2 hours away and mom also has a sister that has been adamant about the ladies needing more care for the last 3 years.
Falls are common due to rigidity and lack of balance. My mother’s doctor ordered home health so that she could work with a physical and occupational therapist. She also received an aide that assisted with bathing and helping her to get dressed. Mom’s strength and balance improved significantly.
Mom had one really bad fall which resulted in a hospital. The doctor ordered rehab treatment for her. Medicare paid for it. The hospital transferred her to the facility. She was able to participate even though she was in her 90’s and she did improve.
As far as evening bathroom trips go, I placed a bedside commode in her bedroom for her to use at night.
My mom did wear an alert necklace and I placed a lockbox with a code on it so the emergency workers could enter quickly. The alert necklace will detect falls and notify family members of the fall.
As you know, Parkinson’s disease is progressive and doesn’t have a cure so she will continue to deal with challenging symptoms. Some people, but not all will also get dementia along with their Parkinson’s disease. Mom did develop dementia later in her life.
Please speak with your client’s family about her needing more care. Falls are frightening and dangerous.
PT and OT helps if she is capable of doing the exercises that are designed specifically for Parkinson’s patients. My mom lived to be 95 years old and wasn’t bed ridden until the last few weeks of her life when she was in an end of life hospice facility.
Of course, the best solution for your clients would be for them to be in a facility where they could receive 24/7 care. Hopefully, the family will agree to this before a catastrophe occurs.
Wishing you and your clients all the best.
Parkinson's goes hand and hand with Dementia. Plans are needed to be made for special needs daughter, too.
Some caregivers (especially if agency employed) have a protocol to not try to lift the fallen person by themselves. It may require a 911 call in those scenarios.
If a person is not incapacitated the POA doesn't mean anything. You work for the mom and she gave you her friend as the contact, that doesn't make you liable for anything with the actual appointed POA.
Perhaps it is time to encourage your client to get a needs assessment to ensure both are getting the proper level of care they need.
You are not legally responsible for her choices or responsible to communicate with her POA, don't let anyone tell you that you are. The estranged daughter may be named as POA but, that doesn't make her responsible either if she hasn't accepted the appointment.
Best of luck getting these two the care they need, it sounds like a tough situation for you.
No one else has anything to do with any of this at this point.
If the Mom is incapacitated and you can't get good info on who is in charge you need to assume that NO ONE IS and call APS. You then need to quit unless you have solid proof someone has a POA to act for the mother and her child.
This sounds a horrid mess top to bottom. But as long as the mother is well enough to direct you and you wish to work for her then you are welcome to work for her. No one else has authority over a person who is legally competent. NO ONE.
She pays you. She directs you. She is your boss.
When there is no competent boss it's time to quit.
If you work for an agency you should mention that they , in your opinion are not safe alone when no one is there.
If the mother is cognizant there is not much you can do other than to document what suggestions you have made and her response.
If Mom is cognizant and and you do not feel that they are safe you could report to APS (understand that she may be upset and you might lose your job)
If there is family you could express your concerns to the other family members.
The OP claims to not be getting paid in cash and is legally employed. So no, not responsible for them when their paid shift is up.
You are not responsible for the hours you are NOT responsible for and not hired for.
Elders fall. We ALL fall. And often a fall of some kind or another is the "beginning of the end".
That said, it is up to the women you are caring for themselves, and their POA if they are not mentally competent, to assess needs. You already found a client on the floor. This is going to be more the norm than not when you do in home care. People, families, caregivers often find people on the floor.
Falls happen. No one is responsible for a fall.
If patient/client and POA are making decisions, that is their business to do.
If you feel incapable now of handling the clients due to any reason (your bad back, their weight, etc) it is time to quit the position. It sounds like getting tough now.
All falls you are made aware of are reportable to the POA.
If you feel a POA is neglectful I would take that to your agency.
If you feel a POA is not acting in a dangerous situation and you are not hired by an agency I suggest a call to APS telling them what you witness during the day, and that you feel they are unsafe alone when you are not there, let alone when you are.
As a caregiver I would be insured and bonded. It is important.
You aren't responsible, but that doesn't mean someone nefarious cannot bring a suit against you about ANYTHING they choose. Your insurance coverage, whether umbrella policy or whatever, provides you an attorney for defense.
Another thing for YOU to consider is that the homeowner may not have enough liability coverage if YOU got hurt on the job (think about wrecking your back while you're picking client up off the floor, especially if it creates a permanent disability). Also, IF you're getting paid in cash there's no way to prove you got hurt "on the job".
The increasing care needs is a concern you bring up to the PoA (via email or text so that you have a dated record of when you voiced the concern). You now need to consider how long you want to work there if the PoA doesn't act fast enough.
If you think there are vulnerable, unsafe at some times of the day, you can call APS about it.
I don't think so. I own a homecare agency and no agency is going to legally hire an hourly aide 12 hours a day because over 40 hours (when you're hourly) becomes overtime and gets overtime pay.
So, more likely you're working under-the-table and getting paid in cash. You should be more worried about getting in trouble for that. Or if you're working illegally in the U.S.
I'm sure you already know the answer to your question.