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My mother is an alcoholic. She is ninety years old. She has had numerous falls over the years that resulted in evident injury or hospitalization. Her doctor has advised her to not drink alcohol. I live in another state so can only make periodic visits. I refuse to buy my mother alcohol when I visit. I have some practised responses and leave the room; I won't get reeled in for a debate about this. I've encouraged the caregivers from the agency to do the same thing. The alcohol abuse was still evident when I visited this time. I asked the care aide how my mother was getting the alcohol and she said that sometimes my mother buys it herself (my mother sends the care aide to other parts of the store and then she will go to the alcohol dept and buys it herself). The care aide can express concern, but I am told that she is overruled. Sometimes she is ordered by my mother to go get the alcohol and she said that she cannot refuse. Is this true? Is it true that anything that a client wants the caregiver agency has to get it for them even though they have realistic concerns about the purchase? What can they do and still keep their job and their integrity? What can I say/do from long distance? No, there is no guardianship in place. This would be difficult for me living long-distance and having limited resources. Per this question I am concerned about the care agency having to do this and knowing it is harmful for my mother. What can they say/do? What can be done? I'll read more about other effects of alcoholism in other discussions. Thank you.

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Get the doctor to write a formal order and include it in your mother's plan of care for the agency. Then the c/g's would be going against doctor's orders to buy alcohol for your mom. What she does in the store behind the c/g's back is her own business. Alcoholics will get it somehow.
My dad was an alcoholic and lived in a board and care home. He was allowed 2 beers a day by the doctor. My well meaning ex-husband would bring beer and wine in plain paper bags in his room. Dad didn't care if he drank warm beer or wine, just as long as it was alcohol. "I'd drink it out of a dirty boot." was one of his sayings. I believe it. Too bad they get so hooked.
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Same here in WA state. You must understand a caregivers role, we can not make or force a client to do anything, only try to gently persuade and advise according to their conditions and health plan. If they go against that advise it is "their choice", and that is the rule. Their choice, even if it's a bad one, we can do little about other than notify the agency you work for of their self harming behavior. I can not buy alcohol for my client, if this caregiver doesn't know this then the agency should inform him/her. This is usually directed down from the DSHS case manager or equivalent in charge of their case as directives to the agency. Don't blame the caregiver for the clients bad choices / or ignorance without proper directives.
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Side note:

In Tennessee, we are not required to pay overtime, at least to non-medical caregivers. It's such a different type of job. Sometimes our caregivers had it made, and really didn't work much at all. We had one client whose caregiver got to take her shopping and to the movies all of the time!

A caregiver can be there all day long and actually do two or three hours of work. However, some caregivers have very difficult clients and work their butts off! A lot of those type of clients tend to go through caregivers often. Some caregivers had overnight hours, but couldn't do housework because of the noise. So they'd quietly fold laundry and just be there.

It's a very difficult industry to regulate.

And when you get to live-ins, it's even crazier to regulate.

Sharon
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Its been a few years, but I used to own a home care company. Here in Tennessee, alcohol and cigarettes could be purchased for a client, but if the client's children told us not to, then it didn't happen.

It is very difficult for a caregiver to be in that position. If they truly care about your mom, then they may break a rule for her. Rules get broken all of the time. Our caregivers were not allowed to accept gifts, but I know that clients would always try to give them a $20 for "gas money" or whatever, and some of the caregivers would take it.

Keep in mind, my caregivers were not home health aides, they were non-medical caregivers.

I would suggest having a talk with the owner of the company or an office manager. Tell them what you've mentioned here. Actually, my company would have known about this problem before we ever sent a caregiver out. It would have come out in the consultation. And, yes, we would comply with adult childrens' wishes. They knew their parents better than we did.

Sharon
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Sorry to hear about you having difficulty w/getting overtime, hspooner. It's really unfair to have to fight for something like that, and even if you do finally get the right to overtime, there's still obstacles to actually getting paid. REALLY not fair.
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I'm honestly not sure.....I've worked for a couple different agencies and its been the same there. It would seem like a good law to have, but home health care agencies are funny loophole companies that can do weird things. Until last January we actually didn't get overtime, it just didn't exist for us. They passed a new law though, that says anything over 9 hrs or 45 hrs a week is overtime. The problem with that is that now the insurance companies that pay for the care won't pay for that, so they bill any overtime to the clients (who also don't want to pay it) and so we very rarely get overtime.
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hspooner, just curious -- is it a California law, or is it a company policy?
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Hi, I work as a home health aide and here (in CA), we can't buy alcohol (or cigarettes) for a client. However, that's the odd part about the job, we also aren't able to tell people what to do. We can "advise" and remind them, but when it comes down to it, we would not be able to tell someone that they can't do something unfortunately.
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Nothing is going to make your mom stop drinking unless she wants to, and it doesn't seem like she wants to. Even if her doctor prescribes Antabuse, she would probably refuse to take it. And if her caregivers will no longer buy her alcohol, she could have it delivered, or pay the guy who mows the lawn or someone like that to get it for her.

Unless she's hospitalized as the result of a fall or pneumonia or something, she's probably going to find a way to keep on drinking. It's a shame, but that's the way it goes.

You didn't mention if she's ever tried AA. Maybe she'd like it. She might enjoy the company of a couple of people from AA dropping by to see her, if you want to give that a try.

My MIL's boyfriend is the same age as your mother and he's an alcoholic who drinks all day to the point of passing out on the floor. MIL's "solution" is to try and get him to buy a smaller bottle of alcohol than the size that he wants when they go to their neighborhood grocery/liquor store. I would imagine that just necessitates more trips to the store when the smaller bottle runs out, followed by more arguments. The main issue -- boyfriend's alcoholism-- is never addressed, because he's old and all his friends are dead and he doesn't have long to live, according to my MIL, but really, she's afraid of confronting him. I'd say that if he's lived to be 90 while drinking like that without his liver shutting down, then he may well be around for anther five years, at least.
Part of the problem is that they come from a generation where socializing centered around alcohol, and now that they're old and bored, they drink because they've done it all their adult lives.
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Holly, the simplest solution is a written order for NO alcohol from mom's MD. Care agencies follow written orders from doctors, but requests from family are not as binding. Don't punish the agency, assist them with the written order.
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Holly, I'm so sorry to learn of your mother's fall, especially since it was caused by drinking. That really brings another safety element into the picture.

I have limited experience with home care agencies, especially those contracted on private pay. But I just can't believe that caregivers should be put into a situation of literally contributing to health complications. It occurred to me that it even might be cause for APS intervention, and perhaps some sanction against the agency if news of this ever reached APS.

I'm wondering if you can call your local Area on Aging, or anonymously (with phone number blocked by *67) call APS and ask them. You don't want to get them involved, so don't identify yourself, or given any details which could lead them to your mother. I wouldn't normally suggest lying or misrepresenting the truth, but you might say that you're aware of a situation, then describe it, and ask what the options would be.

I don't know if pay phones still exist, but using one is an option.

The other issue is that if she doesn't have alcohol, she'll go through withdrawal which isn't going to be easy for an elderly person. She really needs to be in an AA treatment program. This might be something you can raise in your call tomorrow, to see if there's a way to facilitate that.

Wish I had some better suggestions; this isn't something I've experienced but you certainly have my best wishes.
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"Garden" in answer to you question about who is paying for this -- it is currently private pay by my mother.
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Thank you folks, for giving me input on my question. Any other inputs before tomorrow will be appreciated. I am supposed to get a call from the staff coordinator and want to be able to ask about this. Here's what happened when I was enroute on the road for the visit -- Life Alert responses confirmed my mother had been drinking. She fell hard enough against a piece of furniture to bruise her back and she was having trouble moving. I called her doc and took her to the Urgent Treatment Center, so another doc was able to see and x-ray the spot. The UTC was supposed to send the report of findings to her Primary dr. I do not know of any follow up at this time; my access to medical info is limited. The one caregiver (who does the shopping, the other is housekeeping) in particular was scheduled several days later. She was able to see the bruise while helping my mother dress. She was very shaken. We went to the grocery -- she and I -- and were able to talk privately a few minutes. She and I were in tears. She said the agency said she is not supposed to refuse purchase of anything for a client. I do not know if this is some state or federal law. The contract is at my mother's house. When I have my phone call tomorrow I will have to "punt" with what info I can gather. Lawyers are expensive, much of my research is on the 'net and in this AgingCare site.
I do not think that this agency means intended harm, but there must be some law that they are in fear of. If there are physicians or elder law attorneys on this site who can offer input on this it would be appreciated.
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Your home healthcare agency needs to be made aware of this situation. They need to speak to your caregiver. A solution needs to be reached.

I agree with Garden in that it's very inappropriate for the caregiver to get caught up in this. She needs the support of her agency.

And since your mom's Dr. has told her she is not to drink alcohol doing so is going against Dr.'s orders and the caregiver shouldn't be expected to participate. And if you, the daughter, even refuses to buy alcohol for your mom no one should expect the caregiver to.
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Nice work Garden!!!
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I don't know for sure one way or the other, but putting the caregiver in that position is not appropriate, although I can understand that your mother may have such a need for alcohol that she can be manipulative.

It does seem to me though that the caregiver would have the right to refuse to participate in actions or purchases that contribute to destructive and unhealthy behavior.

Did you hire this caregiving agency, and if so, did you sign a contract? If you did, does it address a situation like this?

Was it your mother who told you that the the care aid is "overruled"? And overruled by whom? Your mother?
Who's paying for this help?

If Medicare or Medicaid is paying for the caregiving assistance, I don't think there scope of reimbursement would include activities that contribute to addiction.

But first I would also contact the caregiving agency, speak to the owner or someone with authority and ask for their help in addressing the situation.

Don't accuse the caregiver of purchasing the alcohol as given your mother's alcoholism, you don't really know what the situation is and what might be fabricated so your mother doesn't see herself as the person who's perpetuating the situation.

Explain to the agency that you see an issue and ask for their help in addressing it, stating also that you want to clarify the caregiver's role when it comes to purchasing alcohol. They'll tell you what they can and/or can't do. They may actually be glad you raised the issue, if in fact the caregiver can't refuse.

But I still don't think the caregiver's responsibilities extend to facilitating an addictive behavior.
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