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My inlaws live on an island 2.5 hrs. from my home. Ferry ride to visit. He is 85 she is 84. He has alzeimers and is fairly checked out. Local caregiver who runs adult daycare program called APS on my M-I-L claiming she is not capable of good enough care. APS came to the location of the daycare and questioned my M-I-L. Caregiver calls me and informs me she has called APS and that my M-I-L failed their cognitive test. Caregiver is pushing hard for my inlaws to be institutionalized. Caregiver requested I call APS and report also. I am not going to do this. My M-I-L is tired and worn down but loves her husband and is planning on keeping marital promises of keeping him at home for as long as possible. She has caregivers set up 5 days a week at the house and seems to be holding down the fort. My F-I-L is calm and chill and tired most of the time. He does respond to M-I-L and is still eating, walking and taking a shower. However, this caregiver is not giving up. She has inserted her opinions to other medical providers and tried to encourage them to call APS. Recently, F-I-L was admitted into hospital for failure to thrive and then on to skilled care for about a week. He is home now, but the home health nurse seems to be tied into the original caregiver who called APS. The new home health nurse is now coordinating care for OT, PT and speech therapy. She is pushing, has had my M-I-L sign electronic paperwork without leaving copies or emailing them and is asking questions that indicate she has been told false information by original caregiver - hmmmm. This is all very unsettling as my M-I-L is providing adequate care and love, food and protection, and is bringing in help. Should I be concerned by this over zealous caregiver who seems hell bent on getting my F-I-L institutionalized. The inlaws own 2 homes, have long term care ins. and a little savings. The problematic caregiver works at the nursing home on the Island. Does she have monetary reasons for her pushiness? I appreciate people who care enough to make sure that a fellow citizen is being cared for; however, she is not backing off. I have been working closely with a social worker who has approved of our current care plan for the inlaws. She is the discharge social worker from the skilled nursing home that he was recently discharged from. I have discussed this problematic caregiver with her because this same caregiver called the skilled the nursing facility that the social worker works at and suggested she call APS on my inlaws. After long discussions the social worker agreed with me that this caregiver really needs to mind her own business and that our family has it under control. However, this issue seems to be more layered each day as each person that comes to the house seems to have "heard the news" from this original caregiver....very frustrating. At first I thought my M-I-L was maybe paranoid, but now I realize she is correct. Maybe a restraining order and gag order is needed for this person? Maybe time to get an attorney. Your thoughts??

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The caregiver is the person I would trust most. They are with the elderly and see many things you do not. There is no financial gain for a caregiver. Many times, the family is afraid of financial assets being used for home care or losing control of financial assets, if the person is put in a nursing home. I am an elderly person that lives in a complex where most of the residents are suffering from dementia or Alz. or some sort of disability that we need help. We rely on home health aides more than we do on family. The elderly can be very needy and demanding. We resent needing help. I find many of my neighbors relying on me or my family to do things for them. They have family but not all families are the same. My next door neighbor eats food that has been sitting for hours. Her 3 daughters are all in the area but they are living their lives. Not until the daughters noticed Mom had spent too much money in one month, did they become concerned. She had an outsider going to the store for her, to get cigarettes and coffee she was not supposed to have. The outsider took advantage of the situation. If the daughters had been more understanding, it could not have happened. My neighbor is not capable of independent living any longer. She will burn the place down one of these days, eat something that is poisonous or she will die from having coffee and cigarettes (which is the way she prefers). Trust the caregiver. There is not one thing gained by them, if your parent goes to a nursing home. I see finances being a major source of contention in families. If your parent has money use it for their care. That is why they saved it. Just my two *sense.
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Good point - mandated reporter considerations may be applicable. Actually we had a similar situation with neighbors. A very stubborn husband and a slowly failing wife. He adamantly refused help, but a friend (trained nurse) of the wife's worked to help her and to intervene to get her into a safe situation. Yes, she pressured Adult Protective Services, etc. and she did the right thing. She disrupted that old man's life but his wife was really hurting. Maybe being stubborn helps in some cases, but life situations change and refusing to recognize that doesn't cure anything.
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I worked for a VNA agency and it is one of their obligations to Office of Aging if they feel a patient isn't being taken care of. Just like a teacher has to report abuse of a child.
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CM raises an interesting question. Is this caregiver a private duty caregiver or a medical home health worker? I'm not sure about the mandatory reporting obligations of a private duty caregiver as their focus is not medically based, nor do they always have medical qualifications. I learned this in the process of finding one for my father.

In fact one guy who owned a franchise bragged that he could train his caregivers in about 4 hours to handle a dysphagia patient on oxygen. I think not; first and last conversation with him.
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It appears that the caregiver is passing on false hoods.

To quote the OP "There have been several other things that have happened and been said - things that are simply untrue that have been told to their health care providers; things that are coming from this particular caregiver. Things she said to me on the first phone call that I didn't know and then found out thru investigation that were not true. These things she told also to my S-I-L - were not true. We were at the hospital visiting FIL and making future arrangements with the social worker and with our MIL -- and I had the opportunity to ask questions to the doctor, that were confirmed, that what this caregiver told us - was not true. "

This raises red flags for me. The caregiver is not a reliable reporter. 
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Countrymouse,
You opened this discussion, it looks as though you're closing it as well. Your insight as to what's going on, what should and shouldn't take place, and not jumping on the bandwagon against the caregiver, who's dealing with unreasonable resistance with zero support doing what they're hired to do I applaud. If God forbid something dreadful had happened to one of those elderly folks, this discussion would have focused on the caregiver not doing what some are claiming is going to far. Thank You.
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Just on a point of order: if a professional in healthcare observes a problem, it is not only okay for her to report it, it is mandatory.

I agree that discussion with the family is important. The difficulty is that, with the best will in the world, you can't be there enough to know better than someone who is with your in-laws during their daily routines. In seeing a problem with her client and reporting it and following it up, the caregiver acted entirely correctly.
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Also, wanted to mention that although I did use the term "failure to thrive" as reason for admittance to hospital...I actually heard that term not from the doctors at the hospital but from my close friend who runs a memory care facility. When I was telling her that the doctors were holding him and going to administer tests on why he was weak and tired; she actually used that term - that term was not used by the doctor to us. So, my bad for being unclear in my original explanation of what was going on. He has been eating okay - drinking okay - he has lost weight over the past couple of years but he is not as active either and just doesn't eat that much. My MIL has a loaded fridge and is pretty on him to eat - when I ask him to eat or when we are around he always says I am not hungry and she still puts food in his mouth. Getting old sucks.
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Thank you for your responses. It was good to get some different perspectives on this situation. Most important is the care for my family. Second is dealing with this person if they don't back off.
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Revealing personal information on a client to a hairdresser as well as to people at church is as others stated a clear violation, not only of privacy but probably of the terms of her employment, if she works for an agency. Fire her ASAP. The agency can provide someone else, but make sure the owners understand why she's being fired.

Assuming that you learned this information not only from her contacts with you but also with your other relatives, who don't have dementia, you may also have grounds for either slander or libel, depending on whether she "shared" any personal information verbally or in writing, and how much she advised others that you were not providing proper care.

I'd go after her legally and shut her up. Perhaps a threatening letter from an attorney would stop her and you wouldn't have to go any farther. But her employer definitely needs to know.
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Where did you hear all the info on church members, hair dresser, etc? MIL failed cognitive testing. Maybe she too, has dementia? Forgetting to feed FIL so failure to thrive. I think, you, the family, should make arrangements to stay with in-laws for a couple of weeks to evaluate the situation, first hand. If stories are coming from MIL the paranoia of all these people talking about her, is a symptom of dementia.
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Contact a lawyer about possible harassment charges against the caregiver - not that you would actually press charges - but maybe the lawyer can send a letter to the caregiver telling her to back off or else she's in trouble with the law.

There's no financial incentive for this caregiver to have your in-laws institutionalized other than getting a group or people to rob your in-laws homes. I really don't understand why this caregiver keeps pushing to have your in-laws moved to a facility.

Your statement: Caregiver calls me and informs me she has called APS and that my M-I-L failed their cognitive test.

If APS really saw your MIL has cognitive issues, then they would've contacted you about your MIL...right?

There's something very odd with this caregiver...

Can you get another caregiver? Fire this one ASAP. If this caregiver is from an agency - then whatever she says publicly is a clear violation of HIPPA and the agency should address this immediately.
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The caregiver is overstepping her bounds - hairdresser and church members??? If she is hired through an agency advise them about what is happening. If she does not come from an agency I would contact a lawyer and get his/her advice. I am assuming she does not work for them anymore. Perhaps a letter from a lawyer would curb her tongue. Good luck.
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My in-laws lives at their home on an island. There are local doctors and EMS services. No big hospital though. It is only 20 miles from me, but I have to get across on a ferry and make the long commute thru heavy big city traffic. Takes me about 2 hours sometimes, 2.5 hours to get there. The island is intertwined and more so than I realized. My objection is really with the caregiver calling APS when she had the numbers of family members that she could have called first. My 2nd objection is she was very insistant that we call and report to APS; stating that it may be uncomfortable or a hard call to make but it is for the "best" and that either way, this is not going to end well. After consulting with my sister in law and husband we decided not to agree to her suggestion. We did however get more assertive on this situation and stepped up our resolve to get to them more frequently and check on the caregiver situation and take a closer look at what is going on. There have been several other things that have happened and been said - things that are simply untrue that have been told to their health care providers; things that are coming from this particular caregiver. Things she said to me on the first phone call that I didn't know and then found out thru investigation that were not true. These things she told also to my S-I-L - were not true. We were at the hospital visiting FIL and making future arrangements with the social worker and with our MIL -- and I had the opportunity to ask questions to the doctor, that were confirmed, that what this caregiver told us - was not true. I guess she was just trying to put urgency on the matter - I am not sure. But, what I do not understand, is how the care teams that are now coming in are asking about these "conditions" that don't exist and were confirmed by the doctor staff that they don't exist - I just simply was looking to find out if this is typical or if she is stepping across some lines. Just because she works for a particular facility and that facility works closely with the hospitals and doctors off island - I guess this gives her all rights to inject herself. Also, did she really need to tell the island hairdresser all of my inlaws personal situation and going ons? Its been too much. It's a sad day when my MIL gets to take some time for herself and goes to get her hair done and the hairdresser knows her whole story and his too. Tomorrow my inlaws will be skipping church because this caregiver has been talking to people there also. Its annoying and wrong. I think you nailed the nail on the head when you said the interconnections with caregivers, patients and healthcare providers. I am not sure how to navigate this or what to do. I know one thing for sure ----on a positive note - because of this caregiver we are more involved than we ever have been - I am glad my FIL is home and seemingly doing well. My MIL is letting us help set up better and safer conditions for them and she is also having the caregivers in 5 days a week for 6-8 hours. I am keeping a log book on all of this and if things continue we will have to take some sort of action. Seems like she is crossing a line to me. HIPPA for sure - telling the hairdresser - SMH
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Okay, while I was typing and doing other things, MostlyMe has posted twice and Moosey has posted once. Reading these updates, and perhaps I'm wrong, but I think Moosey's objection is not so much to the recommendation as the fact that the caregiver is being so aggressive and contacting others about her strong feelings.

And with that I concur that she's overstepping her bounds, and she may also be breaching HIPAA violations if she's also a health care professional. However, I believe that private duty caregivers are also bound by HIPAA - not sure about this but I think they are.
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Moosey, could you clarify something first? Your profile states you're caring for someone in independent living. I had the impression from your post though that your in-laws are living at home.

An issue that disturbs me is that they're living on an island, 2.5 miles from your home. How large an island is this? Is there a hospital on the island Emergency services? I'm assuming so as you didn't indicate that your FIL was hospitalized on the mainland.

I was going to respond on a different level until I read CM's and Windy's posts, and realized they had insight which I lacked. Perhaps it's b/c I had an encounter with a meddling therapist, and have through the process of finding private duty caregivers learned how some of these companies are linked or intertwined with others. That was my first thought - that the caregiver was in some way6 officially or unofficially affiliated with another caregiving institution or facility.

During one experience in which I saw these interconnected relationships, not only was a staff at an agency's home office in contact with a visiting physician service which they wanted us to use, one of the therapists was as well. That was completely outside of her jurisdiction, so it raised suspicions.

In another situation, a different company was pushing for us to get hospice; just so happened there was a hospice arm of that company, and a very aggressive, pushy and obnoxious person called either later that day or the next day intending to set up a meeting with me to get hospice on board.

(One of our doctors advised a few days later at an appointment that this therapist overstepped her bounds. Then another doctor said my father does NOT need hospice.) Those were clues that the aggressive therapist had an agenda that wasn't realistic in terms of Dad's needs.

I do think the APS pushing caregiver overstepped her bounds in contacting the social worker at the nursing facility.

Have your parents' treating physicians offered their opinions on this, specifically on moving to a facility?

The caregivers who come 5 days a week - how long do they stay each day, and what do they do? I assume these are private duty staff, but that the caregiver who's pushing for institutionalization is part of the home healthcare team? Or is she private duty as well?


BTW, when the pushy therapist's company called later for a progress update (several weeks after I had terminated their services), I raised the issue of the therapist/markteter pushing hospice. It wasn't even surprising how much the follow-up nurse "backpedaled" and covered for the pushy therapist. And she was still encouraging me to hire them again if the need arose. Fat chance of that!
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I do understand your point, also your MIL insisting she knows what's best. Because she's mentally strong doesn't make her a professional, who has seen this type of thing countless times and has the resources to back them up. Your MIL being strong mentally can be confused with being stubborn and not knowing when enough is enough. Surely you want what's best for your MIL & FIL you love them and care about they're well being, be careful not to let your emotions cloud what's really best. I'm not sure about this I'm only a police officer not an attorney, I would think if you didn't want someone caring for them you have a right to have them removed, or at least not able to contact physicians without your ( family ) approval. You can make that clear to anyone treating them, that way they wouldn't accept the caregivers calls, emails.
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We (the family, 3 of us) try and get to them once a week. It's tough with the distance. They seem to be doing pretty good currently. More help at the house now, he is getting around a little better and is certainly happy to be back home. When he was taken to the hosp. they struggled for a reason to keep him. With family encouragement and social worker intervention; they kept him for testing. Each day though was a struggle on keeping him admitted. The caregiver should have called family before she took matters into her own hands. At what point would it be okay to call APS and not family first if you have concerns about quality or capability of care? Just seems backwards to me. My MIL was taking dance classes and swim lessons 2 years ago. She wants to be his caregiver and she wants to keep pushing forward. She believes it is what keeps her mobile and not institionalized or in assisted living. I have yet to meet an 84 yr. old that is not tired and worn down. I would love it if they sold their home and moved into a beautiful assisted living and lived happily everafter. However, that is not her plan or dream. She is strong mentally and doing pretty good physically for 84.

I am glad she has found more help, I am just concerned about this other caregiver not moving on and inserting herself into this situation. Last communication I had with her 2 weeks ago - she said we would not hear from her again. But I guess that didn't mean that she would move along. I guess that meant she would continue to call on their care providers and request that they call APS - caregiver gone too far.
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Why are you so against what the caregiver is trying to do? You live 2.5 hours away, your FIL is 85, your MIL is 84, did you ever think that maybe, just maybe your MIL isn't capable of providing good enough care to your FIL? At 84 it's no wonder she's tired and worn down, taking care of herself on a daily basis is a full plate, the additional burden of taking care of your FIL as well has to be overwhelming. You're wasting your energy on trying to discredit the caregiver instead of spending it on what's best for your in-laws, that should be your primary concern. You need to spend some time with your in-laws, to see for yourself how much of a struggle it is for your MIL each and everyday. To think of a restraining order and getting an attorney involved in my opinion is not necessary, what's your reason,,because the caregiver wants what's best for your MIL & FIL?
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I see lots of warning signs in your account of things. In laws have a host of problems and you said mil is tired and worn down.

It may be that this caregiver is overstepping a little but i don't see how she would profit by getting your in laws placed in care.

Have you visited lately? How do things look to you? It may be they are at the tipping point of independence or facilty living. 

I'm getting to the same place with my parents. They should be in assisted living but refuse to leave their home. I understand this but by being stubborn They are in danger of a serious crisis, fall, etc and will end up in  facility care in any event, but in much worse shape than if they moved now.

Good luck to you.  This is tough stuff to sort through.
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Overzealous?

Your FIL was admitted to hospital for failure to thrive. Hospital! Failure to thrive!!! How bad does this situation have to get before you agree that someone should actually do something for this struggling elderly couple?

Nobody is disputing how much your MIL loves her husband or how good a wife she has been to him for so long. What is at issue is whether the poor lady can continue to flog herself along in a vain attempt to "hold down the fort," as you put it. The clue is in the word 'hospital', admission thereto, for failure to thrive.

Doesn't MIL deserve a rest? Isn't it time somebody looked after her? Instead of abusing the caregiver - who, after all, has absolutely nothing to gain for all her trouble - start working with the professional team, ideally to get your MIL and FIL placed together in a continuing care facility.
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