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A well intentioned former caregiver who charges my mother by the hour and wants my mom to move home secretly takes her to her home. My mother doesn’t tell me that. We haven’t done anything with her home or furniture because we’re waiting on LTHC approval. These visits are terribly upsetting and she becomes isolated and combative with staff when she returns. I’ve taken a hands off approach but this is becoming a problem.

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Do you have Power of Attorney for Health and Finances for you mother?

Have you spoken to the AL social worker about not allowing your mother to be taken off the premises without your permission?

The caregiver sounds as though her intentions are for her to be paid as your mother's full time caregiver; she may be trying to get mom thrown out of the AL.  I'd shut this down ASAP.
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AT1234 Jan 2019
Yes, I have POA. AL does not have authority to stop her, they do not have social worker.
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The caregiver doesn't sound very well-intentioned. She must know that these visits home upset your mom and affect her behavior once she's back at the facility. And any decent and professional caregiver would not find it necessary to do anything for her patient in secret.

This caregiver has stepped way over the line. It's time for a hands-on approach.
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AT1234 Jan 2019
She’s also kept her out past her med time. I had not been told where they were going or when they were scheduled to be home. I was a wreck.
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Talk to her doctor about them ordering her not to be taken out.

If the AL cannot comply with doctor's orders, then it's time to move her to a secure Memory Care unit.
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I've read in many articles that "people with dementia often deny that they have dementia." They can even fool themselves (and sometimes others) into thinking they are mentally "all together."

As POA, you have been given a gift of responsibility in caring for your mom. Both of my parents (now deceased) had dementia issues. My mom had Parkinson's disease and my dad had cancer which brought him to the point where he just couldn't make wise and healthy decisions for himself or my mom, so I was required to do this for them. (Both parents had 2 doctors state in writing that they could no longer make financial and health decisions. My dad willingly signed over the legal documents for me to make decisions first for my mom and then later for him.)

At the AL facility where my mom resided, we gave an approved list of people who were allowed to take my mom places. We also gave a very short list of people who could not have contact with her. Most facilities recognize that there are people, including family members and even grandchildren, who take advantage of the elderly and the vulnerable. The facility personnel, like those responsible for their loved one, don't want to have people visiting who will harm their resident in any way.

I had a great attorney who would have willingly assisted me with making sure my parents were safe and would have readily advised me in this situation. It would cost my parents' trust account to do this, but I (and my family) would have recognized it a justifiable expense—anything to keep our parents safe!

My parents' house was sold after my mom passed away and my dad had to move into a nursing care facility. I took time to discuss with my dad how much it cost to hold on to his nearly empty house. We did some updates to the house, took Dad through the house, sat outside for a bit to share memories we had for the years he and mom and us 5 kids grew up there—along with the years of hosting family gatherings with the grandchildren, and we even talked about the neighbors who had passed over the years. It was a sweet time—difficult, but necessary. Dad for those moments knew that the house was going on the market and that this part of our lives would change. Because we have the hope of a forever home in heaven, we've known all along that someday we will leave this earthly home and that all of this pain and turmoil will come to an end.
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JoAnn29 Feb 2019
This was so sweet.
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As Samsung said talk to the Caregiver first. Tell her that you are asking she is no longer take Mom out of the AL and why. That you would appreciate her not even mentioning home. That "home" is not an option anymore. That Mom needs to adjust to her surroundings. Don't tell her ur planning on selling the house, etc. Tell her she is welcome to visit because Mom enjoys her company and you appreciate all she did/does for Mom.

Don't tell her you have talked to the AL but inform the AL what people are allowed to take her out of the facility. Tell them and put it on the paper, that the Caregiver has been informed that she is no longer allowed to take Mom out of the facility. That if she tries, they are allowed to ban her from the facility. Their responsibility is to keep Mom safe.

If you don't feel comfortable with this caregiver, then ask the AL that she not be alone with Mom. That when she visits, she is to visit in the common area. Believe me, the CNAs have big ears. Residents talk and they hear. So if she continues to talk about "home" a CNA will hear. Moms AL was small, 39 rooms. So I knew most of the staff and would feel comfortable asking them to watch the Caregiver.

I agree too, to change the locks on Moms house.
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NeedHelpWithMom Feb 2019
JoAnn,
That is really sensible advice. Agree with your thinking on this situation.
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When my Mom was in AL, they couldn’t have control over freedom to leave the facility. We got an order from her dr. that she could only leave with family. If this person goes against your wishes and it negatively affects your mom, ask for a prescription to limit or stop this. It’s mentally upsetting for your mom. The AL has to follow dr’s orders.
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WHAT THIS CAREGIVER IS DOING IS CONSIDERED KIDNAPPING!!! NO MORE HANDS OFF APPROACHES!!! When she does it again, call the cops and tell them that what she's doing is endagering an elderly patient. Then press charges. I'm surprised that APS hasn't been called. Stop being so passive and start protecting your mother!!
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Lymie61 Feb 2019
I'm not sure that's true if mom is free to come and go or even if she's free to come and go with aproved people and this caregiver is approved. Sounds to me like that is exactly the situaltion. this caregiver is being "hired" by mom to take her out to do errands etc so I'm not sure you can call it kidnapping or an APS offense until and unless the caregiver is no longer being paid and no longer on the list and expressly told she is not to take mom off the premises or barred from them entirely. My impression is this caregiver worked for mom while she lived in her house before she moved to AL and the extension of her visits and responsabilities is meant to help keep things similar and help the transition. I may be all wrong on that and reading into the OP with my own colored galsses but still I don't have the sense it would be easy to make a kidnapping claim, yet or call the OP "passive".
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As her POA you can ban her from visiting. You can tell the AL this person is not allowed to remove your mom from the facility. It isn't a social worker that implements this, I would talk to the administrator and put it in writing.

Anything done in secret is problematic, if it is okay, what are you hiding?

I would contact the caregiver and tell her what her actions are doing and that she needs to stop doing anything that causes mom so much upset.

If she chooses to ignore you, you can file an injunction for no contact.

I would also change the locks on the house, she could be helping herself to what she wants.

On the other hand, you can let them deal with it and live with her meltdowns. If they won't stop the outings after you put your wishes in writing they are playing with fire. If something happened while she was out, they would be responsible.

This is a tough one, picking your battles when you have someone that alleviates your burden is difficult.
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Please consider talking with the former caregiver. Explain the situation.They may not have the professional knowledge and skills to recognize your mothers's limitations and risks. They may also think that what they are doing is what she wants and not recognize the fall out. It is also important to understand that if your mother is in an AL it is not a health care facility, rather it is based on a hotel model with some additional services such as medication administration made available. In this model of care she is free to come and go. If her cognitive or physical limitations are significant then it is important to make sure she has a POA and use it. A move to a more appropriate setting is most likely necessary. It is also important to understand that older adults such as our parents can while still competent, have the right to make bad choices.
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JoAnn29 Feb 2019
This AL has to know Mom has limitations and Dementia. They do a care plan every 3 months. Her Mom can no longer make informed decisions. My Moms AL was very aware that my Mom was not to leave the building. And other residents. I was very careful when coming in to not allow any resident out.
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The caregivers actions are unacceptable only if you have informed her they are. If you have taken a hands off approach as POA and the caregiver is acting under the wishes of your Mother and has no idea of your displeasure, she is hardly at fault. I suggest you get more involved and let the caregiver and ALF know of your disapproval. If the caregivers visits don't cease after clear communication then you can take proper action. Communication is key. Good luck to you.
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AT1234 Feb 2019
Maybe I left that detail out, I have talked to her and explained why. It’s stopped for a short while maybe two weeks and began again.
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