Home health aide authority, any thoughts?

No shoes? In Detroit? Is this b/c she needs help getting them on? Something's amiss here.

I understand your position, though. Have you spoken with whoever hired you to determine if the aides are responsible for helping her dress?

I think I'd do this before riding anywhere else with her. You could be subject to neglect or abuse charges for taking someone out in our still cold SE Michigan weather, w/o coat or shoes.

Oftentimes there are problems between a facility and a private home healthcare aide. On the one hand the staff like that there is an aide because it makes their job easier but on the other hand they don't like it when the aide makes any kind of a request, even if the request is suggested by the home healthcare agency. An aide has to watch where she steps in a facility. Lots of land mines.

You're in a no-win situation. Your agency says you can't help her but the facility won't help her. If this lady just needs assistance getting herself together to go to her appointment (shoes and coat on) I'd help her. But if she needs more assistance than that discuss it with your agency but don't let the agency put you in the position of dealing with the facility. Your agency should do that, not you. The agency needs to speak to whomever hired them (you) about this problem.

Just deal with your agency, not the facility.

I agree with the above statement that talked about abuse and neglect.

As a CNA is there a Duty to Act?

I am assuming the family has made the arrangements for an aide to go with Mom. Maybe your boss can have the family member call the facility and ask that Mom be ready. Also, that when u return, an aide take over from you to see she gets back to her room. This was an ongoing problem for me. I would call ahead but still would find Mom with food down the front of her and one time sound asleep. I expected her in the common room ready.

Eyerishlass raises a very good point about getting in the middle between the facility and your agency.

This woman clearly needs more help, especially with her diabetes management, and that seems to be a gap in the care.

Is your agency in touch with her family, so that they could intervene and straighten out the responsibility and liability issues? They could at least document to the facility, which seems to be where the care for out-of-facility trips is questionable.

I hope you're documenting; after reading Eyerishlass' post, I think you should be, as eventually this issue is going to come to a head.

Yes this is Detroit.

It is assisted living, not intermediate or skilled nursing, so there is help for her but it is scarce.

There have been times when I brought her into the building after her appointment and she was sweating so i helped her get her coat off.

She is diabetic and one time she felt her sugar was low. She pointed to her tray and asked me to give it to her so i did.

My employer insists it’s not my job. I think she doesn't want me doing it because the other aides like to drop her and run, plus my boss says it is the facility’s job.

I dont like leaving her until i know she is OK.