My mom has a new home health aide that stays overnight. Tonight she told me that the caregiver pushed her arm and hurt her wrist earlier in the week.

I tried to talk to her about the details, but the story was wrapped up in another story, about the care giver taking her for a ride, and her going to a room that seemed like a jail, which definitely didn't happen. (She has moments that admits that she is not sure if this part really happened - she is aware she had dementia). Parts of my mom's story are true (e.g.: she said that the care giver doesn't sleep as if that's a bad thing - but the care giver really does try to stay up for a good part of the night. She said the caregiver spoke contemptuously about other clients - that might have happened. The caregiver did share a story with me about her other clients, but in her version, the family had treated her poorly, and she didn't speak contemptuously of them.)

The caregiver isn't coming to stay overnight again until Sunday, so I have a little time to think about what to do.

So, how to respond? The caregiver comes from an agency who has always sent us solid folks, but she is new. I will follow up with the caregiver, but should I follow up with the agency as well? If it didn't happen, is the situation ruined and we need to find another person? (My mom says she can't remember the story, but she does remember the push). Or by tomorrow will it all reset, as many things do with folks with memory loss....knowing that it could come up again?

My mom is often suspicious, and has fantastical stories, but this is the first one about someone physically mistreating her. My mom didn't tell me this earlier in the week and we did speak several times, and the caregiver has been there since then. The family friend did tell me about a situation with the caregiver, but my mom's story to the family friend was that the caregiver was crying and was upset about her family. Nothing about pushing, or her wrist being hurt. I will follow up with them in the morning.

We are only using the caregiver for about 6 weeks, until my mom is scheduled for knee surgery - after that she will transition to rehab and then remain in their long term care faculty. So, this isn't a long term issue.

Has anyone had this happen? Even if it didn't happen to you, how would you respond?

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I agree that the caregiver speaking negatively about her previous client is very unprofessional and gives you a little peek into what kind of person she is. However, sometimes a caregiver gets too comfortable in a client's home. It can seem more like a social visit than the caregiver's job. It tends to be more personal than if the caregiver were working in a facility. The home environment and a pleasant client can lend itself to a false sense of familiarity for the caregiver. I worked hospice for many years and I understand how this can happen so my way of not letting it happen, to remain professional throughout a 12-hour shift, was to keep my shoes on the entire time. I wouldn't get too comfortable in the client's home. If it was a resting overnight shift I would lay down on top of the comforter, not get in bed. I found that these things prevented me from feeling like a house guest as opposed to the employee.

As for your mom's allegations that the caregiver pushed her arm and hurt her wrist, instead of pussy-footing around with the caregiver to try to suss out what actually happened, if anything, just ask the caregiver. Tell her what your mom said and see what the caregiver has to say. Don't be accusatory, just ask. Between wheelchairs and walkers and mechanical beds and Hoyer lifts and all kinds of other contraptions I've probably pinched fingers, knocked elbows against the wall, gripped arms too firmly if I thought someone was going to fall, lowered a bed rail when someone's hand was in the way and any other number of things. I've also placed my patient's safety ahead of my own on several occasions to keep someone from falling and walked away with a pulled muscle or a painful backache.

Talk to the caregiver. Give her the benefit of the doubt.
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Speaking contemptuously of other clients and complaining of being mistreated by a previous client demonstrates at least a certain lack of professionalism in the care giver and perhaps some personality problem. I would be inclined to believe Mom's account was somewhere between possible and likely based on that factor alone and remove this care giver from Mom's care rotation on that basis alone. But I also understand and share your reluctance to state a problem to her agency based only on Mom's account.

If I wanted proof to support an agency report then I would respond by placing a voice activated recorder (or two) in the house during the next overnight and then review the recordings. Assuming you are your mother's POA, such recordings would be legal and admissible in court if you are in a single party consent state or your state has adopted exceptions for venerable persons; check with a lawyer. Even if you never report the recordings to others, they could give you personally enough confirmation to pass your mother's allegations on the agency.
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This is a tough one. My Mom also has very vivid dreams usually that’s she’s fallen, or hurt herself in some way. I have to reassure her that it was a dream and she’s fine, after going thru the motions of checking her all over for bumps etc. I think in your situation where your Mom thinks a caregiver pushed her, I would casually mention it to the caregiver, (out of Moms earshot) giving her the benefit of the doubt. Almost like “Wow, Mom has been having some wild dreams lately, she even thought you pushed her. Has she told you any dreams like that?” This gives you the opportunity to see her reaction. The caregiver may be mortified and want to reassure you that it was a dream and she’d never think of hurting her. Don’t bring it up again with your Mom, she will probably forget about it quickly. And if it’s unfortunately true, it also lets the caregiver know your mom is with it enough to know she was pushed and told you about it, so it won’t happen again. It also may provide additional dream info the caregiver may have.
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