Sounds like you yourself give your parents alcohol. That it's diluted does not really matter. Yet you are trying to make the hired caregiver liable if your parents fall? I can understand why the caregiver would feel uncomfortable with such confrontation. Cut out the alcohol and stop going out to restaurants where alcohol is served.
As a professional caregiver I was NOT ALLOWED to "hand" my clients anything alcoholic. If they asked, I said no. Luckily, none of them were capable of getting up and getting it themselves.
I cannot imagine what a mess that would have been--clients on tons of meds, almost ALL stated "no alcohol to be consumed while on this" and a person fighting to get to the liquor cabinet.
I worked ONE DAY for a man whose daily regimen consisted of being bathed and dressed (in a depends all day) placed in a recliner in the living room and watching TV all day while his caregiver worked around him..oh, and brought him a beer every hour on the hour. I remember him saying "what's it to you? I just pee all day in this thing and my night guy handles it?"
As a caregiver, I wouldn't stay and take it. He was abusive when not drunk. And I couldn't and wouldn't facilitate the drinking.
From what I've read here and observed myself, elders often segue into different eating (and sometimes buying) habits, with more of the sugary foods. I've not done any research on this issue, but adding personal observations, I've been wondering if the stress of aging, of losing abilities, skills, becoming more dependent, and all that goes with that, prompts them to seek food which nulls the trauma of aging.
Chocolate and designing gardens do that for me; others may drink. but when I'm upset my hands automatically go to the chocolate. If I immediately start reading a good novel, put on music, start a workout, caress my pointe shoes or silky fabric designed to be used years ago, that helps. I have to work hard though to combat caregiving related stress. And sometimes the chocolate wins.
That may be why your mother became more dependent on alcohol after developing dementia. And you mention that your father is a recovered alcoholic. So aging may be the silent push toward resuming drinking, if he was already predisposed to it.
So, can you substitute something for the alcohol? How does Al-Anon work? I would contact them and ask for specific recommendations. I think this is behaviorally based, so ask about that. I honestly don't have any experience in this area and can't offer any other suggestions.
Do you think they would enjoy volunteer activity, something that makes them still feel worthwhile and reinforces their self image, but isn't alcoholic? What were their professions? When I can avoid the chocolate and do something positive, including practicing piano and imagine that I'm playing for folks in facilities, my mood is elevated and by the time I'm through chocolate is long forgotten.
I do think the situation needs to be escalated to a level of professional help, or at least consultation to help you sort out what options might be available.
First, I'd also discuss this with any doctor prescribing medicine and ask your pharmacist, the geriatrician if you have one, and the prescribing doctors what interactions could occur so that you can be prepared if it happens. Have med lists and personal medical histories (all consulting doctors and contact information, surgeries, medical conditions, etc.) available at the home in case the caregivers have to call EMS.
Second, I'd contact the local Alzheimer's Association and ask to confer with a social worker. It might be that this behavior has been seen before. If you have a geriatric doctor, I'd raise the same issues, especially the issue of using alcohol as a mood stabilizer to combat aging stress.
Third, I would try to get some home therapy to strengthen their arms and legs and minimize damage from falls if (or when) they occurred. Some hospitals and senior centers host fall prevention lectures which would be worth attending. Vision, hearing and balance are all factors in falls.
Fourth, make the home more fall proof; that's easy enough to do. But walking to and from the restaurant is a different story. One caregiver could barely even catch one person falling, let alone two. Maybe they need to exit the restaurant one at a time, just in case.
If the parents have not been declared incometant they can do anything they choose. All the caregiver can do is not take them to an establishment that serves alcohol or go out and buy it for them.
There is a liability issue, complicated by the fact that the caregivers are not through an agency, if I understand correctly. So let's address that first.
When I considered hiring people just for cleaning, I contacted my insurance agent to get comp coverage under my father's homeowners policy, in the event the individual was injured. In Michigan, comp isn't a personal issue; it's a professional issue and recovers a professional workers' comp policy, then at approximately $750 - $1000 annually. Coverage can't be provided under a HO policy.
FF has addressed this issue, but in her state she apparently could get a rider on a HO policy. FF, please correct me if I'm wrong.
Caregivers working through an agency would be covered by its liability (and health insurance coverage if the agency is a good one). My insurance agent told me that anyone working in the house, for pay, has grounds to sue us if he/she is injured. They're there "for hire" and aren't "invitees."
So, if either of the caregivers are injured, they might have grounds to file a workers' comp claim against you and/or your parents. That's a different twist on the liability issue about which you're concerned.
And since you have no contract with them, their work scope is probably somewhat flexible, if not undefined. So there's no contract for them to breach.
Rainmom raises interesting points as to liability through contract obligations. It's a good point. I have no experience with this aspect of personal services, but I think that a work/duty scope would be most realistic if the duties were ones which the caregivers could actually perform, w/I their area of expertise, but didn't involve behavioral analysis or change, or prevention of certain behaviors.
The one caregiver is enabling, but I'm not sure how that plays out legally as it could also be considered subjective rather than outside of or in conflict with her obligations and duties.
This issue has arisen in other posts, such as caregivers taking patients shopping, to casinos, etc.
Perhaps all the caregivers could do in that situation is notify the daughters and document their concerns. They're not hired to control or modify behavior; that goes beyond the scope of being a caregiver.
Truthfully, I'm not sure what can be done by the caregivers or you, directly, to control and/or decrease the drinking. But I do have a few suggestions, in the next post (if this one gets too long, no one will even read it!)
Of course she says, "daughters says you can't go". Parents know perfectly well caregiver doesn't make the rules for them.
I have no idea whose liability it would be if your parent fell. What if your parent fell on the way to the table, before any drinks were served? Old people fall. Demented people fall. We do our best to prevent that, but they sometimes fall anyway.
If they are both "competent" they can order drinks. I would try to stop them by saying it is time to go now and stand up to leave. Don't know if that would work, but I'd try. Other than something like that, I don't know how I'd stop them. In fact, if I were the caregiver in this situation, I'd quit. Too much responsibility, and too little authority.
How many drinks do they each have? 3? 5? Do they get tipsy? What happens?
My husband's doctors said he should limit himself to 2 drinks per day. What do your parents' doctors say? Perhaps everyone should be saying "Doctor says" instead of "Daughter says" or "Caregiver says." It won't hurt the doctor any. And they really should hear it from the doctor.
At our first post-diagnosis visit I asked the neurologist in front of my husband whether he could have alcohol. To my amazement he said, "No more than 2 a day." Well, that became the rule.
Unless your parents have been declared incompetent and you or your sister have guardianship, your parents are free to drink as much alcohol as they like. There is no way that you telling a caregiver to restrict their alcohol would be considered a legally binding agreement with enforceable liability on the caregivers behalf.
If there is any legal liability on anyone's part it would be the restaurant and the bartender and/or the server if they continue to serve alcohol to someone already showing signs of being inebriated.
One question. You say "if we say they can't go, she puts the blame back on us, as in "daughters says you can't go". Very hard on us". What would you rather she say?
Parents have insisted on staying in their own house until one of them falls badly and has to go into assisted living or dies. They do not drive. Caregivers or us drive them. They are 87 and 88.
I was attempting to find out if caregiver would have any liability if out with them and permitting them to order more alcohol than we have agreed is okay for parents and then one of them consequently falling or passing out as a possible way of showing her just how serious the situation is as her personal beliefs differ from ours. Thought we could maybe scare her into being more assertive with them. I have assured both caregivers that we hire and fire, not parents so they can take flak from them and not worry about losing job. It all blows over later. We have no written agreement.
You raise good questions. My sister and I hired the caregivers although parents pay them. Mom has become an alcoholic since developing Alzheimer's. She will agree to 1-2 drinks only(by the way we get them diluted), but will then attempt to order more. If I am with them, I simply take over and refuse to let her order one. The caregiver feels awkward, doesn't like conflict so does not try as hard to stop them. She also believes they are old and should be able to drink if they want. Yes, they are both on medications that they should not drink at all, but both do. We were providing diluted alcohol as the alternative was Mom walking to store and getting own undiluted alcohol. She was doing pretty well with our system which included being able to go out to lunch 1-2 times a week with 1-2 glasses of wine, but recently both parents have insisted on going out almost every day and drinking at lunch with this particular caregiver. The other one has made it clear that she does not approve of the drinking so they don't like to go with her. Yes there are mobility issues, Dad use a cane, Mom has some unsteadiness due to mild Alzheimer's. We have not wanted to restrict them completely from going out especially as this particular caregiver will also always blame us(the children)so parents become angry at us for controlling them, rather than standing up to them in any way. They love her and she is a personal friend of mine, but will not intervene with wait staff to stop them despite our asking her too. If we say they can't go, she will put blame back on us, as in "Daughters say you can't go". Very hard on us. I feeling like we are going to have to restrict them to alcohol free restaurants-then Dad won't go out at all-yes, alcoholic, supposedly recovered:( Or let this caregiver go because they see her as their alcohol Buddy. We are going to attempt a family meeting and a meeting with the caregivers, but parents will agree to whatever and then do what they want.
Wolferini, I am confused about this.... mainly because people, mainly elders, usually take medicine that say do not mix with alcohol.
Sounds like your parents take control over the dinner order and it would be very difficult for the caregiver to reel them in regarding alcoholic drinks. Curious, when you take your parents out for dinner, do they order as much as they want?
As for falling, an elder can fall when eating out without having one drop of alcoholic.
You raise an interesting and complicated question.
If she was hired through an agency, there likely would be a liability limitation in the service agreement. Unless your parents (or you if you hired them) and the caregiver executed such an agreement, no liability presumably would be addressed contractually.
Then the issue might turn on what verbal arrangements were made, what instructions and limitations were addressed by whoever hired her, and who pays her. But not all verbal agreements are considered contracts; in some states, "oral" contracts aren't binding.
I get the impression someone "instructed" her to limit their drinks. How is this "instruction" to be implemented? What control can she exert to monitor the drinking? If it's expected that she is to restrict people who are accustomed to drinking, I think that's a bit outside the scope of a caregiver's responsibility.
Then the issue might turn to just plain common sense but also what your parents medical situation is. Are they alcoholics? If so, it can't be expected that she could try to correct the situation.
Your use the terms "allow them to order..." - how does she "allow" them? Alternately, and very importantly, how exactly could she prevent them? Does she take them to dinner? Who pays?
What "instructions" were given and were they in writing? Did your parents and she both sign the agreement? If they were verbal, are you sure that clarity existed on the part of all who discussed the issue?
As to liability, that raises some other complicated issues, arising in part form the tasks to which she agreed and for which she was hired.
In addition, Is she trained in fall risk prevention? What is her background? And what were the expectations? She's one person; presumably there are your mother and father. Is it expected that one person could prevent falls for two people?
Lastly, people are going to fall. We fall from the time we're babies; it's more risky when we're older, and especially if we drink too much.
So, specifically (and I'm not being facetious but making a precise point), how exactly would you anticipate that she could prevent a fall? What are your parents conditions? Are they mobility compromised? And this also turns on the scope of their need for a caregiver.
Your profile states that you're caring for your mother with dementia. I'm a bit concerned first of all that someone with dementia is imbibing, and secondly that someone else may be charged with monitoring alcoholic consumption of a person with dementia. Depending on the state of dementia, it's confusing enough without complicating it by drinking.
Could you just accompany them on these occasions and ensure that no alcohol is ordered?
I think there are perhaps some misunderstandings and expectations in this situation but it behooves whoever hired this person to clarify those expectations, for everyone's sake and safety.
I cannot imagine what a mess that would have been--clients on tons of meds, almost ALL stated "no alcohol to be consumed while on this" and a person fighting to get to the liquor cabinet.
I worked ONE DAY for a man whose daily regimen consisted of being bathed and dressed (in a depends all day) placed in a recliner in the living room and watching TV all day while his caregiver worked around him..oh, and brought him a beer every hour on the hour. I remember him saying "what's it to you? I just pee all day in this thing and my night guy handles it?"
As a caregiver, I wouldn't stay and take it. He was abusive when not drunk. And I couldn't and wouldn't facilitate the drinking.
Chocolate and designing gardens do that for me; others may drink. but when I'm upset my hands automatically go to the chocolate. If I immediately start reading a good novel, put on music, start a workout, caress my pointe shoes or silky fabric designed to be used years ago, that helps. I have to work hard though to combat caregiving related stress. And sometimes the chocolate wins.
That may be why your mother became more dependent on alcohol after developing dementia. And you mention that your father is a recovered alcoholic. So aging may be the silent push toward resuming drinking, if he was already predisposed to it.
So, can you substitute something for the alcohol? How does Al-Anon work? I would contact them and ask for specific recommendations. I think this is behaviorally based, so ask about that. I honestly don't have any experience in this area and can't offer any other suggestions.
Do you think they would enjoy volunteer activity, something that makes them still feel worthwhile and reinforces their self image, but isn't alcoholic? What were their professions? When I can avoid the chocolate and do something positive, including practicing piano and imagine that I'm playing for folks in facilities, my mood is elevated and by the time I'm through chocolate is long forgotten.
I do think the situation needs to be escalated to a level of professional help, or at least consultation to help you sort out what options might be available.
First, I'd also discuss this with any doctor prescribing medicine and ask your pharmacist, the geriatrician if you have one, and the prescribing doctors what interactions could occur so that you can be prepared if it happens. Have med lists and personal medical histories (all consulting doctors and contact information, surgeries, medical conditions, etc.) available at the home in case the caregivers have to call EMS.
Second, I'd contact the local Alzheimer's Association and ask to confer with a social worker. It might be that this behavior has been seen before. If you have a geriatric doctor, I'd raise the same issues, especially the issue of using alcohol as a mood stabilizer to combat aging stress.
Third, I would try to get some home therapy to strengthen their arms and legs and minimize damage from falls if (or when) they occurred. Some hospitals and senior centers host fall prevention lectures which would be worth attending. Vision, hearing and balance are all factors in falls.
Fourth, make the home more fall proof; that's easy enough to do. But walking to and from the restaurant is a different story. One caregiver could barely even catch one person falling, let alone two. Maybe they need to exit the restaurant one at a time, just in case.
Wish I could offer more.
All the caregiver can do is not take them to an establishment that serves alcohol or go out and buy it for them.
When I considered hiring people just for cleaning, I contacted my insurance agent to get comp coverage under my father's homeowners policy, in the event the individual was injured. In Michigan, comp isn't a personal issue; it's a professional issue and recovers a professional workers' comp policy, then at approximately $750 - $1000 annually. Coverage can't be provided under a HO policy.
FF has addressed this issue, but in her state she apparently could get a rider on a HO policy. FF, please correct me if I'm wrong.
Caregivers working through an agency would be covered by its liability (and health insurance coverage if the agency is a good one). My insurance agent told me that anyone working in the house, for pay, has grounds to sue us if he/she is injured. They're there "for hire" and aren't "invitees."
So, if either of the caregivers are injured, they might have grounds to file a workers' comp claim against you and/or your parents. That's a different twist on the liability issue about which you're concerned.
And since you have no contract with them, their work scope is probably somewhat flexible, if not undefined. So there's no contract for them to breach.
Rainmom raises interesting points as to liability through contract obligations. It's a good point. I have no experience with this aspect of personal services, but I think that a work/duty scope would be most realistic if the duties were ones which the caregivers could actually perform, w/I their area of expertise, but didn't involve behavioral analysis or change, or prevention of certain behaviors.
The one caregiver is enabling, but I'm not sure how that plays out legally as it could also be considered subjective rather than outside of or in conflict with her obligations and duties.
This issue has arisen in other posts, such as caregivers taking patients shopping, to casinos, etc.
Perhaps all the caregivers could do in that situation is notify the daughters and document their concerns. They're not hired to control or modify behavior; that goes beyond the scope of being a caregiver.
Truthfully, I'm not sure what can be done by the caregivers or you, directly, to control and/or decrease the drinking. But I do have a few suggestions, in the next post (if this one gets too long, no one will even read it!)
I have no idea whose liability it would be if your parent fell. What if your parent fell on the way to the table, before any drinks were served? Old people fall. Demented people fall. We do our best to prevent that, but they sometimes fall anyway.
If they are both "competent" they can order drinks. I would try to stop them by saying it is time to go now and stand up to leave. Don't know if that would work, but I'd try. Other than something like that, I don't know how I'd stop them. In fact, if I were the caregiver in this situation, I'd quit. Too much responsibility, and too little authority.
How many drinks do they each have? 3? 5? Do they get tipsy? What happens?
My husband's doctors said he should limit himself to 2 drinks per day. What do your parents' doctors say? Perhaps everyone should be saying "Doctor says" instead of "Daughter says" or "Caregiver says." It won't hurt the doctor any. And they really should hear it from the doctor.
At our first post-diagnosis visit I asked the neurologist in front of my husband whether he could have alcohol. To my amazement he said, "No more than 2 a day." Well, that became the rule.
If there is any legal liability on anyone's part it would be the restaurant and the bartender and/or the server if they continue to serve alcohol to someone already showing signs of being inebriated.
One question. You say "if we say they can't go, she puts the blame back on us, as in "daughters says you can't go". Very hard on us". What would you rather she say?
Sounds like your parents take control over the dinner order and it would be very difficult for the caregiver to reel them in regarding alcoholic drinks. Curious, when you take your parents out for dinner, do they order as much as they want?
As for falling, an elder can fall when eating out without having one drop of alcoholic.
If she was hired through an agency, there likely would be a liability limitation in the service agreement. Unless your parents (or you if you hired them) and the caregiver executed such an agreement, no liability presumably would be addressed contractually.
Then the issue might turn on what verbal arrangements were made, what instructions and limitations were addressed by whoever hired her, and who pays her. But not all verbal agreements are considered contracts; in some states, "oral" contracts aren't binding.
I get the impression someone "instructed" her to limit their drinks. How is this "instruction" to be implemented? What control can she exert to monitor the drinking? If it's expected that she is to restrict people who are accustomed to drinking, I think that's a bit outside the scope of a caregiver's responsibility.
Then the issue might turn to just plain common sense but also what your parents medical situation is. Are they alcoholics? If so, it can't be expected that she could try to correct the situation.
Your use the terms "allow them to order..." - how does she "allow" them? Alternately, and very importantly, how exactly could she prevent them? Does she take them to dinner? Who pays?
What "instructions" were given and were they in writing? Did your parents and she both sign the agreement? If they were verbal, are you sure that clarity existed on the part of all who discussed the issue?
As to liability, that raises some other complicated issues, arising in part form the tasks to which she agreed and for which she was hired.
In addition, Is she trained in fall risk prevention? What is her background? And what were the expectations? She's one person; presumably there are your mother and father. Is it expected that one person could prevent falls for two people?
Lastly, people are going to fall. We fall from the time we're babies; it's more risky when we're older, and especially if we drink too much.
So, specifically (and I'm not being facetious but making a precise point), how exactly would you anticipate that she could prevent a fall?
What are your parents conditions? Are they mobility compromised? And this also turns on the scope of their need for a caregiver.
Your profile states that you're caring for your mother with dementia. I'm a bit concerned first of all that someone with dementia is imbibing, and secondly that someone else may be charged with monitoring alcoholic consumption of a person with dementia. Depending on the state of dementia, it's confusing enough without complicating it by drinking.
Could you just accompany them on these occasions and ensure that no alcohol is ordered?
I think there are perhaps some misunderstandings and expectations in this situation but it behooves whoever hired this person to clarify those expectations, for everyone's sake and safety.