Home Healthcare Workers: We're just wonderin'...

In My Humble Opinion
1

So, the saga of my SIL’s continuing battle with cancer and respiratory problems has brought her to her current status of home hospice care and a full-time caregiver who lives with her.

Her caregiver came from a reputable company (my BIL’s mom is using the same company and gave us rave reviews). SIL pays $3600/mo, plus room and board. Hospice, which includes pain meds, hospital bed, recliner, personal equipment, etc., is all free of charge to my SIL. SIL is over the moon with this woman. Gave her a TON of clothes and is in unbelieveably high spirits for someone who is dying. Cheerful, optimistic, and is now walking (with a walker) to the bathroom (she hasn’t walked in 5 months).

The caregiver has done some things that have us rather concerned:

  1. When she started, she had been between assignments for a few weeks. My SIL wrote her a check for $400 to tide her over until her paycheck came. I don’t know if she’s paid her back or not, but we found this to be very unprofessional.

  2. She hasn’t left my SIL’s side in six weeks, with the exception of one long day with her family for a graduation party. My SIL asked my 83-year-old MIL to take care of her that day so the caregiver wouldn’t lose a day of pay. We found this to be extremely unprofessional as well. Nothing scary happened, but fercrissakes, she’s 83 years old!!!

  3. Hospice supplies a person for X hours per week. The patient can choose between a multitude of services that this person would perform. Two hours of laundry, bath and hair care, heavier housekeeping chores, shopping, etc. Well, SIL told MIL that the home caregiver (rather than the hospice helper) did a couple loads of laundry, involving trips up and down a short flight of stairs (I’m talking maybe 6 steps). She was complaining of aches and pains associated with the trips up and down the stairs…the same stuff all of us “over-40” folks complain of. I don’t know whose idea it was; SIL or caregiver, but caregiver took SIL’s MORPHINE pills for the pain. SIL has also informed us that she is only taking half of the pain meds she was taking six weeks ago. She doesn’t appear to be in extraordinary pain.

Now, call me crazy, but it seems to me that each of these incidents would be a fire-able offense by itself. Put 'em all together in the short span of six weeks, and we have to think something stinks here. My understanding of home caregivers is that they are not medical professionals, but are trained on how to check blood pressure, administer meds, and dial 911 should an emergency arise. She never takes days off (with that one exception) and came to SIL’s with just a small suitcase, so I assume she doesn’t pay rent on her own place and probably crashes with relatives when she’s between gigs.

SIL is utterly taken with this woman. The sun rises and sets on her. She’s happy, making progress (though we all know eventually the downward spiral will kick in). I understand the kind of close bond that is inevitable when you’re spending every minute with someone. I’ll also say that SIL has always been a very emotionally clingy person. Her pattern with men has always been “love at first fuck” and she’s always b

So…do we take comfort in knowing that she’s happy spending her last days at home with her cats, with a full-time companion who has encouraged her to get out of bed a little each day, makes her laugh, doesn’t let her sit in her own filth, and cooks delicious, healthy meals for her?

Or do we have a potential junkie who is taking advantage of her?

She doesn’t have anything to “take”, so to speak, but that’s not the point.

What do y’all think?

2

Most home health aides around here are at least LPN’s, and every agency my husband (an RN) has worked for has required drug screens on a regular basis. How was this woman hired? If it was a “caregiver needed” ad in the paper or something like that, the woman may have no qualifications and not be subject to any drug screening.

Since your SIL seems happy and is making progress, it’s hard to want to rock the boat. If she’s happy with this caretaker, she won’t thank you for messing things up for her.

I would keep a close eye on things - especially finances and drugs - and see how things go. Also, make sure your SIL knows it is illegal to give narcotics to another person.

3

This agency was suggested by our BIL who hired them for his mom. So she’s definitely with a reputable agency. And my SIL is well aware of the situation regarding giving controlled narcotics to people. (She also gave one to the BIL who was complaining of a sore back or somesuch).

4

Don’t bother keeping an eye on things. My mother was a home health nurse for many years in both a working and mangerial capacity so I can tell you from her experience: fire this woman now and report her not only to her boss, but her boss’s boss and the board of nursing in your state (if she is a licensed nurse) or at least the governing agency for the company that you hired her from.
The money issues, even if not a firable offense, are extremely unprofessional. I can see how a charitable person would want to help out someone that is living paycheck to paycheck, but your family is being taken advantage of.
The fact that she took your SIL’s pills is a whole different ballgame. That should not only be ground for termination from the company that hired her, it can put a black mark on her record (IOW, she can get a job at a hospital but can’t get the keys to the narc cabinet).
For your SIL - I know you don’t want to hurt her feelings, especially at a time like this, but it’s this or deal with a possibly worse situation down the road (“My car broke, can I borrow $4000 to get it fixed?”). I would just have a back up ready so there is no lag time.

PS - I don’t know if everyone else feels this way, but I see a huge difference in giving your brother/BIL an extra pain pill once for pain and giving one to the paid health professional that is bound by certain laws and rules of conduct from doing such things.

5

The other bits were a matter of unprofessional conduct. The abuse of opiods is a firing offense, with definite professional sanctions and possibel criminal consequences. And I suspect that this is a chronic pattern of behaviour with the aide.