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Overstepping Boundaries?
lrob
Posted: Saturday, January 14, 2012 8:16 PM
Joined: 1/14/2012
Posts: 5


Hello!  My husband and I are caregivers for my Mom, who is at stage 5-6 with alz.  She has lived with us for the last year.  6 months ago we hired a friend of our daughter's to come to the house for 5 hours, two days per week.  She showers mom, takes her to the YMCA for excercise and provides companionship, as well as allowing my husband to have a little free time each week.  He is retired and I work full time.

 

Mom developed psoriasis about two months ago.  I've been treating with overthecounter creams. Last week my husband and I were able to go away for 4 days while family members came and stayed at our house with Mom.  We decided to have the aid come on her normal two days so that mom would have the routine. 

 

We got home last Saturday and Mom was upset with the aid, although she could not communicate the problem.  After some detective work, I found a note from the aid, along with a filled prescription for hydrocortizone cream.  She wrote that she had taken Mom to a dermatologist because she was "worried" about the rash not clearing up and wanted to be "100% sure" that it was psoriasis.  Eventually, I spoke with my daughter who said that the aid, called her to get Mom's social security number, and other information necessary to fill out new patient forms.  My daughter works part time in my office and she obtained this information by going into my personal office, and  into my personal records, where I keep, well, personal information.  I am livid.  And my daughter sees nothing wrong with any of it.  Even Mom, in her confused world, knew enough to know that something was wrong with the strange Dr. visit. 

 

I am interested to hear other opinions of this incident.  The aid has been out of town visiting her sick father since we returned.  She is due back at our house on Monday.  I will have to address this with her then.


mygma1918
Posted: Saturday, January 14, 2012 9:40 PM
Joined: 1/14/2012
Posts: 1


The fact that you left for 4 days without leaving all this information with the aid is beyond me. I'm sorry but anyone who has an aid needs to give all personal information ins etc in case something like this happens.
Cheryle Gardiner
Posted: Saturday, January 14, 2012 10:15 PM
Joined: 11/30/2011
Posts: 529


I disagree with mygma. The aide had no business making a dermatology appointment in your absence, and your daughter had no business giving out all of your mom's personal information.

The aide may be (and probably is) trustworthy, but if she wanted to "be sure" it's psoriasis, she should have communicated her concerns to you and let you handle it. IMHO, she went way beyond what her job calls for. Taking your mom to a scheduled appointment is one thing; initiating an appointment with a new doctor without talking to family is way out of line.

As far as your daughter's involvement, you don't say how old she is, but if she's working for you, she should have at least a minimum of awareness of identity theft and how dangerous it is to share things like your mom's SSN. When the aide called her and asked for them, she should have declined to give it, and told the aide to wait till you got back.

As far as her going into your personal files, that's a conversation you definitely should have, but it's not directly related to the incident of the aide, except for the part about the SSN. If you don't want her in your personal files, lock them and don't give her the key.

As far as the aide, I think you do have to address this with her, but do it carefully unless you don't care if she quits. Have you had other issues with her? Do you trust her enough to keep her after this? Why did she think it was okay for her to take on this role without discussing it with you? I assume you are your mom's POA and/or Medical POA. As such, no one should be taking her anywhere without your permission.
rose_ro
Posted: Saturday, January 14, 2012 10:44 PM
Joined: 12/21/2011
Posts: 2431


I would be so mad my head would explode.

 

I wouldn't trust your daughter again, sorry.  If she doesn't see what went wrong - and how she needs to be a ''gatekeeper'' - well, then I couldn't trust her.

 

did you leave a phone number for them to call you?  If so, and they didn't, I'd be even more angry.

 

this IS overstepping boundaries.


SafeSecureContent
Posted: Saturday, January 14, 2012 11:28 PM
Joined: 12/16/2011
Posts: 43


That's not just overstepping boundaries, that's catapulting over them. I can almost promise you that if she is employed by an agency and they were to find out..... heads would roll for sure.
rose_ro
Posted: Saturday, January 14, 2012 11:36 PM
Joined: 12/21/2011
Posts: 2431


SafeSecureContent wrote:
That's not just overstepping boundaries, that's catapulting over them. I can almost promise you that if she is employed by an agency and they were to find out..... heads would roll for sure.

  totally, totally...was the daughter just being stupid?

 

Or - naive?

 

Taking mom to the doctor is one thing, getting private info like by a non-family memer is possibly criminal on some level - how can you be assured she won't use it RIGHT NOW

 

i seriously would look into one of those identity protection things that let you know immediately if there's a ''problem'' - and I'd send the bill to the daughter!

 

I mean - here some people are, debating whether or not THEY as family members can get pertinent info from the doctor - and a non-relative is pulling this stuff?


in the moment
Posted: Sunday, January 15, 2012 12:01 AM
Joined: 11/30/2011
Posts: 53


I too am amazed that the aid who is a friend of your daughter was able to sign up your mom as a new patient of a doctor.  She may have been concerned but she should not have taken it upon herself to do so.  She or your daughter should have called you.

 

If you decide to keep her as an aid, you have to establish the boundaries and both the aid and your daughter need to be aware of what they are.

 

I would also recommend that you contact the credit reporting agencies for information on freezing her accounts and for not allowing new accounts to be opened. 

 

 

 


MLB61
Posted: Sunday, January 15, 2012 7:58 AM
Joined: 12/2/2011
Posts: 726


She did this all because of a "rash"?  That's something that can wait 4 days.  If it was an emergency, then she calls 911 and they call you.  She might have had good intentions, but it was not the right thing to do.

 

If she did not have good intentions and just took advantage of an opportunity to get the SS# and date of birth, then that's a whole other story.  With those two pieces of information, a lot of things can be done.  How many accounts does your mom have? Might be a good idea to run a credit watch to make sure no credit cards are issued.  I hate to think this way, but you never know.


lrob
Posted: Sunday, January 15, 2012 7:59 AM
Joined: 1/14/2012
Posts: 5


Thank you all for taking the time to respond.  Sometimes when you're so close to a situation your emotions can dictate and cloud your objectivity.  I can't believe that I even doubted myself.  This was definitely wrong and I will have a meeting with the aid, privately, before she comes back to work.

 

Please know that I left a copy of all of Mom's legal documents with my sister and brother-in-law who were staying at our house, caring for Mom in our abscense. 

 

Additionally, my cell phone  number is known by everyone who is even remotely connected with Mom.  Even all of our neighbors have the number (just in case wondering becomes an issue).

 

My  daughter is 31 and we work in a Law Office of all things...........I have dealt with her already (very loudly, I might add) She does not think any wrong doing took place.   I realize that she is not trustworthy and I will certainly be locking and passwording, and protecting our files.

 

The aid, however, is great with Mom and I hope things can work out with her.  We will see how the conversation goes............Thanks again everyone!


AlphaLeah
Posted: Sunday, January 15, 2012 9:59 AM
I would give the aide - and your daughter - the benefit of the doubt of having your mother's best interest in mind. 

Perhaps start the conversation with "I'm confused as to why you didn't call me to discuss taking her to the doctor before doing so?" (Versus approaching it in a way that makes her defensive.)

Certainly there are boundary issues to address - but it sounds to me like the boundaries were not clear to the aide. So it would be a good first step to take upon yourself the fact that more could have been done to make boundaries explicit and to then have conversations with both your daughter and the aide about expectations for the future.
jfkoc
Posted: Sunday, January 15, 2012 10:50 AM
Joined: 12/4/2011
Posts: 17569


At best it is goofey. No call to you? From anyone?  No call to the PCP? Over stepping the chain of command? Certainly. Poorly handled but I would want to think that best interest was the motive.

 

I agree with Alpha. Find out the reasoning behind the actions. If you do not like what is said then you need to find someone else.

 

BTW: What did the new Dr. diagnose? It was important enough to take  your mother in and get a perscription but did not fill or use it?????  What the????


Zolly
Posted: Sunday, January 15, 2012 11:54 AM
Joined: 12/15/2011
Posts: 2283


irob

Feel lucky that Mom did not need invasive surgery or have pnuemonia during your absence, and the aid followed your expectations by sitting on her hands.

 

I am going to need a Care Person forthcoming. Give me your aid's phone number.


lrob
Posted: Sunday, January 15, 2012 12:52 PM
Joined: 1/14/2012
Posts: 5


I appreciate the positive view points.  I know that the aid only had Mom's best interests at heart.  She is only 27, and  leans towards the "panic" mode with health issues, as I've noticed with her two young children as well.  She truly loves Mom and no evil intent towards Mom was present.

 

The diagnosis was psoriasis, which I already knew.  But, I also know that the aid felt that I was not as concerned as she would have liked, and that I was not addressing the rash in the way which she thought was correct.  Please know that I am a loving daughter, and would never jeapordize my mother's health.  We're talking about a rash, not a heart attack.   Anyhow, I'm doing what I swore I would not do.....succomb to feeling that I need to justify my actions (or in-action). 

 

The aid took Mom to the dermatologist Friday afternoon.  I arrived home at Noon the next day.  My itinerary was known to all.  She basically waited until I was out of town, and did what she wanted to do all along.  This is what concerns me the most.  But we will work through it...........honestly, this is the least of the issues that I have had to contend with since my Mom was diagnosed with this horrible, horrible disease.  I'm sure you all can relate.


Zolly
Posted: Sunday, January 15, 2012 5:58 PM
Joined: 12/15/2011
Posts: 2283


irob

I do understand your concrrn. However, in the world of management one has to delegate authority to the person closest to the topic to be handled.

 

In my case I have given full authorty to the Staff at my wife's Care Home to handle meds, visitors, allowing wife out of or retianing her withing the Dementia Unit, and any trips to the Hospital. No need to call me. Staff is on scene and can best judge, and are the only judge on site to handle what is observed as real or boderline issues. Appriase me after the act has been completed.

 

This is normal delegation of authority.

 

irod, your quote:

"The aid took Mom to the dermatologist Friday afternoon.  I arrived home at Noon the next day.  My itinerary was known to all.  She basically waited until I was out of town, and did what she wanted to do all along."

 

If that be the case then fire the aid who took advantage of your absence. Send her to my wife's Care Home. ~~~ This is one of the glaring complaints of Next of Kin Caregivers. Care Homes that do not act on issues that arise.

 

I would rather pay for an ambulance, an ER fee, and a return ambulance rather than allow any suspect symptoms of my wife to surface without absolute action on the overseeing aid or employee Caregiver.


jfkoc
Posted: Sunday, January 15, 2012 6:23 PM
Joined: 12/4/2011
Posts: 17569


Wow...the further explanation makes me very nervous.  She can NOT go behind your back. PERIOD.
jfkoc
Posted: Sunday, January 15, 2012 6:23 PM
Joined: 12/4/2011
Posts: 17569


Is she paying for the appt??? LOL
Stephanie Z
Posted: Sunday, January 15, 2012 6:31 PM
Joined: 12/15/2011
Posts: 4219


I agree that the aide absolutely had no business doing what she did. In an emergency she should call 911. Anything less, she calls you. She could lose her license for doing what she did, good intentions or not. I'm also concerned about the physician's office taking her as a patient with only her nursing assistant and no family member there. Not good medicine and may also be illegal. Also, did your mom have her medicare card with her? Who paid for this?

I'd either get rid of the aide or watch her very carefully if you decide to keep her. This is definitely something she should not have done especially since she did it a day before you came home.

Just my opinion

Stephanie


JAB
Posted: Sunday, January 15, 2012 6:50 PM
Joined: 11/30/2011
Posts: 740


This is so wrong from so many standpoints, I hardly know where to begin.

You left information about what to do in the event of an emergency, where you were, how to contact you AND you left two responsible, knowledgable adults in charge while you were gone.  Neither your daughter nor the aid tried to contact you.  Neither of them consulted your sister or BIL.

Two-month-old psoriasis is not an emergency by anyone's standards, ESPECIALLY when we're just talking about waiting overnight.  And to go delving into your personal information to get your mom's personal information, to set up a new doctor and an appointment and make the decision to buy and start using a new medicine without your knowledge and approval or your sister's or BIL's ... oh, man, that is SO far over the top, I'm almost incoherent.  I mean, for one thing, I very much doubt the information included a sufficiently detailed medical history for the doctor to be sure exactly which treatments might be safe for your mom.

This shows the most appalling lack of judgment, even if you did not suspect that she deliberately waited until you were gone to act in direct defiance of your express wishes.

But if you believe she intentionally went around you, that's simply beyond the pale.  That does not come anywhere close to being "good intentions".  And it sounds as if your daughter may have actively conspired with her to flout your wishes.

What on earth do you think she'll do if there actually is some sort of crisis when she's taking care of your mom?  Do you really think she'll be able to handle it?

I'm sorry, but 27 is not that young.  If she'd been 15, then maybe I could see it.  Maybe.

 

Frankly, it sounds as if the aid needs a babysitter.

 

Heck, even your mom knew enough to be upset with the aid.

Even with what you've said about her ... taking advantage of your absence like this, with such a flimsy excuse, I, too, would wonder whether you or your mom are being set up for identity theft.  And I would take steps to protect her and yourself.  Better safe than sorry.

And, quite frankly, with such an enormous lack of judgment on your daughter's part, are you sure you want to trust her working in a law firm and having access to all the firm's clients' information?  In this case, she may have jeopardized your financial situation and your mom's financial situation and/or health.  Next time, it might be a client who would sue you for your socks.


JAB
Posted: Sunday, January 15, 2012 8:03 PM
Joined: 11/30/2011
Posts: 740


The more I think about this, the less sense it makes.

 

In my experience, one does not get in to see a dermatologist overnight.  It can take weeks to get an appointment, especially if it's a new patient.

 

So I wonder when, exactly, the aide began planning this little escapade. 

 

 And just exactly how qualified the doctor was who saw your mom and gave her the prescription.

 

And what other information your daughter provided to the aide.  She would have to have information about insurance to set up a new patient account.  Yes, she could use the SSN to guess what her Medicare number would be -- provided she knew for sure your mom even has Medicare -- but how did she know whether your mom is also covered by secondary insurance?

 

And who, exactly, signed the forms accepting financial responsibility for the bills?

 

And ... how did the aide explain her involvement to the doctor?  Did she tell him about your mom's cognitive problems?  Did she claim to be a family member?


Elizabeth
Posted: Sunday, January 15, 2012 8:16 PM
Joined: 12/31/2011
Posts: 9


Irob,

 

To me, what your daughter and her friend did is absolutely horrific.  In my opinion, you should immediately fire the aide.  It doesn't matter how good she is with your Mom, what she did has so many repercussions that even a 27y/o would definitely know better.  This is going to be hard to hear, but if your daughter has access to confidential/critical files at the law office, I would notify your supervisor of her poor lack of judgement.  This will cover YOU incase there are any acts on the part of your daughter that could hurt you (assuming that since you are working, that you need your job).  If your daughter truly doesn't understand that what she did was wrong, even after your conversation with her, I am very frighten for her and her future.  You have your hands full taking care of your Mom, you don't need/want that kind of 'help'.  My thoughts are with you.

 

Elizabeth


Cricket
Posted: Monday, January 16, 2012 6:57 AM
Joined: 1/12/2012
Posts: 8


mygma1918 wrote:
The fact that you left for 4 days without leaving all this information with the aid is beyond me. I'm sorry but anyone who has an aid needs to give all personal information ins etc in case something like this happens.
I think the last thing ANY of us need is additional criticism to add to our stress. This comment seems uncalled for and counter productive.

TiredCindy
Posted: Monday, January 16, 2012 7:16 AM
Joined: 12/21/2011
Posts: 70


Whatever the aide's intent was, she overstepped her boundaries.  She should not have underminded your caregiver authority for a rash.  That was uncalled for as was your daughter giving out personal information.  Regardless of how trustworthy the aide.  Maybe the aide is a friend but she is being paid to care for your mom.
hercules
Posted: Monday, January 16, 2012 8:01 AM
Joined: 12/19/2011
Posts: 146


I would have to agree with most here that some overstepping occurred.  I would mention, however,  that you should really contact the doctor where mom was  taken and ask pertinent questions.  I also agree with notifing the credit bueraus with a flag for no new accounts and the banks, call(go see) with possible identity theft. 

We live in a dangerous world anymore.  Ya just never know who is capable of what.