ethical delima help please

Maybe you can refer them to someone else.

Are you comfortable with sitting with her and do you want to sit with her?

If not as natania said refer them to someone you trust. I'm sure part of the reason they asked you is because they know and trust you and want someone who truly cares for their mother taking care of her.

If they insist on paying you, negotiate a lower wage and maybe put some of the money back into their mother. Bring treats and things she might enjoy in order to make your job a bit more fun.

I am in the same situation with my neighbor. If they pay me it brings up more legal issues than I want to deal with. I told her to get me a good Christmas present, and that I need to build up some good neighbor points in case I ever need to go to the hospital or something.

Discuss how you are feeling about all of this.
Sometimes it helps to go to the source and express your concerns about getting paid.
Bottom line is do you want to do this? If so go for it.
If not seek some one else to assist this woman.
I wish you well in what ever decision you choose.

The problem with a situation like this is that you have one foot in each camp (friend and professional). You need to get both feet firmly planted in one area and stick with what you decide.

I would suggest refering them to someone else (who would be paid) and being available (not for pay) as occasional back up.

If you accept pay (other than things like a plate of cookies or the like), you enter into a contractual relationship that involves, among other things, liability, confidentiality, and professional standards. Might not seem like a big deal with people you know and love, but what if something goes wrong? It's like a couple who decide not to get involved romantically because they don't want to lose the friendship if it doesn't work out.

Professional detachment is a good thing, designed to protect all involved. Sounds like that would not be at work in this situation.

The other possibility, that you would take this on as a friend and commit to a large amount of time doesn't seem practical either. It's one thing to sit now and then. But if this is an ongoing or increasing need, you could find yourself feeling trapped.

What you could do is offer to help them find suitable arrangements and vet job candidates. That way, you are offering your assistance but not taking on the job yourself. And, as I stated earlier, you could be an occasional back-up person. You can also monitor things periodically and make sure that proper care is being given.

If you don't want to enter into a "professional" relationship, tell your friends that you want to keep this woman as part of your extended family and don't want to turn her into a professional contact. You can also tell them that most medical professionals make that same choice. Yes, we might oversee the care, but most of us step back and let others provide it so that we can be free to see the person as a family member.

They are blessed to have you in their circle of friends.

I lived in a very affluent area for many years and did private duty nursing for several years. I'm talking about fabulously wealthy people, some highly public figures. I can tell you that some of these people had service staff (maids, drivers, personal staff) who had been with them for many, many years, were paid huge wages as a reward for their loyalty and service and were treated like family members although they were still the paid help. Not all wealthy people are wonderful in this way and treat their personal staff this way. Some, in fact, are real crumbs to work for.

I worked a private duty in-home case for one lady whose husband was constantly interfering with the patient's care. We had been with the patient from her hospitalization when she had thrown a blood clot into her leg and nursed her for three weeks while the leg developed gangrene and finally had to be amputated. The husband had initially refused to give the surgeons permission to amputate, so this poor woman went through weeks of the leg literally rotting away. He didn't want the nurses to do this or that. In the hospital he wasn't as much of a problem. But once the patient went home he turned into an ogre. He objected to the very basic procedures we were doing to position her new lower extremity stump to prevent it from developing a contracture. Consequently, he constantly requested that the agency replace the nurses they were sending. Most of us who had been with this woman through her acute hospitalization were gone within a week or two of her being transferred to her home. The only nurses who worked any length of time on the case were the ones who bent to his demands. Some years later when I was working at a nursing home, this same lady was admitted as a resident. I don't know why she came to be admitted, but by then, her stump was permanently fixed in a flexion contracture at the hip (when she was lying on her back it stuck straight up in the air). It looked horrible. She was miserable and constantly screaming with pain.

A cousin of mine was working as a caregiver for a young client who was a paraplegic. While taking him to a doctor's appointment, she was involved in a car accident. The client ended up suing her for the pain and injuries he sustained in the accident since her insurance did not cover all his injuries. It set her and her family back financially for years.

Now, I can give you quite a different scenario. My mother worked as a nurse and companion for the mother of a very, very famous entertainer. If I said this person's name you would recognize it immediately. The family was one of the nicest, kindest you would ever want to know. This was in contrast to many of the stories in the media about this person. They followed the doctor's orders and treated the nurses like the professionals they were. It was one of the loveliest and most memorable jobs my mom had and she was well paid for it.

One of my nieces has been working as a companion (combined housekeeper and caregiver) for the elderly father of her brother-in-law and taking a salary for it. What has been good about it, I think, is that the only family that gets involved is this brother-in-law and he is not at all demanding or picky about the way things are being done for the father. In fact, he's hardly ever around to see what is going on. However, I think that it could be quite different if the brother-in-law was constantly checking up on his father and demanding that things be done a certain way. It would be a very delicate situation indeed since when you are taking money for work, you have some kind of obligation to the people who pay you. When you are an independent caregiver in an in-home situation you do not have the backup of any administrators or facility policies to help you out if a family starts making demands on how they specifically want you to do things with "mom" or "dad" and as a trained caregiver you know what they are asking is against good nursing practice. That's a tough spot to be in.

Another reality here is that if these people go to a bonded agency, it will cost them an arm and leg. Most people are looking to save a few bucks. I wouldn't be surprised to find that these people, as nice as they may be, are thinking about saving a few benjamins. So, don't discount the fact. While they may be nice about it, they are, in some way, taking some advantage of your friendship and good nature here. Maybe using the phrase "calling in a few favors" might not apply, but do you get the idea I'm trying to convey?


You have a lot to think about. I would list the pros and cons. If you decide to do it and take payment then you are an employee. If one of those situations comes up where you are asked to do something you don't feel is in keeping with good nursing practice, how do you think you would handle it? And, how will it affect your friendship? If you decide to do this on a voluntary basis then what will happen if you decide you can't put in the hours they need? How will you feel if you have to pull out? How will it affect your friendship? What if you ultimately end up losing your friendship with these people over this? I think these are some of the issues you have to seriously consider. Only you know what these people are like. Even then, we never really truly know what people are like until we see how they act under stressful situations.

As some have said, either accept the money or don't. Tell them you will provide caregiver services (not sitting) at a discounted rate if you are not comfortable with what they are offering.