What should i do? a question of ethics

  1. i have become aware of a difficult situation and would appreciate some feed back on the view of what i should do, if anything about the situation. its fairly long winded but i would appreciate any advice. (sorry about the spelling)

    The patient is a married women with physical disability of walking long distances due to an acident years ago.
    Her husband works long hours as finantually they are not well off.
    She needs carers three times aday to help with personal cares.
    A spacific carer started looking after her 1 year ago and they became good friends.
    The carer left her husband and moved in with her patient and her family and stoped caring for the patient on a perminant level, doing personal cares only when the agency could not get anyone else due to shortness of staff.
    The husband was grateful as being away at work he was concerned that his wife would get lonely.
    However it has come to my attention that the carer is sharing a bed with the patient nightly.
    The husband got suspisions and accused his wife of having an affare with the carer ( although he did later appologies he says he still feels something is wrong with the relationship between his wife and her carer). The patient says she could never forgive her husband for saying such a thing and is devorsing her husband.
    The husband is angry and feels the carer has abused trust. there is a 30 year age gap between the carer and patient and the husband is confused as to what to do if the carer leaves his wife to persue a relationship.
    The patient and carer deny a sexual relationship but they sleep nightly together in a single bed and the patient does not like to go anywhere without her carer.


    This is basically it and i dont know what to do, if anything.
    I dont think what has happened is right but i dont know where i stand in this situation.
    Please help
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  2. 15 Comments

  3. by   Tweety
    The relationship is definately inappropriate.

    Wondering what concern it is of yours? Do you work with the carer? Are you his supervisor?

    Otherwise, it just sounds like adult people making adult decisions and it's not your business.
  4. by   moongirl
    what are you asking? if this is right or wrong.. or what you should do about it?
    is it any of your business?
    just because I know the neighbor is having an affair- this effects me how? as long as its not with my husband, it is really not my concern.
    yes, it is wrong for a HCP to get involved with a pt, but it appears that this particular care provider has turned over duties to others in order to pursue the relationship with the pt....???
  5. by   Summershores
    the patient is my mother in law
  6. by   Tweety
    That's a tough question when it's your mother in law. Still it's their life.

    Is this care giver sleeping with her while being paid to take care of her? Then perhaps turning him in to the employer or whatever the equivalent of the state board is. But then again, is that your business? Should you open that potential can of worms, angering your mother in law and causing family strife?

    The question is: what is the best interests of your MIL? Is she being taken advantage of? Hurt?
  7. by   Summershores
    i just want to make sure that i dont have to report it to someone.

    i dont want to be accused of neglect of duty should this all go pear shaped. my mother is fairly old and the carer is young, and money is vanishing from her account. The family think shes giving it to the carer, but its her money so her business but i am conserned.
  8. by   moongirl
    why dont you call a family meeting and decide together what is to be done. Like Tweety says- you risk really upsetting your MIL. What does your husband think of this?
    If your MIL is set that this is what she wants, she has that right to make the decision, but maybe she cant see the forest for the tree. I hate the fact that this HCP is taking money from her.
    Maybe someone else will reply to this thread that knows more of the legal aspect of your question
    Best of luck to you,
    Moon
  9. by   Summershores
    Thank you all for you comments. I have spoken to the family and the only person not worried about this is my MIL. It's just that know one knows what to do.
  10. by   CritterLover
    [font="comic sans ms"]do they think this care giver is taking advantage of her? is she capable of making decisions? is some of the money disappearing her husband's money?

    i have seen several instances where caregivers in a ltc situation (nursing home, assisted living, home care) became emotionally involved with the patient and/or patient's family.

    it sounds as though the caregiver recognized this, and no longer acts as a caregiver, and is now more of a "friend."

    to me, how inappropriate the relationship is depends on the "friend's" motivation. this, of course, is difficult to determine. it does sound pretty fishy, though. is it really naive of me to say to keep an open mind until you know more about the situation? i would definatly be interested in where the money is going, but there could be legit expenses. since the family is not well-off financially, they wouldn't be the typical target of someone looking to swindle a family.
  11. by   Summershores
    its definatly not a "friend" relationship. there is a lot of dependance between the two and an extreamly strong emotional tie. My mother in law is leaving her husband and has broken of contact with her children in favour of her carer. The family were close and this carer appears to have systematilcally broken the relationships in the family with the mother in law.
    It might or might not be of conciquence but this is a female carer. and im not homophobic but this situation is seriously weird
  12. by   LPN_mn
    I do not agree that this is none of your business. Whether it is your MIL, your neighbor, and another client. What this care giver is doing is against the law in many states and yes you are required to report elder abuse in many states. It is similar to child abuse. Would you say that just because it is not your child being abused or mistreated that it is not your business or concern. That is ridiculous. Elder abuse is a crime and needs to be reported and that can be done anonymously to the ombudsman or department of human services in your area. If this person started out being a care giver it doesn't matter if she gave up you position with the person she is still responsible for her actions of abuse and neglect. She may not be physically harming the patient but she is certainly abusing her position and the trust that the family put in her as a care giver and trusted employee. This definately needs to be reported and immediately. You should be able to report anonymously and by the way in some states you can be held accountable if you knew of this type of abuse and neglect going on and you did not report it.
    Last edit by LPN_mn on Oct 28, '06 : Reason: wanted to add something
  13. by   NRSKarenRN
    Patient lives in ENglad so not aware of what laws/care support available there.

    This is a great ethical question and from your account emotional/psychological abuse by the caregiver has occurred due to the patient becoming so dependent on this caregiver that

    a. caregiver has moved into patients home
    b. caregiver and patient sleep nightly together in PATIENTS single bed.
    c. broken off contact with her children in favour of her caregiver
    d. caregiver is sporadically being paid by caregiver agency to perform personal care for client
    e. patient now divorcing spouse.
    f. patient and caregiver moving to new location further distancing patient from neighbors/loved ones

    This is not considered routine caregiving by any means in US. No caregiver should ever be sleeping in same single bed as client as unprofessional.

    I had a similar situation in which caregiver moved into a patients home and witnessed that patients care WAS NOT being provided during times aide was documenting being in the home to her agency: found patient lying in own dried feces, foley catheter bag filled to top and about to explode, complaining of hunger hadn't eaten, began to loose weight despite 17yo emancipated daughter(had infant)/POA + boyfriend and caregiver living in home. Patient was 32 years old and bedridden from MS; discussed with her suspicions of neglect which patient denied.. I reported caregiver to her agency (supervisor visited, found similar conditions) and was removed from case and fired from agency. Caregiver had become "best friends" of daughter and continued to live in the home. Reporting situation to outside agencies found that only those under age 21 and over age 65 had legal protection in US. Patient ultimately was placed in a nursing home due to lack of caregiver and totally dependent for all care.

    What can or should you do is the question now.

    a. If not previously done, I would call and report situation to Management at the agency that's employed caregiver and followup with written documentation so it can be placed on this caregivers file.

    b. If you get poor response, is this caregiver certified/licensed in your country? I'd file report with them.

    c. How far you go and press issue is dependent on what your father as patients spouse wants done. Is he willing to fight for spouse or let her go.

    d. You still care for MIL as a person who deserves NOT to be exploited.
    Letting go might be what he wants. What would happen if caregiver decides to leave patients home, would she be abandoned and unable to make contact with outside world? Only you and he can make the decision as to what's in MIL best interest vs totally being cut out of her life.


    What tough choices. Sending you a {{{{{{{HUG}}}}}}}}}}} and hoping that others might have some sage advice to offer.
    Last edit by NRSKarenRN on Oct 28, '06
  14. by   Summershores
    thank you Karen and LM. i guess i was just wanting someone to confirm to me that i would be right to step in and report this.
    It will make my MIL mad at me, but better me than anyone else in the family who is blood related and better that shes mad than hurt in some way.
    She is moving into a house with her carer and i dont like the way shes being moved from family and friends.
    I worry she will see noone but this carer for days at a time.

    If anyone knows about english procedures could they let me know?
    but if not, i now feel i can bring this to the attention of social services or someone, justifiably and not just as an over paronoid person (which i probably am).

    thank you

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