Nurses aren't maids!

AnaCatRN · May 17, 2011

It's unfortunately a game parents will play - and I can assure you there are many posts here detailing families wanting the nurse to clean the bathrooms, do the family dishes, and/or babysit for the other siblings.
Many of them have the belief that since it's 1:1 care you have a "cushy" job and if there are HH aides in the house who do housework they will compare you to them and what hard workers they are while "nurses just sit around". They have no grasp at all what critical thinking or assessment skills are.
Even with a family I got along wonderfully with for years - muttered something under his breath about nurses, and I said to myself "no more". I'm a human being, too - and when I can't afford the insurance I pay taxes so you can get for free. No. Not happening anymore. I felt myself getting very close to the edge of losing it with them.
However, I don't feel this falls in line with the "customer service" trend exactly, but what happens is sometimes the agencies side with the families if the families threaten to change agencies. My agencies did not have that type of dysfunction going on, but it is not all that unusual from what I can tell.
I wash the dishes I use for the patient's meals, the DME and associated tubings and supplies, restock suction catheters or other medical supplies the patient uses, and sometimes put a stained sheet to soak but that was as a favor for the daytime caregiver and not something I felt obligated to do.
I certainly have felt the same frustration! Hope it works out for you. :)

I've been asked to babysit by 2 families (because the other nurses do it), but I didn't do it. See that's the problem. If we don't get the office to step in and say "this is not acceptable," the pushover nurses (and I'm almost one of them - but not there yet!) and the families will just have a free for all over what new tasks can be added. I've also had parents comment on how little we actually do on the night shift. You know what, I don't make nearly as much as I would in a hospital. I only have one patient (which is why I do this, so I can focus on one patient and give the absolute best care possible), and when I'm not doing what I need to for that patient, I'm gonna study or watch a movie on my computer (always ready to jump up and tend to the patient). That's my reward for not getting a break at all during my 12 to 14 hour shift and having such low pay and NO benefits. Last time *I* got sick, I racked up $20,000 in hospital bills I can't pay and couldn't get a nurse to help me with my wound that I had a hell of a time tending to myself. Yeah, you're so right. It's not fair that we work so hard, have no benefits, and get treated like crap. I stay because I love my patients like my own family. However, I don't do my family's laundry, either.

kids · May 17, 2011

In a former "life" I was the clinical coordinator for a branch of a "nation wide pediatric agency" that shall remain nameless.

If the child is medicaid their service plan very likely includes doing the child's laundry, washing their dishes, preparing the meals, cleaning the child space and equipment, etc as part of the nurse's duties in the home as time permits. If it is included in the service plan it is the agency's contract with the state and you have to provide the service.

I've also seen private insurance contracts that also list those tasks, again, as time permits.

Medicaid (and many private insurance) know that very often the 'nursing care' being provided over night consists primarily of monitoring the child and intervening as needed.

Check the child's care plan and 485, what does it say about meeting the child's environmental needs?

Private duty Peds nursing isn't just about the patient, it's about providing support to the family too.

AnaCatRN · May 17, 2011

In a former "life" I was the clinical coordinator for a branch of a "nation wide pediatric agency" that shall remain nameless.
If the child is medicaid their service plan very likely includes doing the child's laundry, washing their dishes, preparing the meals, cleaning the child space and equipment, etc as part of the nurse's duties in the home as time permits. If it is included in the service plan it is the agency's contract with the state and you have to provide the service.
I've also seen private insurance contracts that also list those tasks, again, as time permits.
Medicaid (and many private insurance) know that very often the 'nursing care' being provided over night consists primarily of monitoring the child and intervening as needed.
Check the child's care plan and 485, what does it say about meeting the child's environmental needs?
Private duty Peds nursing isn't just about the patient, it's about providing support to the family too.

Nope - the care plan says nothing about housekeeping chores. My supporting the family means (to me) that mom and dad can sleep at night so they can work and do chores during the day. If the plan includes this, they should provide a home health aide to do this. I'm sure an agency home health PT, SW, or OT isn't expected to do housework. No where in my state's nurse practice act does it say that nurses do housework. Someone at the corporate level at my agency said our agency does not do this and I should report the office to corporate HQ if asked to do housework (so, if I hear in the morning that the agency told mom I would do laundry, I will be reporting it to corporate). I don't think in my state they would waste precious nursing money for maid services. If Medicaid pays for that for *anyone* under 18 (because honestly, anyone under 18 should have at least one parent who should not be so damned lazy), I will stop paying taxes! No one deserves free servants! Where's my government-supplied maid?!

Seriously, I will leave nursing forever if this is what it's coming to. I'm a college educated professional! I'm a little ticked off that people think that night nurses should do all the junk no one else wants to or "should" do. Day private duty nurses don't really do much more than we do. That's a weak excuse to use college educated professionals as indentured servants. No one would go into nursing at all if it really involved being a freaking maid (unless they're stupid - who pays tens of thousands of dollars for college to do someone's laundry on the tax payers' dime for so little pay?)!

allnurses Guide · May 17, 2011

Maybe it's a state by state thing then as far as it's delegated or contracted with the families, but (and I have only two agencies to speak of through experience) the client had to sign an agreement to be placed in the front section of the home chart stating in specifics what we can't do.

We are supposed to evaluate the environment for safety hazards (both tio the patient and the nurse) and make sure there was a safe exit for the patient in the event of an emergency (fire, earthquake, etc).

Here in California the state (Medi-Cal, our name for Medi-Caid) itself will train caregivers of the patient's choosing provided they pass a (not very strict) background check and have a valid social security card. They pay them a little bit more than minimum wage ($8-9) here. Here they have separated the monthly allotments to these patients all along into "skilled nursing" (RN/LVN) hours and HHA hours. The 485 will have a specific number for hours for both that can't be exceeded, or category switched.

As we've hit the wall here in our state budgets they are trying to save money by whittling down the patient's skilled nursing hours to the bare bones, hence even private duty nursing jobs are drying up when we used to have staffers literally driving a 60 mile round trip to take a nurse to a case.

Our 485s never addressed the subject of housework at all.

PS AnaCat - if I ever have occasion to need an extra support person to get my point across -- I will come to your house and get you!! :up:

AnaCatRN · May 17, 2011

Maybe it's a state by state thing then as far as it's delegated or contracted with the families, but (and I have only two agencies to speak of through experience) the client had to sign an agreement to be placed in the front section of the home chart stating in specifics what we can't do.
We are supposed to evaluate the environment for safety hazards (both tio the patient and the nurse) and make sure there was a safe exit for the patient in the event of an emergency (fire, earthquake, etc).
Here in California the state (Medi-Cal, our name for Medi-Caid) itself will train caregivers of the patient's choosing provided they pass a (not very strict) background check and have a valid social security card. They pay them a little bit more than minimum wage ($8-9) here. Here they have separated the monthly allotments to these patients all along into "skilled nursing" (RN/LVN) hours and HHA hours. The 485 will have a specific number for hours for both that can't be exceeded, or category switched.
As we've hit the wall here in our state budgets they are trying to save money by whittling down the patient's skilled nursing hours to the bare bones, hence even private duty nursing jobs are drying up when we used to have staffers literally driving a 60 mile round trip to take a nurse to a case.
Our 485s never addressed the subject of housework at all.
PS AnaCat - if I ever have occasion to need an extra support person to get my point across -- I will come to your house and get you!!

We have to evaluate the environment, too, but the agreement signed by the parents states that it is the parents' responsibility to clear any obstacles (so they have to clean the mess blocking the exit) or the nurse can leave and they can be reported to the state and lose their hours. We don't have anything called a 485 that I know of. Just an agreement with the parents and the agency that clearly states that a professional nurse's role must be respected. That to me means no maid service. Our state has a huge backlog of patients who need nursing and little to no funds, but they are still paying for currently open cases, so our agency needs nurses big time, but they won't keep any nurses if they ask us to do housework. That won't fly around here.

We should band together, nursel56!

ventmommy · May 17, 2011

I agree that nurses aren't maids. We have nursing - 16 hours per day (12 from private ins., 4 from Medicaid). The agency we use DOES state that nurses are responsible for all dishes, cooking utensils, laundry, towels and garbage that they use for my child or themselves.

I do not permit our nurses to wash bottles or syringes. I also do not allow them to wash any drinking glasses that they have used. Our kitchen is too far from my son's room. I wash everything when our day nurse gets to work. I also make all the formula for the day.

I do my son's laundry. One of our awesome night nurses will peek in the washer or dryer. If his clothes are in the dryer, she will grab it and fold it and put it away. If they are in the washer, she will transfer them to the dryer and then take care of them. I never asked her to do this but she knows how much I appreciate it! I do ask ALL the nurses that if my son's clothing or bedding becomes soiled that they put it in the washer and soak it. She is also the wonderful nurse that every few weeks stays over her shift a couple of hours on a Saturday or Sunday morning so we can sleep in!

The nurses wash the suction canister when I wake up (night nurse) or just before they leave (day nurse). I try to empty it when the night nurse arrives so she doesn't have to deal with it.

Nurses take out the garbage from my son's room when they leave for the day.

You asked how parents get away with demanding nurses to provide housekeeping - it's sad but here is why: insurance pays a lot of money to your agency. Your agency pays you a little of that and sends you to the house. If you don't do what the parents want, they tell the agency not to send you back because you were "uncooperative" or "lazy" or "disrespectful" or whatever. They tell the agency that they need the nurse to do ABC, WYZ and only send nurses that will. The agency will do what the parents want because they make good money! I don't agree with it but I have been doing this for long enough to have met some really lousy parents and I really sympathize with some of their nurses.

As far as what to expect, our agency has a very detailed information sheet with stuff about our house so that all nurses are prepared BEFORE they consider working with us (for ex. we have cats, we keep our house temperature at 67, we have religious considerations so nurses can't bring in certain food items, food allergies so they don't bring nuts, that they must use a baby monitor if they leave my son's room for any reason, etc.).

Our day nurses do a LOT more hands on care as they do PT/OT exercises, transfer him in and out of his wheelchair/bed, get him ready for appointments and go with us to the appointments, do multiple nebulizer treatments and chest physiotherapy multiple times. They help me bathe him (daily) and they help me change his trach tube (weekly) and vent circuits (weekly). One of them will usually help me check in supplies when our 180 pounds of supplies arrive each month! Our night nurses do all the "maintenance" things - change and wash filters on the vents every other day, change suction canisters and tubing twice per week, wipe down equipment, change nebulizer sets weekly, change the feeding pump bag daily. All of the nurses are obviously responsible for diaper changes, never-ending suctioning, an incredibly complex medication schedule plus PRN meds/neb treatments, position changes, etc.

As a parent, I can tell you that even with 16 hours of nursing, I am EXHAUSTED all the time. Once our night nurse gets here, it takes me a bit to give her report and get myself ready for bed. Then I need to be up a bit before she leaves so I can take care of other kids, cats, myself so I never really get much more than 6 or 6.5 hours per night. Sometimes a lot less when I hear pulse ox or vent alarms going off a lot. Sometimes none when the nurse doesn't call out until five minutes before her shift and the agency can't find anyone to cover. Our son is adopted and I wouldn't change a thing and I don't regret for a second our decision to take him. The life he has had with us is infinitely more rewarding than the first year of life he spent in a hospital with no visitors but a SW.

To the OP, I hope you find a great family to work with! To ALL the nurses, thank you for everything you do to make the lives of your patients and families better.

allnurses Guide · May 17, 2011

Bless you, ventmommy. :redpinkhe I really only have a partial understanding of the relentless stress that comes with your situation. I'm sure it must be difficult to explain - as most stresses, no matter how horrific they may be, have an endpoint, the thought of (even if it's death) will keep you motivated to hang in there, or that your pain will end.

I always tried to remember that for us, we go home at the end of our shift, and for the families, there is no "go home".

It sounds like your family is exactly the family most of us wished we worked with every day.

But I aint washing your husband's skivvies!! :) ( I bit of jest, of course.)

AnaCatRN · May 17, 2011

I agree that nurses aren't maids. We have nursing - 16 hours per day (12 from private ins., 4 from Medicaid). The agency we use DOES state that nurses are responsible for all dishes, cooking utensils, laundry, towels and garbage that they use for my child or themselves.
I do not permit our nurses to wash bottles or syringes. I also do not allow them to wash any drinking glasses that they have used. Our kitchen is too far from my son's room. I wash everything when our day nurse gets to work. I also make all the formula for the day.
I do my son's laundry. One of our awesome night nurses will peek in the washer or dryer. If his clothes are in the dryer, she will grab it and fold it and put it away. If they are in the washer, she will transfer them to the dryer and then take care of them. I never asked her to do this but she knows how much I appreciate it! I do ask ALL the nurses that if my son's clothing or bedding becomes soiled that they put it in the washer and soak it. She is also the wonderful nurse that every few weeks stays over her shift a couple of hours on a Saturday or Sunday morning so we can sleep in!
The nurses wash the suction canister when I wake up (night nurse) or just before they leave (day nurse). I try to empty it when the night nurse arrives so she doesn't have to deal with it.
Nurses take out the garbage from my son's room when they leave for the day.
You asked how parents get away with demanding nurses to provide housekeeping - it's sad but here is why: insurance pays a lot of money to your agency. Your agency pays you a little of that and sends you to the house. If you don't do what the parents want, they tell the agency not to send you back because you were "uncooperative" or "lazy" or "disrespectful" or whatever. They tell the agency that they need the nurse to do ABC, WYZ and only send nurses that will. The agency will do what the parents want because they make good money! I don't agree with it but I have been doing this for long enough to have met some really lousy parents and I really sympathize with some of their nurses.
As far as what to expect, our agency has a very detailed information sheet with stuff about our house so that all nurses are prepared BEFORE they consider working with us (for ex. we have cats, we keep our house temperature at 67, we have religious considerations so nurses can't bring in certain food items, food allergies so they don't bring nuts, that they must use a baby monitor if they leave my son's room for any reason, etc.).
Our day nurses do a LOT more hands on care as they do PT/OT exercises, transfer him in and out of his wheelchair/bed, get him ready for appointments and go with us to the appointments, do multiple nebulizer treatments and chest physiotherapy multiple times. They help me bathe him (daily) and they help me change his trach tube (weekly) and vent circuits (weekly). One of them will usually help me check in supplies when our 180 pounds of supplies arrive each month! Our night nurses do all the "maintenance" things - change and wash filters on the vents every other day, change suction canisters and tubing twice per week, wipe down equipment, change nebulizer sets weekly, change the feeding pump bag daily. All of the nurses are obviously responsible for diaper changes, never-ending suctioning, an incredibly complex medication schedule plus PRN meds/neb treatments, position changes, etc.
As a parent, I can tell you that even with 16 hours of nursing, I am EXHAUSTED all the time. Once our night nurse gets here, it takes me a bit to give her report and get myself ready for bed. Then I need to be up a bit before she leaves so I can take care of other kids, cats, myself so I never really get much more than 6 or 6.5 hours per night. Sometimes a lot less when I hear pulse ox or vent alarms going off a lot. Sometimes none when the nurse doesn't call out until five minutes before her shift and the agency can't find anyone to cover. Our son is adopted and I wouldn't change a thing and I don't regret for a second our decision to take him. The life he has had with us is infinitely more rewarding than the first year of life he spent in a hospital with no visitors but a SW.
To the OP, I hope you find a great family to work with! To ALL the nurses, thank you for everything you do to make the lives of your patients and families better.

***I became a nurse to help heal people, and that is all I care about - healing people. I do NOT give a rat's behind if anyone thinks I give good customer service. I do NOT strive for 5! I DO strive to keep your butt alive. Nothing else matters to me. Dr. Gregory House is my hero (even if he is a rude jerk to nurses).***

I want to believe you weren't flaming me, and that you meant what you said about not agreeing with the nurses as maids idea, but you didn't really convince me after you listed all of your demands (yeah, this ignorant woman thinks she has the right to demand that I become a freaking vegetarian four times a week, that I wear special indoor shoes in her house, and that I wear a specific outfit). You do see nurses as servants who deserve no respect and are lucky to have jobs. That's so wrong. Patients and their parents may be "clients" or "customers" to the agencies, but they are PATIENTS to the nurses. You don't tell us what to do. No one tells us what to do. If you could tell me what to do, I wouldn't need malpractice insurance. I make my own decisions.

First of all, I have had wonderful families that I would go to the ends of the Earth to help, and I have done special things for them, because they appreciated me and didn't expect it. This was the first night with this family and she talked to me like you would a new maid on her first shift. My agency DOES NOT have a policy allowing (let alone forcing) nurses to do housework, yet this mother started the conversation by saying "This is the laundry room. When you do her laundry..." NO, MA'AM! She has not yet impressed me with how much she cares about her child and appreciates the help she ignorantly complained the state took too long in giving her (especially since she and her husband are well-paid healthcare professionals themselves who obviously think very little of nurses). I do nothing special for anyone who expects/demands it, and certainly never before they EARN it! Being rude and condescending to me on my first shift will not make me care how tired this woman is after partying with her friends all night while her husband oriented me to the case and I took care of her kid (yep, she came in after 11pm so she could talk down to me). Furthermore, this child does not really need a nurse at all in my opinion (there seems to be a lot of that going around at my agency), and I'm angry that Medicaid is paying for this case just so the parents can get out of parenting (because like I said, the parents are AFFLUENT). The parents are affluent, and the kid doesn't need a nurse all night. I'm not cleaning jack crap! Everyone is making money but me, and I'm not gonna bend over and take it like that!

You might actually deserve the special care your nurses give (and if you do, then I would probably bend over backwards to help you around the house, too), but unfortunately, you also use an agency that should be destroyed for abusing and exploiting nurses to satisfy their greed. Who knows? Maybe you live in a backwards state that still thinks women are their husbands' property, too. Something is wrong where you live! NO ONE, no matter how sick their kid is, deserves to expect or demand free housekeeping services paid for by tax payers. Maybe we abused nurses should expose this crap to the media and see how long that garbage keeps going on. Why is it that people on welfare (sorry, that includes Medicaid and disability because very few people actually deserve it, most are scam artists) get to live better than people who work their butts off with no benefits and sub-par pay, AND apparently get to tell others what to do? When the tax payers are footing the bill, you don't get to demand ANYTHING! How dare someone getting assistance paid for with MY TAXES judge me and what I will or will not be expected to do (especially when that is DEGRADING to anyone with my education and experience)?

Are you seriously implying that I'm lazy because I won't do a high school drop-out's job? Because if you are, HOW DARE YOU?! I graduated from college! I have a BSN. Does anyone even know what nurses really do since the 1950s ended?! It has NOTHING to do with cleaning or being subservient to ANYONE! I don't do chores. I will clean the heck out of any medical equipment - no problem! I have NO problem washing bottles, syringes, suction canisters, trachs, any equipment the kid has, because that's something you need training for to avoid contamination. I will happily empty the trash in the child's room at the end of the shift and as needed. I'm a night nurse (who is really sick of people thinking day nurses work harder than we do - you freaking stay up all night and have no backup or any breaks at all - see how long you survive that with a smile and a chipper can-do attitude), and I don't use anything in the patients' homes. I bring my own sandwich and soda, and I take my garbage home with me (if I find time to eat; many mornings that sandwich goes right back home with me, because something ALWAYS happens to screw me right out of any kind of a break). Do you work 12 to 14 hour shifts with no break, sometimes even to go to the bathroom, always having to triple check everything you do to avoid killing the patient or losing your hard-earned license? Of course not, because as a nurse, I'm just a servant and you're better than me. I never use the parents' plates, cups, or utensils. I don't make a mess, but if I did, I would clean up my mess.

The day nurses you have are nicer than the ones I've worked with. The ones I work with like to make sure that ALL maintenance things, stocking, cleaning, changing, etc. is left for the night nurses. Who has time to keep the kid from dying, do all the busy work no one else wants to do, and do laundry/clean the house? Keep the kid from dying, you say? Why yes, that is why we're there. Nothing else matters but keeping the kid from dying! NOTHING!

No one would ever ask a physician to do their kid's laundry! Why, oh WHY do people think that nurses are some low life servants who will do demeaning and degrading things? We are physicians' PEERS! I was educated to heal and save people, use nursing judgement - not clean! That parents are rude enough to expect that is ridiculous!

My mother is sick and bed ridden, but I manage to work and take care of her, and no one supplies me with a nurse to help nor a maid to clean up after her for me (and I would kill for that). She has been to the point where she wanders around filthy and naked, and doesn't know who I am. I'm single, and I can't afford to hire a nurse or put her in a home. I get paid crap to be degraded - I've been sexually assaulted and treated like I'm less than human. No benefits. You expect me to feel sorry for the agency for having to suck up to obnoxious parents who are bilking tax payers, just so they can make their money while screwing the nurses over? Not gonna happen! Do people really still think that nurses are servants and prostitutes? Come on! Who the hell do these parents think they are, and how DARE they think people should feel sorry for them or agree that they deserve to demand that someone else take care of THEIR parental responsibilities?! What idiot decided that family centered care means the parents can shirk all of their responsibilities and treat highly educated healthcare professionals like servants? NURSING IS A PROFESSION, NOT A TRADE! When you drop your laundry off at your doctor's office, or your accountant's office, and they don't throw you out on your butt for thinking they should personally do your laundry for you, come back and tell me how lazy and disrespectful I am. I am NOT subservient to my patient's parents. I don't OWE them respect or have to do ANYTHING they say!

ventmommy · May 17, 2011

I am not sure what demands you are referring to and I certainly didn't flame you. My only requests as far as housekeeping goes are: put soiled bedding/clothes (on the rare occasion it happens) into the washer; take out the trash on your way out because I can't leave my son in the house alone to take it out; clean suction canister every shift and wipe down his equipment.

I have worked 10-, 14- and 24-hour shifts as a LICENSED paramedic. I know what it is like to have to pee for many hours with no relief in site.

I didn't call you lazy at all. If you read my post carefully, I merely explain what other parents do to make sure that the agency only sends nurses that will comply with all the parent requests however demeaning.

There are LOTS of parents that require indoor shoes of nurses and their own family. Kids with trachs are susceptible to germs. Many SN kids can play on the floor. Think about where your shoes have been (tramping through dirt, grass peed on by dogs, in medical facilities) and when you think about a sick kid playing where you have just walked with dirty shoes, why would you object to the parent's request? Our house is a no-outdoor-shoes house. Nurses can bring clean Crocs or slippers or go in socks. We use Crocs or slippers. When our DME, PT, OT, SWs come, they leave their shoes at the door.

I don't know what kind of outfit she wants you to wear but many of our nurses are in RN or BSN school, doing clinicals or work a second job. I require clean scrubs. Until you see YOUR OWN CHILD on nitric and a HFOV because they have some rare strain of pneumonia, you might not understand how important this is.

As far as being vegetarian, we are vegan. We don't allow pork/shellfish/nuts in our house for any reason. We do allow nurses to bring meat but they must bring their own utensils and drinking glasses. If they have something that is vegan, they can use our stuff. Some of them bring veggie or vegan, some don't. I'm not going to force my moral choice on you. I will enforce my Kosher standards however as it is my house. The nurses have their own non-Kosher microwave for their use.

I do all my own orientations and have sat with countless nurses that are fresh out of school and need a ton of hand-holding. When there is a poop emergency at 2am, I get up and help the nurse clean it up. When there is a respiratory emergency, I respond.

I work from home. If I am free to do whatever my son needs at the time, I will go in his room and do it or help the nurse do it.

My son most definitely needs skilled care. If I could clone myself or stay awake forever, then I wouldn't need it. But I have a child that turns blue at the drop of a hat, has uncontrolled seizures and requires suctioning multiple times an hour. He usually require manual ventilation several times a day. Are there parents that somehow finagle skilled nursing for a kid with a simple g-tube, no meds and no real issues? Yes. Do I think it's wrong? Yes.

Yes, there are crappy parents. Really crappy parents. That pay no attention to their child. We are not those parents and the vast majority of the parents I know are not crappy parents.

Home health nursing is NOT like hospital nursing (I worked in an ICU for a few years so I am not completely ignorant). There is a fine line and a lot of customer service required. A parent can ask a nurse to never come back for ANY reason, not just for cause. I am not saying you need to totally kiss --- but respecting the rules of the family IS a big deal.

I am sorry you were assaulted on a home health case. Our favorite day nurse was raped in a previous case. I can't even imagine feeling that unsafe in a workplace.

No one knows the child better than the parents and even a highly experienced nurse needs to learn the nuances of the child.

Home Health Columnist / Guide · May 17, 2011

Private Duty Homecare is an entirely different sort of nursing care.

It is about caring for a totally dependent person AND their suroundings: preparing meals + feeding them if not tube fed, helping with ALL ADL activities, PT/OT exercises, maintaining organized bedroom environment re medical supplies. Changing the bed linens/clothes when soiled and doing their personal wash, provoding emotional and social stimulation, etc.

You are the RELIEF NURSE + CAREGIVER during the hours contracted by insurance company. It is about keeping a child AT HOME out of institutional environment. As such, routine caregiving tasks that are parent does, may become part of the job.

I've even helped trached almost blind 19yo wc bound client build crafts that he sold as part of his therapy to promote independece. Took him for WC walks around his block in the sunshine to enhance his life. Also taught him to make sandwiches + cut up fruit --smile was priceless.

caliotter3 · May 17, 2011

I do laundry for patients as long as everything that I am responsible for is done. Patient laundry only. I can easily fold laundry in the presence of the patient. This policy has been emphasized by my employing agencies.

systoly · May 17, 2011

I don't see where the problem is. If you don't like the case, don't take it.