Awful PCA situation

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hey there, I have a situation:

first off, I'm 21, I've had one nursing class. I'm not certified in anything but CPR, I know basic sterile technique and could probably get a job as a CNA in some states, but not the one I'm in currently. I have no prior nursing experience and will probably be going into social work instead when I return to school.

I was invited to move to a new state by a friend I had talked to online for 6-7 months. we'll call her Sarah. this friend is a Live-In PCA for a 30 something year old man with physical and emotional disabilities. we'll call him Lee. He has a heart condition and compartment syndrome, as well as depression and OCD. Sarah has lived with Lee for a year, not paying rent, being paid $250 a week to clean, cook, and be his "life coach." Sarah has no prior caretaking experience and no training or certification of any kind, and had been living entirely on social security before. she is epileptic with a degenerative neuromuscular disorder, the acronym for which I can't recall. some of her worse seizures left her with brain damage. She has childhood abuse issues which I think are clouding her judgment (to put it mildly) and she considers herself to be "plural" (I'm not sure how distinct, if at all, this is from MPD) and will occasionally go on about children and spouses she has in her head.

for months before moving here I was told by Sarah she had to be a tough-love kind of caretaker to do what was right for Lee and to help him grow, but after living with them for the past month (officially working for both of them as a second PCA, doing the heavy-lifting things they couldn't) I'm thinking she may just be emotionally unstable and borderline abusive to him. when I told her he told me he was suicidal her response was a derisive "oh, he uses that." and she brushed it off. last week she became furious with me for going to Lee in the middle of a massive panic attack and walking him through deep breathing and meditation exercises, talking with him for half an hour, and getting him into bed. she thinks we should just ignore him when he's upset, referred to his weeping on the floor as "rage" and went on about how he "hurt her" by having his emotional breakdown, when he did nothing of the kind. the only raging I observed was her. she seems to be projecting emotional issues with past men in her life onto him.

when just ignoring him hasn't stopped what she calls his "rages" in the past, she's videotaped him and threatened to post it on youtube until he leaves her alone. occasionally when he's near her and she freaks out (abuse issues? just living with him for too long?) she'll just yell MOVE MOVE MOVE MOVE! and then lock herself in her room. when I was still a long-distance friend she had me convinced she had to be this assertive to "deal with him" and make him do things like get out of his chair and walk on crutches, and I was worried Lee would be very difficult to live with, but since getting here he's been nothing but pleasant and she's been kind of overbearing, emotional, and aggressive. after hearing the way she's characterized last week's episode to all her friends, I don't know if I can trust anything she's told me about Lee in the past. after making both of us cry and being the only one in the house to raise her voice, she told her friend on the phone "living with these men is like living with a pack of wolves." I'd almost prefer to think she's lying through her teeth than to accept she's so out of touch with reality as to actually perceive things this way. her mom left a voicemail today including "hope you're keepin those guys in check!" - yep, she doesn't even pay rent and has forbidden us to observe non-jewish holidays in this "jewish household." funny thing, of the three of us, only one is Jewish, Lee and I share another religion, Lee is the only one paying rent. obviously I'm not a neutral party at this point, but I really can't see us pushing her around by any stretch of the imagination.

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Lee has a contract with Sarah until March. she is on his lease so even if he were to fire her he'd have to live with her for months, which wouldn't really resolve anything. he has said he wants to fire her and hire me...admittedly I have more training than Sarah, but that's still practically none, and while I can clean and cook as well as she can and we're talking about working on more life skills (like teaching Lee to cook for himself and so on) I'm not capable of all the help he needs. I have serious concerns about two emotionally unstable people living together like this, with one supposedly caring for the other. they've managed for a year before I got here (I'm told 911 calls and "narcissistic" suicide threats were "normal" and I'm over-reacting to the situation) and everyone agrees Lee has grown while in Sarah's care...but I'm concerned and don't know what to do. I want to talk to Lee's therapist (he got one after last week's incident.) but I'm living paycheck to paycheck, have no institutional support whatsoever, and frankly would feel like an ******* getting my apparently insane and physically disabled friend Sarah fired and evicted, if that's even possible. Sarah paid for my ticket up here, moving to this area was one of the best decisions I ever made (****** work/living situation aside), and I feel like I owe her way more than that. when she's not freaking out and being irrational, she's an amazing woman and friend, and I really believe she thinks she's doing what's best for everyone. I struggle with this because while I'd like to see Sarah as in the wrong, she has brain damage and childhood abuse issues and really has just had a ****** life, and I'm worried not taking care of her as well (though she considers herself an independent professional...) is wrong of me.

after the blowout last week I'm now working exclusively for Lee, worried I'm taking advantage of him at $50 a week for just carrying groceries and cooking for him every now and then. I've been looking for a second job so I can pitch in with rent, but with 5 colleges in town most of the stuff I'm qualified for is taken. if I don't live here I'm either homeless or moving back in with parents 1000+ miles away...so I basically just have to make the best of this situation and try to do right by everyone involved. I put in a transfer application to the local University 6 months early (was going to wait for in state tuition, but I really want a new place to live) but I won't have alternative housing until January. Lee and Sarah both agree their "professional" relationship will dissolve in March, but I'm worried Lee will not be ready to be on his own by then, if he ever will be, and really need help finding him resources.

any advice at all would be appreciated.

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Adult protective services.

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Adult protective services.
how do I get them involved? what would happen? Lee needs help but I don't want somebody to institutionalize him unless he seriously has no other options. He's been happier since school started than he ever has been in his life, and a lot of that comes from the relative independence he's had lately. what would it mean for Sarah? this is selfish of me, but what would it mean for me?
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how do I get them involved?

Call them and read your Original Post to them.

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I think more with Adult protective services they would remove Sarah from the situation to allow Lee to have a better quality of life. From what you have said it sounds like a situation they would be able to assist in a solution.

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They will definitely want Sarah out of that home. She's not well and she doesn't even have the basic skills and knowledge to care for him. They might get a qualified person to move into the home or perhaps move him into a home with assisted living. You should get yourself into a HHA course ASAP. Let APS know you are in school to get yourself certified as a Home Health Aide and perhaps they will allow you to help care for him. If she moves out and you get some needed training it sounds like it would work for both you and Lee.

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Specializes in ICU, Telemetry.

It's not like the 60's where they just routinely put people in state hospitals. The folks I know who work at APS are all about helping, not hurting. And I think both Lee and Sarah need help. They can get the resources on board to help everyone involved.

But I'm also worried about you. I know at large schools, if you go talk to student services and tell them about your situation, they may be able to help with getting you a work/study program, or may just know someone in the community who can give you a place to stay if you need it, without you having to live with Sarah (who frankly sounds like she could just look at your wrong and start screaming "rape" and that could ruin any chance you would have at your local schools if that hit the paper; it could ruin your life).

Get help for Lee, but also keep you safe, too.

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I agree with all the posters who suggest you contact adult protective services, or whatever the equivalent is where you live. Welcome to Social Work 101, trial by fire!

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I think you need to protect yourself first, as suggested above. That would mean moving out, probably.

I guess you can find out from the local police or library or the 911 Operator (but that method will not be anonymous) how to reach someone to protect Lee.

$50 is not a lot of money these days. Don't feel guilty getting paid for what you were hired to do.

I think Sarah is in need of psychiatric care.

Best of luck to you in this nutty/scary/complex situation.

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APS has the resources and they will assign a caseworker. If he needs to go somewhere for at least a little supervision they can assist with that. At least it would be safer and more beneficial

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APS, then RUN RUN as fast as you can!!!

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thanks everyone. I've talked to Lee about the situation. tonight, Sarah made a joke about killing the cat that Lee has been saying for a while now is his only reason to live. She kind of alarmed both of us by her tone (which I think was largely in stone cold serious response to his Jovial "I'll kill you back") in this exchange and we talked about it via instant messenger so she couldn't overhear us.

Two days ago, after getting the flu and being bedridden and unable to eat for three days, I was asked by Sarah to run errands around the neighborhood and to "keep my blood moving" by doing chores like washing the dishes for the entire household. In the midst of this I decided I was moving out. called my parents for help, I feel like a bit of a failure, but I have a train ticket that will be purchased and used within the week. so much for the wonderful new state experience, but I guess I'll join Americorps and try another area of the country.

During our talk about Sarah, I told him I'm leaving, most likely on Saturday, and that I'm going to talk to professionals about this situation and see what they recommend. He knows a caseworker at his school and we're going to go see her/him and talk about this situation, as well as hopefully his therapist, to make sure he has a good handle on the situation and some support before I go. I wasn't sure if I was going to tell anyone or not (Sarah is probably not going to know I'm leaving until she wakes up and I'm already on the train) but I know this whole experience is going to be really hard for him. My parents are being adamant that I can't be responsible for this situation and just to get the hell out, but I'm glad I'll have the opportunity to talk to people with Lee before I go.

Lee also managed to find this thread by googling "abusive PCA" (and thank god was not upset and feels everything is anonymous enough, I was worried because I hadn't "filtered" it to be something Lee would read, but turns out the truth as I see it doesn't actually need a filter for him) and appreciates your advice to us in this tough situation.

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