Caring for a neighbor?

Long Term Care Columnist / Guide · Oct 17, 2019

Your nursing judgment is correct.

There are so many ways for this to go haywire. Who protects your license when you're giving care to someone who isn't "officially" your patient? How would you keep him safe if you're not there all the time? You said he's very high risk for falls, what if he gets up by himself and breaks a hip? It makes my head spin to think how fast the wife would sue you if something bad were to happen to him while in your care.

My advice? DON'T DO IT. You're welcome.

antesignani, ADN · Oct 17, 2019

3 minutes ago, VivaLasViejas said:
Your nursing judgment is correct.
There are so many ways for this to go haywire. Who protects your license when you're giving care to someone who isn't "officially" your patient? How would you keep him safe if you're not there all the time? You said he's very high risk for falls, what if he gets up by himself and breaks a hip? It makes my head spin to think how fast the wife would sue you if something bad were to happen to him while in your care.
My advice? DON'T DO IT. You're welcome.

Believe me, those are all questions i asked myself. I kind of feel bad for offering before i sat back and thought of the legal implications of this scenario. I think i just wanted to help because they're super nice, and friends of the family. I also beleaguered the fact that this man is about 6'4' and 300+. All signs just pointed to "nope", just needed to make sure i wasn't crazy.

JKL33 · Oct 17, 2019

No.

Why is she going out of town?

antesignani, ADN · Oct 17, 2019

9 minutes ago, JKL33 said:
No.
Why is she going out of town?

I didn't ask.

JKL33 · Oct 17, 2019

I asked because I personally would be slightly more compelled to help out (but not take on everything she is requesting) if there were some dire situation necessitating her travel. Because I do want to help others and I would consider that the actual liability isn't necessarily the same depending upon her relationship with you, and the reason she is leaving.

If she is a close personal friend of yours and has a dire emergency? More likely to be extremely grateful for any assistance rendered, come what may.

But if she has been planning to go on a trip and just now realized that she knows of a nurse and wouldn't that be perfect since he has a lot of health needs? -- More likely to expect that you will provide for them as she does if she simply rattles off everything you are to do.

I trust that there is no dire emergency if you haven't heard about it.

I have compassion for the fact that primary caregivers desperately need respite. But that simply can't involve fully planning and intending to leave and then looking around in hopes of making informal arrangements with volunteer professionals who can cover significant needs.

antesignani, ADN · Oct 17, 2019

That's an interesting perspective i really haven't thought of. No, as far as i know there is no emergent need for her to leave. She actually contacted me a week ago, and she's leaving on the 18th. I mean it's not like he's going to be alone. She does have grown kids that will help him out, of course. Sorry for leaving that out. She said she would just be more comfortable with somebody with medical knowledge around. I had originally offered to help out with minor things if they ever needed it, such as lift help, If i was around and her and her kids needed it. I honestly didn't think i'd be acting as a home health nurse for 5 days.

JKL33 · Oct 17, 2019

That's a difficult position to be in. Sometimes the things people are willing to just casually ask of others is quite impressive; of course you didn't know she was going to ask for all of those things when you said you don't mind helping out now and then--because most people don't respond by saying "Great! Here's a short list of 50 ways you can help." ???‍♀️

antesignani, ADN · Oct 17, 2019

1 hour ago, JKL33 said:
That's a difficult position to be in. Sometimes the things people are willing to just casually ask of others is quite impressive; of course you didn't know she was going to ask for all of those things when you said you don't mind helping out now and then--because most people don't respond by saying "Great! Here's a short list of 50 ways you can help." ???‍♀️

Right? thanks for the input everyone

CharleeFoxtrot, BSN, RN · Oct 17, 2019

I don't think it's something that would put your license in dire danger if you set some parameters for what they expect you to do. Life assist is one thing. Coming over to assess after a fall and suggest any course of action other than "go get it checked out" is quite another matter.

Something I'd suggest would be to help the wife get together:

1. a complete listing of his meds including allergies, set up a pill box or coordinate with the person giving him meds (if he cannot). Make sure patient doesn't need refills. Be sure to include PRNS.

2. a telephone list of his primary care providers and any and all specialists. See if patient's PCP and/or specialists offer after hours telephone help, if so make sure that information makes the list i.e. CALL DR P. CeeePee 24/7 for questions and concerns.

3. ICE contacts, family, etc.

4. Insurance info as needed.

heron, ASN, RN · Oct 17, 2019

I, too, have liability concerns. If you have your own malpractice insurance, I suggest connecting with them to ensure that your coverage extends to such an informal arrangement.

Meanwhile, especially if you don’t have malpractice coverage, I would have a serious come-to-Jesus with the family regarding your respective responsibilities, communication, night-time supervision, etc.

It feels wrong to be so defensive with a friend and neighbor, but if badness happens, a natural reaction in the heat of the moment is to find someone (else) to blame. Unfortunately, in many cases, the outsider comes to mind first. Then, tag - you’re it!

ruby_jane, BSN, RN · Oct 17, 2019

Our neighbors know I'm there for emergencies. Not total home care. Hang in there.