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I’ve always called Change in condition, but never thought to call APS. And now there is something they are going to investigate about the situation,
this guy is a tough one, as my boss had a hard time finding someone to cover if needed. I’m unable to provide my cleaning abilities as he gets upset, or embarrassed, I’m not sure which, but he never purchases cleaners I can use, but by god he has to have those cigarettes.
I never reported shortage of food, because the neighbor goes weekly to get food, as he’s known this guy forever. I’ve tried to get him to come with me to some of the local community places to get help, he refuses. His water heater went out, I called change in condition, as I’m to do, let my boss know , never even thought to call APS, if I though I was supposed to I would have. I would of done it.
I need to know how do I protect myself, other than the word of the neighbor, if my client doesn’t allow me to clean, and care for him?
I told my boss about his situation years ago, but she didn’t seem concerned as long as he is in a safe environment.

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Mousequeen, has your employer actually seen the inside of the house? If not, take pictures and show her/him. This way they cannot deny knowing what is going on. Especially take pics of the conditions that cause you the most concern for your own safety. There must be some rules that outline working conditions for caregivers...so maybe do some research in your state.

What about working with his neighbor/friend and have him take your client out of the house for a while (even a walk around the block) and while he's gone you can make some progress with the cleaning.

Calling APS should be your employer's responsibility, since they maybe need to contact whoever is his PoA first. Someone has to be paying for his care. If he's receiving county services, then someone had to arrange it. If not, then he is already on the county's radar and calling APS probably won't matter. Good luck and make sure to advocate for yourself!
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I will echo GA. Are you especially attached to this fellow? Can’t you refuse him as a client? Are you concerned that they won’t assign another client to you?

You don’t seem content to be with him. He makes you anxious about his home being dirty. So why not leave?

Keep a record of what he does and does not allow you to do. Does his neighbor seem at all concerned about his overall well being? Since he is a close friend he may be be able to give you some insight.

Maybe this man has always been a messy sort of guy.
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I'd be sure to document everything so nothing comes back to you if APS does eventually get involved.  

It seems your client is not a participant in his own care, and makes things more difficult for you. 

Do you have any options to raise the issue with your boss and indicate that you're concerned about liability b/c your client refuses to cooperate with you?

On another issue, I would think you have the right to refuse to go into the house given its condition, as well as the fact that his smoking is a hazard to your own health.
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