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I am a CHHA who works for a senior care agency. I have a client who lives on her own. She is estranged from her only child, a son, and has no other family that live near by. She assigned a friend as her PoA. This client has been doing a lot of catalog Christmas and future birthday shopping over the past few months for her PoA and her adult children and grand kids, as she considers them "like family". I am at my client's house for just two short shifts each week. Her house was already cluttered and we were supposed to be getting things organized but the boxes that come almost daily now just add to the clutter and sorting them takes away from the completion of other tasks I should be getting done. She has balance issues, so getting those boxes off the floor is important to her safety. Her PoA doesn't seem to be coming in much to help as she has her own elderly parents and husband to care for. I don't think she's trying to dissuade my client from buying things for her family. I've tried to tell the client that she doesn't need to buy things for "these people" but she seems to feel she "owes them" as, in her view, they treat her as family. Walking into her home, I feel confused and frustrated. I have spoken to a nurse at the agency so they are aware, but client is still shopping. I've worked with this client for a few years and I'm very concerned for her, but I'm considering asking if they can reassign the client to another aide.

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It's not your place to handle her shopping situation. Her POA already knows about it and that's the person who is responsible. Not you.
One of two outcomes will happen if you press the shopping issue too much. First one is you'll be seen as the person who over-stepped and put an end to her shopping. Then she'll turn on you and you'll be out of a job. The aide always becomes the scapegoat whenever possible.
Or, her POA wants her to charge up and spend as much as she can because they've got plans to or have their eye on facility placement for her with Medicaid paying. By letting her charge up and charge up on those credit cards, the bills have to get paid. Nursing home and Medicaid know this. The POA and her family get all kinds of gifts and the greedy, blood-sucking nursing home they will put her in gets less.
I've been in elder homecare a long time. Trust me when I tell you, do nothing. Just mind your own business on this one.
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What makes you so upset? Should she be spending the money on or saving it for the child with whom you wrote she has a bad relationship? Giving you a bigger tip? Donating to a charitable organization that may misuse the funds? Saving for an ultimate expense … death taxes or an upgraded plush coffin?

This woman has earned and saved her money her whole life … let her do what she wants with it. Clearly she derives joy from getting gifts for snd giving gifts to these people that she values.

Given all housing and care options available for seniors, plenty of people might think that the services of a CHHA are an unnecessary superfluous expense. Instead of criticizing the way she spends her money, be grateful for the job she is providing you and help her the only way that is appropriate by making sure her walkways are clear and safe. It sounds like you could help her wrap up her gifts. Or even take them to the post office (unless she wants to give them personally to see the joy and appreciation on the recipients’ face).

The general job description of a (CHHA) certified home health aid is

To support patients by providing housekeeping and laundry services, shopping for food and other household requirements, preparing and serving meals and snacks, and running errands. This may also include healing with bathing, dressing and grooming.

Let the refining and improving of your own life keep you so busy that you have little time to criticize others.
—H. Jackson Brown, Jr.
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If you feel her house and clutter is posing a danger to her health then you should contact the POA and/or Adult Protective Services. The money being spent I’m sure isn’t more of a concern than for her welfare, which I understand but know that you can do nothing about. Your primary focus must and always be her health and safety. If the clutter in the home is posing a health and safety risk (Could she become entrapped? Is she likely to trip and fall? Are exits blocked? Can all the windows be accessed and opened?) then that must be addressed.
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Geaton777 Dec 2021
Lizbitty, there is no need to contact APS if there is a PoA and an agency admin who are unaware of the problem and haven't even been given a heads-up first.
- The caregiver contacts her admin about her concerns.
- The agency admin contacts the PoA to give them a heads-up as to whether or not there is a problem.
- The PoA works it out with their LO (and all is "normal" for her) or figures out their LO is operating out of a change in cognition.
- The PoA would hopefully contact the agency to confirm what is or is not going to change in the future. At this point the admin should be pointing out the clutter issue to either or both woman or the PoA. The spending issue is none of their business nor that of the hired aid, since everything reportable has been reported.

If the agency doesn't contact the woman or her PoA to address the clutter or the PoA sees no need to do anything and the clutter continues, then the hired aid can certainly ask to be reassigned. The hired aid can at this point discuss contacting APS with her manager if the home is truly a dangerous home environment and the PoA does nothing or the woman won't allow it.
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Let the woman spend her money the way she wants.

You were not given POA. Or any other P.
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Contact the catalogue companies and tell them she is a vulnerable person - they should stop sending to her. No doubt she will find more but it will sort out the current ones, they won't want to be seen to be exploiting a vulnerable person. The ring social services or Occupational Therapy direct if you can and ask for a visit for someone to come and assess any aides or modifications she needs to house - they will hopefully take it from there, but at least get the safety aspect through to her.
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Geaton777 Dec 2021
TaylorUK, respectfully, this would be a breach of personal boundaries and privacy, and also unprofessional. I would never want a caregiver to do this "on behalf of" my LO. I'd want the agency to contact me (the PoA) with a heads-up and allow me to decide how to solve the problem -- if it is even in my purview.
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Stay in your lane.

You should do the job you were hired for and stop judging.

If it is too hard for you to hold your tongue, you should quit. Your behavior is harassing.
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TaylorUK Dec 2021
Are you seriously suggesting that she ignores the safety issue. If the "patient" has a fall who will be at fault. It isn't judging to ensure a patient is safe, and it certainly isn't harassing to ensure she gets the help she needs. Mind boggling.
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nestea: Imho, perhaps financial access to obtaining these boxes of goods should be CUT OFF, e.g. do not let the client possess any access to debit card, credit cards or cash.
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All that you can do is tell the family and the POA. Try to intercept the mail so the catalogs stop - and write the companies to stop mailing them. Someone should take away the credit card at once and put a stop to this if you can't. Try asking for advice from Adult Protective Services. If this person is spending money that SHE MAY NEED, it has to stop at once. Also contact each company - phone and in writing - NO ORDERS ARE TO BE ACCEPTED - Worth a try.
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Your client is indulging in 'retail therapy', and it can become an addiction, truly, getting a dopamine hit every time she buys something. And it sounds like she is transferring her parenting/family-loving to this PoA; it's generous of her but also has a tinge of guilt, that she is somehow a burden to this 'non-family' person. It is her prerogative, of course, how she spends her money, but if it becomes hoarding or damages her finances there is a larger issue that needs professional intervention. If constant wrangling of the clutter of deliveries is not in your job description, your agency may need to intervene. Depending on the rapport you have with your client, and her perceptiveness, explain that you admire her generosity but that it is creating a problem for her and for you. If she insists on shopping ask her to find someone else to deal with her 'warehouse', so you can focus on what you're hired to do for her. All the best.
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I am the POA for an elderly person. She loves to shop from catalogs, and is generous. I’ve talked with our attorney and with her Doctor’s. There isn’t a great answer, unless you want to recommend conservatorship, or contact elderly organization in your area (even then I doubt they will be much help). The person I am POA for has resources, however some days she is more with it than others. On her with it days, she is aware of what she is doing. On her off days, she still feels good about it. Who am I to tell her she can’t spend the money she worked for? Difficult, similar to driving…our Doctors will not get involved in any decisions regarding competency and capability.
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There's an economic theory that can come into play when someone is not able to get out and buy things.   I can't remember the specific name of that specific theory but it addresses the "feel good" effect of purchasing goods, regardless of whether the person is mobile or not.   

It was a basic in Intro to MacroEconomics theory, at least when I took it back in the 1970s.   It has psychological foundations,  manifested through spending.

Older folks who can't get out to buy things use catalogues.  It makes them feel good to buy gifts for others, which they can apparently no longer do freely b/c of physical limitations.   Whether or not it's hoarding is debatable; it depends on factors beyond purchasing gifts, apparently for others.
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Your client is buying things for her PofA "family" b/c she so badly needs to be loved and appreciated. Does the PofA pick up the items? Can she return at least some of them to get them oiut of the way and to restore client's credit balance?
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Please let your agency know about the issue and send pictures about this growing concern. The POA should be notified about this so hi/she can take action. In the meantime, try to arrange the growing mass of boxes into stacks in a room that isn't used often - maybe a spare room.
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Tall to the POA and the isn't again and tell them exactly what you think and the boxes are utterly and dangerous and from mow on, if the items aren't for the Client herself to not have them delivered to her house.

Let the Client know that you can't do your job and if this doesnt stop, you won't be her Aide any longer.

Is this being done all the time or just now for Xmas?

Presents need to be delivered to the persons house who is getting the gift, not your Clients.
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I agree you should leave if you need to But if you care for this lady as you say, I would tell her nicely your concerns about her safety. If she can afford to do so, and chooses so, she might arrange to gift these people in a way that is legal and usual, and less messy. Or she may be bored and likes shopping to pass the time. More visitors, day care? Do turn it over to the proper agency to see if there are legal or fiduciary problems involved, that isn't your call. But the physical danger to the client is. Do emphasize that to the agency and client. If all is legal and appropriate, she might benefit from a professional organizer.
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I agree you should leave if you need to But if you care for this lady as you say, I would tell her nicely your concerns about her safety. If she can afford to do so, and chooses so, she might arrange to gift these people in a way that is legal and usual, and less messy. Or she may be bored and likes shopping to pass the time. More visitors, day care? Do turn it over to the proper agency to see if there are legal or fiduciary problems involved, this isn't your call. But the physical danger to the client is. Do emphasize that to the agency and client. If all is legal and appropriate, she might benefit from a professional organizer.
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Are you able to discuss this with her POA? Her POA can put a limit on her credit cards to control the shopping. The main question should be whether she is living within her budget. If she is going into debt, she may not be making good financial decisions. It may be time for her POA to take over her finances. But if she's buying things for the POA, this may be a conflict of interest. You don't seem to think that the POA is doing all that should be done for your client. Are you able to contact your client's son to inform him of the issues? Your client's spending is not really your responsibility, other than the issue of clearing the apartment for safety.
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Mellcan Dec 2021
Hi, I completely agree with you-as someone who only acknowledged my own addiction to debting and overspending a few years ago (after four decades of it) I can certainly surmise that perhaps compulsion/obsession/addiction are going on here. I wholeheartedly agree with letting the POA know ASAP so that credit card debt does not astronomically accumulate (and we debtors always have such a great "reason" to debt).

Getting in touch with someone (family or POA) who has the power to do the limiting on credit cards is vital.
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This is called hoarding and OCD behavior and she will trip and fall over the boxes - her Doctor needs to be aware of this issue tell her health care proxy and they can speak to Doctor . This is how my mom fell many times by tripping over piles
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This kind of buying can wipe a person out financially. She mustn't be aware of this or she wouldn't keep doing it. Can you take her computer?
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Jasmina Dec 2021
That is called theft to some. I'd notify son.
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Is it possible to get everything wrapped and labeled so she can see how much stuff is really there?

Maybe, seeing that she has covered everyone on her list will help with this apparently compulsive behavior. If there is no list, help get one together and list what has been bought for each.

Maybe, try to find some volunteers to do the wrapping, if I was close I would help. I find wrapping therapeutic.

I would also encourage her that this is the most important time of the year to donate to shelters, that way those struggling without a home can get some new to them items to help them.

Best of luck helping her stop and stay on track.
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This is a tough spot to be in, but I recommend you do not talk to the PoA directly but document in writing and report the growing clutter and safety issue due to the constant purchasing of items to your admin at the agency and let them have the burden -- it's part of their job and the PoA may be more likely to listen to them than you. If your charge doesn't have a diagnosis of dementia or impairment in her medical records, there's really nothing about the spending that is illegal.
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Nestea, you're a good person to be concerned about your client.

Since you've been working for her for several years, have you observed a change in behavior? Is the shopping spree a new thing? She is cluttering her house, making it unsafe and possibly beginning to hoard things. This could be a sign of her cognitive decline.

If she is in full charge of her faculty, then there might be other reasons.

Did she recently assign POA to her friend? If so, she probably feels especially grateful to the friend for accepting the POA responsibility. Perhaps, that feeling will wear off and the shopping spree will cease.

Christmas is just around the corner, the gifts intended for Christmas will be given away, so there should be less clutter.

You already talked to the client, and you already reported your concern to your employer. I think you have done what you should do in your capacity as a responsible CHHA. One thing though, if you suspect cognitive decline, you should let the POA friend know. The POA may need to step in and protect your client's finances.

If you don't want to continue working for this client, you should feel free to request to be assigned somewhere else.
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