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She hired me and couple other aides to do private care to help her with grocery shopping and meal preparation. The doctor instructed her not to drink but she refuses to listen. She wants us to purchase her drinks at the store. The kids said we are not supposed to.


What should we do if the client refuses to listen to children and instructs us to still buy it? She is a high risk person with falling.


Is it a liability issue if we buy her alcohol and when we are not there she falls? Can we be taken to court for buying alcohol for her? She pours it for herself.

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THE ONES WHO CAN TELL YOU IF YOU WOULD BR LIABLE ARE ATTORNEYS OR PERHAPS THE LOCAL DEPT. OF AGING. IF SHE IS YOUR BOSS, AND INSISTS., YOU MAY NEED TO QUIT.
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Only child. The poster stated how alcohol could affect her adversely due to a variety of conditions associated with her aging. Of course she could continue to but it doesn't sound as that will be a positive outcome. This is no longer a situation of simply social drinking. My late MIL was buying herself small bottles of alcohol after beginning the stage of memory loss. The results were somewhat disastrous until we could move her out of her house.
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Although technically you may not be responsible for the negative effects of her drinking alcohol because you are not Medicare CNAs and are private aides hired and paid for by this woman........there is still the possibility that the children can sue you in civil court.

Her adult children may not win the case, but it will cost you a lot of money to defend yourself.

You need to discuss this with her children and get them to talk to her.

If this woman fires you for refusing to buy alcohol, you may be better off.
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I read over the original post. "She pours it herself" does not mean alcoholic. That's first. SHE hired you, that's second.

Are you working for the agency that hired the doctor who made the care plan?

If you are freelance ... I don't see a problem. If you don't give the meds, and pour the drink ... you aren't liable. In my opinion. When you leave, put the alcohol (what is it, by the way?) out of reach. If she's down for the night, she's not going to fall because of alcohol. If she falls after you leave, it's because that's how she wanted it. It's not a demerit on you because you give the lady what she is paying you to give her.

I'd hire you ! Prolonging life isn't necessarily what's best.

Anyone want wine?

Mama
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A ROCK & A HARD PLACE - if she is competent & she pays your salary then you do as she asks - if I was you then I'd ask her to personally write out the list & keep it - sometimes the pleasure of a drink is the last pleasure they can do for themselves -

I'd stop at pouring a drink unless you have done the liquor servers certificate [or equivalent where you live & even then deny it] however giving them a glass of ice with pop [even though you know some alcohol will be going into it] is as far as I think you should go

Remember that if you can not have alcohol, not have chocolate, not have garlic, not have meat, not have bread .... you won't live forever it will just seem that way - I bought my 94 year old dad his rum until he died because that 1 or 2 drinks a day he got was his main pleasure in life & think about if you where in same situation .... I'd have something to look forward to each day & that can extend life even more than a lot of meds
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I would say yes you can be taken to court.

I would not give in... medically (for her) and professionally for you) because it’s your reputation and your job with future employers at risk. Yes, she has hired you for care, but its her family (and lawyers) that can come after you for neglect and improper care.

Caregiving is hard enough without the diva drama that can go with it. Her “I’m purchasing my version of help so I can get my way against any advice of a doctor or family...” is putting her health at risk and your future employment in tough situations at risk as well.

But because you’re a caregiver, (like I am), we have to respect the idea that there’s a fence there... whether they will or not isn’t something we have to get them to agree with us about. you’re not under an obligation to provide something that would be risk to her health at all.

Like a chain smoker in a hospital bed demanding cigarettes, I’d put it simply...” I’m grateful for being hired ... and you trust me to care for you but I can’t do what you ask of me. I’m uncomfortable being in the middle of a decision that’s against the express advice of the doctor and family involved in your care. While I can’t tell stress that you should follow your doctor’s advice about alcohol or your family’s request that you shouldn’t have it, I can tell you that if it’s alcohol you want.... you’ll have to provide your vice without my assistance.”

Don’t assume responsibility for something that will cost you your reputation and job prospects.

im sorry you’re in a difficult situation.
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While you are employed by the drinker, you have few options. The family's option is to go for guardianship (she sounds too competent for a POA), take over her finances, and become your employer instead. If they are unhappy with you, suggest this to them. They could solve the problem, you can't.
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Way too much liability there!
Mixing the meds can kill her.
If the adult children want her to quit, they would be responsible for getting her in rehab.
Maybe she could discuss with her doctor her choice to drink, choosing drinking over her meds, which the doctor can discontinue.

Then, she can have a liquor store deliver her drink.

She won't need caregivers to help her die, hospice can be called in.
One more fall and she will be hospitalized. imo.

Well, on second thought, this is the nuclear option. The tough love option.
Many people drink and smoke, and continue to carry on these unhealthy habits
way to the end of their lives.

CYA.
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Let her family buy the alcohol or decide not to buy it. I wouldnt buy it in case she falls, or it interacts with her meds. Or her personality could change from sweet lady, to a mean one. You never know. Too many risk factors there. I wouldnt touch that with a ten foot pole.

Some families can be quick to blame any caregiver for anything that happens with their loved ones. Id CYA. If you bought alcohol for any other person you could potentially be held liable. No way I would do it. Let her take that up with her family. If she is a,falls,risk, there is a 100% chance she will fall again. That is a fact. And that is with no alcohol.
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If you work for a caregiver company I would ask your supervisor. My FIL has been a lifelong drinker. Initially, we let him do what he wanted because that's what the doctor said. He was well aware of the problems alcohol would bring but because he was able to make his own decisions all the doctor could do was give him professional "advice." Now that his dementia is more advanced, we've had to severely cut back his alcohol intake for our own sanity. It sounds like you keep in touch with her family. I would ask her children to have a discussion about it with their mother and you present so everyone is on the same page and you're not put in the middle. On the other hand, it sounds as if she is fairly competent, in that case they do not have a say, but I see how you are being put in an awkward situation.
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My FIL drank a six pack of Pepsi every day for as long as I knew him and smoked like a chimney even when he claimed he had quit and started seeking them (MIL passed from emphysema) his doctor told him to quit the Pepsi (and the smoking) for years and many would submit that's more harmful to his health than a drink or two a day. My great aunt had a glass of sherry every night right up until she passed and for a good part of her life a cigarette with it, she lived to be 103 (sharp as a tack right up to the end). I think we can tend to get carried away trying to manage our aging parents and their health. A big part of it is emotional as well as gut reaction, we don't want them to die and we want to extend their lives, keep them with us as long as we can but it's easy to loose sight of their real needs, their quality of life and yes their actual desires. Again easy to dismiss what they tell us particularly when there are cognitive issues (things can change from one conversation to the next) and we haven't always been prepared enough to find out their wishes before cognitive issues develop or we don't like them suddenly when we are in the midst of it. It's all rooted in love but simple as love is it sure can get complicated or can complicate emotions.

You have several options, routes to take here and from my perspective a lot of it depends on the actual situation. As others have said, who hired you and who do you work for? Are you uncomfortable being the avenue for her to get liquor because you are worried about her or is that just based on what children or she herself told you about children's concerns? In other words do you have your own reservations based on observation or because you have been told there is a difference of opinion here? Is she competent and legally still running her life, making her own decisions? You could be honest with her and tell her you are concerned about your legal responsibility based on the strong differing opinions regarding her drinking. Or maybe you could tell her it's your policy not to purchase liquor for your clients simply to avoid any possible liability or because alcohol is against your beliefs, you don't purchase it for anyone including yourself. Or you could have limits as to what you alcoholic beverages you will purchase and how much. You could also work with her children on the sly to cut the alcohol that comes in the house like teenagers do in the movies (cut 1/2 with water), it's all dependent on the situation and the players involved, what sit's right with you. If you are purchasing liquor for her though the suggestion about getting a release in writing is a good one and fit's right in with having an open discussion with everyone. I would have the discussion with her kids too about what you are and aren't agreeing to do so everyone is clear.

Sorry, I know you were looking for something a little more definitive and about legalities but first I'm guessing laws may vary state to state and I'm not sure there is one answer and I don't envy the situation you have found yourself in here. You are obviously good at what you do, you care, good luck.
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Be very careful. Discussing this with her family is a normal kinda thing to do. Unfortunately, it may violate HIPPA and/or your contract or state laws unless your client has given you permission. If your client is still competent then she also still has privacy rights.
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You're only Alternatives is to quit your job if she is paying you or give it to her however you might buy the bottle for her and give her a small drink after each meal and take the bottle home with you in the evening. Have you discussed this with her family?
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I would think who has POA and Health Care directive rules.
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I should start by asking who is paying you for your services? If it is the 76 year old woman then she is your employer and can request that you shop for the things she has put on the list.
If it is her children that are paying for your services then you need to abide by their wishes.
Is the woman mentally competent? If so then she can make decisions as to what items need to be obtained when you shop.
And she can also make the decision (all be it a bad one) to continue to drink when her doctor has advised against it.

I suggest that you check the contract and if it has a termination date (like a 6 month contract)
If there is no contract with a chance to revise services it might be a good thing to do as your duties will change as your client declines.
The purchase of alcohol might want to be included. How much if any will be provided. How much and when will she be able to drink. For example a lite beer in the afternoon and a glass of wine with dinner. After that the alcohol is put away and she can not have access to it until another caregiver is present to monitor her.

If this woman is an alcoholic you might want to discuss rehab. There are specific rehab for seniors.
there is the possibility that the intention is to kill herself with the alcohol and drugs. Medically assisted suicide is not legal in many places and this just might be her intention (depending on her condition/diagnosis) If she is in continual pain this might be one of the ways she thinks she can deal with the circumstances. If this is the case you might want to talk to her and the family about Hospice.
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If she is competent, let her buy her own alcohol if you live in a state where you can order it by mail.
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I wonder if drinks with low alcohol content, such as certain beers or wine coolers, are an option. Or maybe drinks like sparkling cider in fancy bottles that look like wine bottles (but have no alcohol in them) would work. And if someone shares a nonalcoholic bottle with her and acts cheerfully imbibed, maybe that would fool her....
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I've seen a lot of children who try to control what's "best" for Mom. Some go to extremes. No sugar, no gluten, no drugs, no alcohol, no fun. I turned down a position because of just that. I frankly didn't like the way the three daughters were treating their mom, but there was nothing I could do to advocate for her.

I don't recall you saying she was a drop down fall down out of control drunk. However, if that was my life, I'd want to live it the way I wanted to. It doesn't sound like she's an Alzheimer's lady or plagued with dementia .... who are we to dictate how a person wants to live or end their life?

As I pour another glass of wine, I just wonder at the desire of people to take control of their parents as though they are nothing more than children that have to be dealt with.

Ask yourself. Who do you work for? It sounds like it's free lance rather than agency. Whoever pays the bill is the boss.

If she pours for herself ... God Bless her! It's a quality of life issue the way I see it. She still has control over herself and her finances, obviously. It's no one else's business.

Qualiity of life is much more important than quantity of life. Allow her the choices she has control over. Respect her wishes. Even if they are against those of her children. Every doctor on earth will say don't drink. Fine. I'll bet they drink.

I feel very strongly about this. Just because we are old does not mean that our children and doctors get to make all the decisions about us! My children would have ME in assisted living right now. Well, if I could afford it. lol

My point obviously is, don't assume Mama doesn't know best!

Mama
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I would call law enforcement. Why is the family letting her live by herself and she wants to booze it up with prescriptions. Don't buy any alcohol--she can overdose and die from the alcohol and medications since family will say she was not cognizant. I would get away from this situation and fast or you may end up with legal charges against you. The woman's family will attack you because even they said not to buy it so if you do you will be held accountable. Let the family deal with her..not you. If you work for an agency talk to your supervisor; even I would think they will tell you to avoid the place due to legal liability. I mean if I were your supervisor I would tell you not to visit the place and I would remove them from the client list. If you feel the woman is endangering herself, tell your supervisor or you can even report it to law enforcement.
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OnlyChildAlone Nov 2018
Call law enforcement because an adult wants to drink? What world to you live in that people lose the rights to make decisions for themselves JUST because they're old and/or have health issues. Getting guardianship over an adult is difficult (and has been made more so in several states because of abuses with it) for a reason. Unless someone has guardianship then this lady is free to drink or not.
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To me the issues are: (1) is your client still mentally competent and (2) does your contract exclude alcohol purchases. If you client is competent and your contract does not exclude alcohol, then you should make the purchase. Talk with your supervisor. I would not contact her doctor because (1) that could easily be a violation of her confidentially as defined in your contract and (2) that responsibility belongs to her children.

People, even the elderly, have a RIGHT to make what others may consider to be poor decisions as long as they are competent. I understand your concerns and I agree with them, but that doesn't change that a competent person has the right to hire someone to make purchases of legal products.
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I am pretty sure that it is liability in that way. I would recommend referring her to a supervisor and they can place her or deal with the issue instead of you or colleagues. If someone's half gone you're still liable for their care. That is apart of it. It's saftey and more. I know it can be hard to say no but it wouldn't be any different if you bought cigarettes for someone on oxygen... they go poof... it on you for providing. Like any substance. I would advise you to seek out help and transfer to a new person in need. Hope that helps
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My concern is that if your client has a drinking problem, it is dangerous to just cold turkey.

If you are not medically qualified, I would tell her doctor via note that she is an alcoholic and she needs oversight to dry out, barring that, how much daily is considered safe.

Lots of AL have an evening happy hour and residents are able to consume alcohol.

Just because someone gets old doesn't mean anyone has the right to dictate life long habits.

I would tell her kids that they need to see that she is dried out under medical supervision and to deal with her directly, you can not be put in a position to have something tragic happen because she is denied alcohol.

We all will die of something, at some point what the #e[[ difference does it make if she can be kept safe from falls.
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My dad is an alcoholic. Prior to his car accident he bought his own 12 pk a day. The dr was telling him then not to drink more than 2 beers due to his age and stroke risk. After his car accident and his losing his license I told his caregiver not to buy him alcohol. We do let him drink but it is only 2 beers a day. One after lunch and one after dinner. If he can get more from "neighbors" he will but that has slowed down as dad has slowed down.

Have a discussion with her children and tell them you will not buy alcohol and you are going to tell "mom" that her kids said for you not to do it. You can remind her of her risks but it probably won't do any good. If she's an alcoholic (and it sounds like she is) then her body is craving it. She may let you go due to this but let me tell you it is so stressful to have to try to control an alcoholic but it is for their own good.
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"She likes to drink alcohol" means (to me) more than just a glass with dinner. Any more booze and she would be at a higher risk of mobility/falling problems.

"(She) is on heavy meds."
Alcohol should NOT be combined with MANY prescription meds, especially narcotics (pain meds), hypnotics (sleeping pills), anxiolytics (anti-anxiety meds), antipsychotics and anti-seizure meds. There have been deaths associated with combining them. I don't think you'd want that over your head.

"The doctor instructed her to not drink" and "The kids said we are not supposed to" (buy it for her).
You are purpously violating doctors orders (essentially you are being the doctor by buying it and allowing her to have access to it.) You are also going against the wishes of her kids. I would think that they would take action against you (for buying it) if something happened to their mother (that was directly related to the alcohol) and they had told you not to.

"She is a high risk person of falling."
I would think that any more than one drink would put her at even more risk to fall.

Doesnt make a lot of sense to keep this lady in booze, does it?

I would seek the direction from your boss and also speak to her kids about your liability in this situation. You have the right to refuse to buy it.
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You simply should not be in a position to buy her alcohol. The consequences are too great for disaster. Whether you may be liable or not the risks are very great. Let her family deal with this issue.
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I would not buy her alcohol and you have a good reason not to. First, her meds. Second, fall risk. Third you have been told doctor says no alcohol and children back this up. I would not take the chance if she falls and really breaks something you are sued as being responsible. You have good reason not to buy her alcohol.
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How do you know the doctor instructed her not to drink alcohol? And what would the medical reason be to tell her not to drink any alcohol?

I'm on the fence about this.

It's common sense that you wouldn't do it if the family and doctor say you're not supposed to... so I'm not sure what you're asking here.

But as someone who thinks doctors often give advice that errs on the side of being overly cautious, I'm curious about the specific circumstances.
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Riverdale Nov 2018
It is stated she is a fall risk. I doubt alcohol is recommended for anyone elderly. Possibly a small amount under supervision could be alright but this doesn't sound like that sort of situation. My late MIL got herself in all sorts of trouble drinking alone before we moved her out of her house. When we take my mother out to dinner she has one glass of wine. We pick her up and bring her back to AL. This is about the only situation I think that alcohol and the elderly can mix. Or another situation that is monitored and the intake is a small amount.
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I would say don't buy any alcohol for her.  Not your job and why would you risk any liability? Leave this to her and the kids.
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I can see where this is a very conflicting position you are in.

I suppose you can ask for a release of liability from your client and explain the compromised situation you are concerned with.

She hired you. She pays you. So she manages her own finances right? Have you had a problem being paid? Does she seem confused?

She evidently hasnt been deemed incompetent to handle her finances.

Does she ask for a great amount of alcohol? Have you seen her drunk? Has she actually fallen? Does she drink 24/7 or more like a glass of wine with dinner...which may even be helpful depending on which news report you believe. “She pours it herself” sounds like it could be a lot. If she’s drunk on her feet you might get hurt helping her to the bathroom or bed or picking her up from a fall. Thats a job liability you might not be up for.

Has she given you instructions on confidentiality?

How do you know what the doctor said? Did she tell you or did she trust you in with her on a drs visit? Or is this coming from the kids?

Does she know her children have spoken with you about alcohol? Are both groups putting you in the middle? Would you have been concerned if they hadn’t brought it up? Or is this openly discussed?

An issue I often read about on this forum is about patients that are obese and have mobility issues. I wonder to myself, who is bringing them all that food that is making them have diabetes, mobility issues, etc.
Food and alcohol are similar as they are both drugs. The problem with abusing either didn’t just start when you were hired. Yet you are supposed to come in and stop a problem that the family hasn’t been willing or able to stop before you arrived. Anyone can say. Don’t eat junk food. Don’t drink. But it’s not that easy is it?
If you look at your shopping list how many other items are questionable? You can’t be expected to be the food police. This isn’t opium you are being asked to buy.
In our culture these are legal substances available to competent adults.

Your client is a competent adult who hired you to assist her. She’s not asking you to break the law OR to make decisions about how she should live her life.

There is a book you may have read called “Being Mortal” by Atul Gawande which discusses aging and living life until we die. I think it helps us seek balance and not get caught up in extremes.

You have a tough job and I’m sure this is a concern for others who do your work.
Thanks for asking it.

If I were in your position I think I would tell the children, I understand how you feel but I work for your mom. Please don’t put me in the middle. Maybe they can work out a compromise on the amount purchased but that’s not really your call IMHO. If she obviously has problems they aren’t addressing I might start looking for another job.
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Speak with her children and tell them what’s going on. This is up to them to handle, not you. You were hired as health aides. Look over your contracts to see what your duties are. I’m sure contributing to her drinking problems or counseling her on how dangerous it is for her to be drinking are not in your contracts. You also need to speak with your supervisor for agency policies onnwhat you should and should not do.
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