I am a certified home health aide and I work through a franchised agency. I have a client who recently had to end services because of financial issues. She has no family close by and her friend, who is her POA, has not been able to visit her as often as (I think) she should due to her own family situation. Former client has several health issues, including a urostomy and bouts of vertigo, and her mobility is poor. On our last day together, she said that her friend asked her to ask me if I could "work off the books", to which she says she responded that she couldn't. She's a former "health care professional", so she knows "the rules". Yet, here she is "asking". She has hinted at this over the past few weeks. I know this would be inappropriate and that I risk my license/job, but I also can't ignore that she really has no one to help her. I want to call her today just to see how she is but I'm afraid of being "manipulated" (and I mean that literally) into "breaking the rules" to help her. I have been looking for alternative services in our area that might be able to provide care voluntarily or at a reduced fee. But it's such an awkward and sad situation.
It is part of professional practice that you do not step outside your boundaries; and working off the books - which also means unregulated, unaccountable, and without access to appropriate support and services which may become vital - is WAY outside. You would be doing the unfortunate lady no real favours if you were to agree. Don't do it.
But good for you for helping her find alternatives, I don't see how you can do more.
Either you or your boss call APS and ask them to evaluate her situation. If you know the POA, maybe a call to her saying the woman needs help. The POA does not have to help her physically but maybe could look into other services. Or she can call APS.
There is Medicaid "in home" that the woman can look into.
My new mantra...I am here to help people find a way, not be the way.
I would call APS and I would consider reporting this case as a possible senior in need of help. She is dealing with a lot of medical issues. The point is for her and for her POA to know what is available to her, and how to access it. She may need a higher level of care, however that is done. Let APS know that you cannot for professional reasons get involved on a personal level but that you are worried and would appreciate a wellness check with this senior and her POA.
Do not risk your license and your ability to care for others, as well as your own livelihood. That will do no one any good.
We are treated like family by our patients. We are sometimes closer than family in some instances because our patients share with us things they feel unable to share/are not allowed to share with family. I understand your dilemma, but it is crucial for you to train yourself to stay within the bounds that are there for our own good, and ultimately for the good of patients and families.
My heart goes out to you. I can recall crying back by the coffee maker in the break room more often than I would have liked to.
It is important to switch out your words. What you feel is not guilt; you aren't an evil doer. What you feel is grief, because you have no magic wand to take care of everything. You are grieving. That means you are a good and decent human being looking at your own limitations.