There’s a dilemma I keep encountering in my job, and it is this: what about when the RELATIVE of the client wants “us” (supposedly the client and me, but actually just me) to do something?
Here is an example. I take care of elderly clients, as you know. Many of them live with their grown children. Sometimes the grown child of a client will ask the client to do something—and it’s something the client can’t do without me, and the grown child knows it. Perhaps the child asks the client to polish three boxes of silverware for a holiday get-together, or perhaps the child asks the client (who no longer drives) to drive 40 minutes away to pick something up. Either way, let’s say the client agrees to do this thing—but that they cannot do it without me.
It’s tricky, and it’s especially tricky if insurance is involved. If insurance is involved, the idea is that the client is medically qualified for a certain amount of care. That is, an insurance company has said, “Yes, this person needs x hours of care per week, and we will cover that.” And you know how reluctant insurance companies are to pay money if something isn’t truly necessary. And then…the client’s daughter hopes that instead of me spending time making her mom’s lunch, doing her mom’s dishes, helping her mom shower, reminding her mom to take her medicine, shopping for her mom’s groceries—instead I will take her mom with me to Sears while I return the curtains she (the daughter) felt weren’t quite right for the living room.
But…she-the-daughter didn’t ask ME to do this, she asked her-mom-the-client to do this, and her mom said yes. And a good way to summarize my job is that I am a robot arm: whatever the client can’t do on her own, I do it for her. And she agreed to do this favor for her daughter. And I am her robot arm. So then I do the favor for the daughter. But it feels wrong, on several levels.
It feels wrong in a financial/insurance/fraud sense. The insurance company only agrees to pay for this because they believe it is medically necessary. They obviously don’t intend the time to be used for curtain-returning. (But…if it were the client’s curtain purchase/return, that WOULD be an intended use of the time: running errands is in my job description.)
It feels wrong ethically. My time is supposed to be spent caring for the client. Instead I am running errands for the grown child of the client.
It feels wrong ethically in a second way. I’m supposed to be taking care of someone who can’t do things for herself. Instead I am doing chores for someone who ABSOLUTELY can do things for herself.
The word I’m looking for is that it feels exploitive. The grown child is exploiting a situation that is supposed to benefit her elderly mother, and using it as a sort of “Can I borrow your healthcare provider to be my personal assistant for a quick sec, Mom?” thing.
I COULD draw a line in the sand, and there are situations where I very well might. If, for example, the grown child asked me to help cater a dinner party she was throwing. But mostly these iffy situations happen infrequently enough and are fuzzy-lined enough (“Well, but this lets the client feel as if she is still useful to her daughter”) that I don’t feel I need to take any action other than thinking about the interesting layers of issues involved.
Edited to add: It is a normal part of my job to drive the client on errands (or to go on my own on her behalf), using the client’s car or mine depending on the circumstances. (If I use my car, I’m paid for mileage.)






