Kidnapping of Your Loved Ones in Plain Site – Carers

The Kidnapping of our Vulnerable Loved Ones in Plain Site

F. B. Chambers BA, BHG, UBAWC – Feb 2007

Finding that your elderly loved ones has cancer is bad enough but a heads up if you are considering care for your elderly relatives – Don’t be quick in your choice of carer or carer agencies. Though the potential savings of a live in Mexican, Polish or Philippine carer may appeal to your a budget, a cheap carer or even a willing and available family member, may in the long run cost far more than you realise

The kidnapping of a family member does not have to be a physical removal to be effective it can take place with in the confines of the loved ones own home.

Early warning signs are a progressive strange disconnect from the person you know and have loved from years whilst a strengthening bond increases between carer and loved one? See the summary list below.

You may want to cautiously and without raising suspicion or alarm, ask other family members if they have experienced the strange or unusual comments or replies from your loved one. Though this symptom can be attributed to diminishing senility and progressive dementia. Unfortunately, this is not always the case. It may in fact be increasing paranoia from the patient and may be the outcome of the increasing level of psychological dependency placed the patient gives the carer for the day-to-day needs they are meeting. They may hear your chat through the filter of a new mindset intentionally or unintentionally formed through the new relationship with their carer. Misunderstanding or misinterpretation is a sure indicator of a downward trend in the patients cognitive skills. If they answer what was not asked or comment on what was not mentioned, then discreet and swift probing is required. Why is this? How is this? Can this be diffused? The patient is experiencing both new and dependant lifestyle in that they don’t know how to respond to being cared for or where to draw the line as to the level of care that they should accept. A period of unsettlement is understandable but diligence should be applied to maintain interdependence with the carer not a co-dependency.

Diminishing Rights of the Patient and Progressive Control by the Carer

As patient reluctantly and often naively cedes independence to a frequent visitor or live in carer, boundaries are crossed on numerous levels that are totally new terrain to all parties involved. Some shifts in power are to the advantage and well being of the patient and on other levels – not so. Mistakes may well be made and fine-tuning required to form an agreed “Care Schedule”. The goal is to achieving a satisfactory and effective schedule that is suitable to all concerned. A difficult situation for all parties involved until time and experience allows matters to level out to all round manageable routine.

Absence of Rules Evidence of Guidelines

Unfortunately, because there are no clear guidelines as to where patient independence is surrendered and the carer’s control begins. Every case is unique and should be handled based on its own merit. The pre-dominant guideline in all scenarios is to avoid robbing the patient of any independence unnecessarily. This is to minimise inadvertent mental, physical and emotional surrender and thus cause the patient to become a premature basket case – or worse!

In the agenda of the deliberate kidnapper, this basket case stage is “fate accompli” – the intended result of the predator carer or the accidental result of the uninformed or inexperienced carer. Either way it is a care disaster.

In the case of the inexperienced or untrained, by way of trying to do more than is required, it not only becomes a burden to the carers own back but a tragic and often irreversible a emasculation to the patient. The carer becomes exhausted and the aging process of the patient becomes accelerated. Neither are the satisfactory results of quality professional caring. Ideally, this scenario would never occur by the efforts of a trained, competent carer, operating within discussed and agreed boundaries of an “Care Schedule” pre agreed with all relevant parties concerned. For safety sake there should be no “Clean Canvas” Policy, whereby the entrusted carer is permitted or in an emergency enforced to make arbitrary decisions without collective agreement of all others involved with the best interests of the patient in mind.

Minimal Care Maximum Independence

Based on the concept that care should be of the minimal amount required and patient independence to the maximum amount possible – A true carer’s goal should only ever be to carefully define the gaps of need in the areas of the patients daily living and discretely fill those needy gaps that the patient can no longer sustain by themselves. Thus minimizing the loss of patient independence and dignity. The aim is to provide a dignified assistance and not either of the following

a. Concentration camp control by increment – The patient is not a prisoner or

b. Kindergarten level of communication and care – The patient is not a child

Age does not eliminate ones innate desire for dignity and composure. A professional carer will aim to amplify the patients sense of self worth never diminish it.

Crossing The Line

In many cases, inadvertently, the carer may assume far more responsibility and therefore control than is warranted. So gradually, influence of the patients role in this new world of “being cared for” becomes distorted. Ailing health and medicinal side effects can reset the patients thinking to begin acting older, weaker and less astute than they actually are. This is a dangerous and unnecessary expectation on the both patient and carer’s part. It can become an expectation of both carer and patient as to how they think or wish each other to behave in this constantly developing episode . This incremental loss of patient power increases the carer’s controlling power and eventually leads to a reverse of roles within the patient/carer relationship and must be guarded against at all costs.

Stockholm Syndrome

This was a real live situation where a bank robbery went wrong and police surrounded the bank with the robbers still in side. For days, the robbers held both customers and staff captive in the banks vault. However, after release the hostages defended the captors in a total reversal of the facts – Why? In crises and absence of independence we as humans tend to make decisions based on our immediate environment and situation often void of the realties of life beyond our current crisis. In the Stockholm bank robbery gone wrong, the captives in the vault had long hours to learn the sorry details of the lives of the captors. After hearing all the tales of whoa of the captors lives and the fact they negotiated food and blankets for their captives to be more comfortable, progressively portrayed the robbers as the heroes and the armed police cordon outside as the enemy. Of course the reverse was true. But such is the potential psychological manipulation of reality for a vulnerable and ailing elderly. Consider, they have never been in care before and suddenly find themselves under the influence of a much younger, perhaps, opinionated carer, who progressively has significant influence and control over them within the boundaries of their own home. The potential for disaster on many levels is enormous, as a brief search of Google will reveal. There is no law in the US to prevent possible care exploitation and abuse only laws to deal with the blowback of care if such abuse is every actually discovered and exposed as fact.

Accidental Kidnapping

Though many culprit carer’s do not begin with an agenda to take advantage of the well off and vulnerable, too often the temptation is too big to resist. Particularly if the carer comes from a poverty stricken nation with many hungry dependents to feed back home. Consider, in the USA one hours pay for a carer is often equivalent to a week’s pay, back in their home nation.

Tragically, the circumstances of a Carer hostage taking are not always so naive or innocent. If discovered, it is merciful to consider the possibility of mitigating evidence. Appeal courts are awash with cases where the carer’s family was under threat or other provocation pressures. Regardless, the law is the law and theft, fraud or corruption remains exactly that and should be dealt with by the relevant authorities accordingly.

If the carer is a family member you may choose to process the exposure of abuse more leniently bearing in mind the impact a legal uproar may have to the patient/victim. Typically, the patient would have been wooed and deceived into believing that the carer is the only one can protect them from the concocted wickedness of all other associated parties – Meaning You! Your loved one may interpret any family or legal investigation of the carer as positive proof that you and the rest of the family are as evil as the carer has cunningly painted you. Ironic in that the wolf (the hired carer) may be considered as more loyal to the patient by the patient than the family itself. , the actual shepherds (The real carer’s).

Summary of Concerning Symptoms

1. Patient becomes guarded and answers what was not asked

2. Carer hints at possible confusion of patient

3. Carer progressively increases control whilst patient progressively cedes independence

4. Medication is increased and so is the chemical haze of the patient

5. Patient becomes less wiling for family visits stating that carer does a good enough job

6. Carer smiles and assures that everything is under control, mentions confusion is increasing

7. That may be code for “Back Off” – A smokescreen”.

8. Carer suggests that they are happy to increase their level of care out of personal concern

9. That may be code for more co-dependency building

10. Carer hints again that the confusion is increasing citing some humorous examples. You think this is the way your loved will go and tend to step back – Leave it the carer

11. Patient displays odd behavior bordering on hostility – Hmm must be the confusion!

12. Medication is increased and the side effects cause the confusion become actual. This permits the carer to deny any thing the patient may inadvertently expose about the carers agenda.

13. Patient displays unwillingness for family visits whilst the carer’s name is frequently extolled

14. Visits become awkward as does monitoring of carer’s conduct and control

15. Visits often reduced to phone calls most of which the carer does the talking and answering

16. Patients finances becomes unaccountable or blurred – Carer smiles reassuringly

Patient seems incapable of kindness to family but has great love and loyalty for the carer

17. A Medical, mental crisis occurs exposing care, diet, medication & finances are out of control

18. Attempts to act in the patient’s best interest are thwarted because its now revealed that the carer has already become the power of attorney and therefore all legal and medical approval must come from them. What a surprise to the family – Your loved one has been kidnapped…

Found yourself in the above situation? Welcome to the good ole US of A, When is your loved one no longer your loved one? When they have been duped by a carer to believe that you are foe not friend. The carer has successfully convinced the patient that they are in fact the savior from the evil family that cant wait to get their hands on all their worldly goods when they are gone.

Perspective

This is in no wise and indictment against Care agencies, the rank and file of legal cases is against individuals and not care corporations per say. Neither is it an alarm against the multitudes of magnificent and sincere carer’s among us. But it certainly is a note of caution against the increasing “home care” industry and the reoccurring disasters within it. This article is not designed to create suspicion but certainly a heads up for due diligence of your loved ones well being.

 Evade & Avoid – Steps to Prevention

Neither is this article is not a treatise on the law or an advisory against the multitude of abuse occurring within the noble ranks of our profession. But it may serve to highlight either inadvertent or deliberate potential abuse. It may save you and all concerned significant grief both now and in the future.

 Prevention is better than cure – Suggested Safeguards

Firstly, do not be naive and assume you are beyond being duped. Untold families have prematurely lost loved ones and legacies to smiling carer’s. If you already have a carer in place, consider the following Prevention is better than Cure procedures:

1. Outline and discuss a specific “Care Schedule” with agreed guidelines, preferences, policy and procedures with your carer. If not you have handed them a clean canvas, they will write the schedule on the fly and you will have little recourse if grows out with the families control. Simply because no clear foundation of care was laid at the beginning.

2. Make clear that no changes small or large should be made to the care schedule without first discussion and approval.

3. Consider making all requested and suggested revisions to care schedule in writing

4. Have amendments and revisions signed by the carer and carefully saved in your “Care File”

5. Let the carer see that you have a “Care Schedule” file and that you are meticulous in your record keeping This will imply that little escapes your attention or policy.

6. Share this responsibility with all other family members

7. Inform carer you wish conversations of a personal matter to be avoided

8. Be clear that you expect the carer should be circumspect in all their conversations with the patient

9. And to avoid matters out with the scope of care and caring. This is not to control the spontaneity of dialogue that your loved one may enjoy with their carer, but it is a heads up that you are cognisant of the potential and power of influence. Shedding a bright light on that early on may offset a glaring disaster later.

10. Thoroughly background check the carer – What is their medical and background history?

11. Is there any previous evidence of blurred lines in carer patient history?

12. What’s your gut feeling with them? Comfortable or uncomfortable – Don’t ignore that.

13. Do the above without making life awkward for the carer who is most likely genuine in their desire to help and do a good job.

For changes in the law and reversal of power of attorney wrongly awarded to your loved ones carer write to your congressman or senator for your state. They are they lawmakers and they alone are the ones to address this ongoing “disaster waiting to happen” scenario, which is a tragic reality to many sincere families.

F B Chambers BA, BHG, SW

Feb 2007