As a parent’s need for support with activities of daily living grows, it is common to involve home health aides from an agency to cover certain parts of the day. In preparation for this, the family should put away anything of significant monetary or sentimental value that easily fits into a pocket or bag. Stuff just has a way of disappearing over time. Just saying…
Setting boundaries for the parent and caregiver around finances is important. Financial entanglement breaks down the objectivity of the relationship. One thing that I see in my practice is where the parent discusses with the caregiver a plan to add them as a beneficiary of their estate. Sometimes the caregiver discusses their personal financial problems. This often leads to the parent “loaning” money to the caregiver. Other times, the parent starts a pattern of giving the caregiver expensive gifts. Patients with no family close by often will give their debit card or bank account passwords to the caregiver as a matter of “convenience.”
There isn’t a bright line of what is or isn’t appropriate here. It all depends on the overall circumstances. Caregivers are not necessarily trained to not accept gifts or not discuss their personal financial problems with patients. The more vulnerable the patient is, the more important it is for family members to set protective boundaries. The parent just wants to be supportive and show their appreciation. Family members should discuss with their parent the importance of not involving the caregiver in their financial affairs and not giving them access to their bank accounts. The discussion should also cover guidelines for making gifts and loans to the caregiver.
The caregiver and patient relationship is built on trust. Truly good people can make bad decisions when tempted. Removing valuable and sentimental tangible things from the premises goes a long way to preserve this trust. Setting boundaries that keep the patient’s finances separate from their caregiver’s preserves the objectivity of the relationship and ensures the quality of care.