Mom, as you likely are aware, has dementia and it is progressing normally. The problem with dementia is that the person with the disease not only forgets, but that forgetting can lead to very erroneous conclusions that might provoke unwanted behavior.
For instance, last week the caretaker on duty early that morning was asleep on the living room couch while my parents also slept. For some reason Mom got up and migrated to the living room where she encountered her caretaker.
This caretaker had been working with my mother now for at least 6 months. She is not a stranger to the household.
But Mom forgot this! Mom assumed that her caretaker was a burglar, and shouted for her to get out of the house and actually began physically challenging her. My sister-in-law had to intervene at 3 a.m. to get Mom calmed down and to sort things out.
The caretaker wasn't hurt, but it demonstrated that even a mild dementia patient can have symptoms that can result in a dangerous situation for the patient and the help.
In Pennsylvania the mother of a disabled man taking care of him in her house under the state Department of Welfare program for transition to independent living was attacked by her son in the middle of the night.
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| Pennsylvania Coat of Arms |
Originally found compensable by a workers' compensation judge, then reversed by the Appeals Board, the state Commonwealth Court agreed with the original ruling finding compensability.
The case is O'Rourke v. WCAB (Gartland). Gartland is the son, O'Rourke is the mother/caretaker.
Gartland had not lived with his mother since he was 15 years old, and he had significant health issues resulting from a long history of drug problems. His leg was amputated in 2007, after which he spent six months at the Riverside Rehabilitation Center.
A nonprofit organization that helps people with disabilities in gaining independence approached O'Rourke and asked if she would be willing to care for Gartland until Gartland was capable of caring for himself.
O'Rourke agreed, and since Gartland did not have a residence of his own, Gartland moved in with his mother on July 7, 2008.
The state Department of Welfare provided funding for Gartland's care through a program that established him as a Pennsylvania employer. Through the program, Gartland received a tax identification number and a workers' compensation policy, and another nonprofit organization served as his payroll agent.
The state program did not pay for 24-hour or night-time care for Gartland, but under the terms of O'Rourke's employment, he could request care to be provided during evening or night-time hours. The program also did not require Gartland's caregiver to live with him, only that the care be provided in his home.
O'Rourke generally worked 40 hours from Monday through Friday and 12 hours per day on Saturday and Sunday.
On Friday, April 10, 2009, O'Rourke indicated on her time sheet that she stopped working at 4:10 p.m. She then left the residence to play Bingo.
When she returned at around 10 p.m., Gartland asked her to prepare him something to eat. O'Rourke and Gartland argued because she wanted to change her dress first. She then went to change her clothes, prepared some food for Gartland and then made the couch up as a bed for Gartland before going to bed at around 11:30.
Roughly two hours later, while O'Rourke was sleeping, Gartland attacked her with a butcher knife. Gartland cut her throat and inflicted three other stab wounds.
Gartland later pleaded guilty to attempted homicide, simple assault, aggravated assault and reckless endangerment of another person.
O'Rourke allegedly lost function in her left arm and developed post-traumatic stress disorder from the attack by her son.
The workers' compensation judge found compensability and awarded benefits.
The WCAB reversed, finding that O'Rourke had finished her employment duties for the day, and her employment no longer required her to be present in Gartland's residence.
She was present, the majority posited, only because Gartland's residence was her residence as well. The WCAB said she was not present in her capacity as an "employee" at the time of the attack.
The Commonwealth Court found the matter compensable under the bunkhouse rule.
While the assault had taken place in a house that actually belonged to O'Rourke and not Gartland, the majority said that this was still the premises of O'Rourke's employer since it was the place where O'Rourke performed services for Gartland for up to 64 hours per week, in exchange for payment.
And while the services O'Rourke performed for Gartland did not occur within O'Rourke's bedroom, the majority posited that since O'Rourke's job basically required her to live with Gartland, and sleep "is a necessity of life," under the bunkhouse rule, the area where she slept had to be treated as part of her employer's "premises."
Judge Bonnie Brigance Leadbetter dissented stating that it defied logic to call the claim compensable because O'Rourke was stabbed by her own son while she lay sleeping in her own bed, in her own home.
Was the majority stretching to find a remedy for O'Rourke? Or is this just one of those very close cases that could have gone either way where reasonable minds differ?
I don't know whether there was any alternative insurance to cover O'Rourke's injuries such as homeowner's insurance. I'm sure there are some underlying facts that are not part of the official court opinion that swayed the majority opinion.
The dangers of home care. I hope Mom doesn't pull out any butcher knives...
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