Yes, I know this is not a real word. Nevertheless, it can be the only solution to serious problems: elder abuse and elder neglect. I am describing the unfortunate circumstance of an elderly person, who depends on one caregiver, usually a live-in home health aide. The sense of dependence is so great, that the elderly person overlooks it when the aide becomes short-tempered, uncooperative, bossy, and/or greedy. When these episodes increase in frequency and severity, the elderly person becomes too afraid to confront the aide. One lady said, “If I say anything to the aide, then she gets angry, and the situation becomes worse.” Another man said, “If I tell the aide that I’m going to fire her, then she threatens to leave me alone and that no one else will ever take care of me.”

The only way severe and dangerous situations like these can be corrected is swift, unannounced removal of the abusive caregiver, an “aide-ectomy.” I’ve managed many of these events. Typically, a concerned family member or friend calls me to inquire about services. He or she explains that they have an aide that they want replaced. If the reason for replacement is possible abuse or neglect, then immediate action must be taken. Each situation is unique, but here are some suggestions on how to get rid of a bad aide:

*Confidentially contact an alternative home health care agency to secure a replacement aide or caregiver. Pick a start date and time.

*Privately speak to the elderly client about the necessary change of help. Give emotional support and reassurance that this will be a positive change.

*If there is evidence of physical abuse, call the police or the 1-800-96-ABUSE hotline while the evidence is still visible.

*If mental, emotional or financial abuse is suspected, start collecting your proof. You can report this at any time to the police or ABUSE hotline.

*If possible, remove the elderly person from the home before the termination occurs. The client should be separated, protected, and accompanied by a trusted relative or friend.

*Tell the appropriate person to fire the caregiver, effective immediately. Tell them to instruct the aide to gather her/his belongings and leave right away. Tell them that the ex-caregiver is to have no future contact with the client.

*If the ex-caregiver causes any problems, call the police.

*When “the coast is clear” have the replacement caregiver and the elderly client meet at the home.

*For added safety, change the locks and change the telephone number.

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