SAN FRANCISCO - People with Alzheimer's disease are not liable for injuries they may cause their paid in-home caregivers, California's highest court ruled Monday in a case involving a home health aide who was hurt while trying to restrain a client.
The California Supreme Court ruled 5-2 that people hired to work with Alzheimer's patients should know the disease commonly causes physical aggression and agitation in its later stages. The court majority concluded it would therefore be inappropriate to allow caregivers who get hurt managing a combative client to sue their employers.
"It is a settled principle that those hired to manage a hazardous condition may not sue their clients for injuries caused by the very risks they were retained to confront," Justice Carole Corrigan wrote for the majority.
The law in California and many other states already establishes that caregivers in institutional settings such as hospitals and nursing homes may not seek damages from Alzheimer's patients who injure them. To have a different standard for caregivers working in private homes would give families a financial incentive to put relatives with Alzheimer's into nursing homes, Corrigan said.
But the two Supreme Court dissenters said it was unfair to put private caregivers in the same category as police officers, veterinarians and other professionals who are barred from suing third parties for on-the-job injuries because of the inherently risky nature of their work. They argued families of individuals with Alzheimer's should bear responsibility and "weigh the benefits of in-home care against the costs it may impose on others."
"Not every patient with advanced Alzheimer's is violent, and violence is not common during the disease's early stages. Thus, exposure to violence is not inherent in caring for all Alzheimer's patients," Justice Laurence Rubin, a mid-level state court judge temporarily assigned to the high court, wrote in the dissent joined by Justice Kathryn Werdegar.
The majority ruling came in a lawsuit brought against a Los Angeles woman with Alzheimer's and her husband, who hired an aide to care for his wife through an agency in 2005. The aide had worked with Alzheimer's clients before and been told the wife was prone to biting, kicking, scratching and flailing.
Three years later, while the aide was washing a large knife, the woman bumped into her from behind and reached for the kitchen sink. The knife struck the aide's wrist, and the injury caused her to lose feeling in several fingers, according to a chronology provided in the court ruling. The aide sued the couple for negligence and battery, and lower courts dismissed the case on the same grounds cited by the Supreme Court cited.
Monday's ruling does not preclude future lawsuits by private caregivers who are not warned in advance that their clients can be violent, or in cases where an injury is not related to the common symptoms of Alzheimer's, Corrigan said. She also urged the Legislature to consider developing professional training standards and enhanced worker insurance compensation for Alzheimer's caregivers.
"The number of Californians afflicted with this disease can only be expected to grow in coming years," she wrote.