Alzheimer Patient and her husband are not liable for injuries inflicted on an in-home health care worker.

In Gregory v. Cott, 2014 WL 3805478, the California Supreme Court was presented with the question of whether patients suffering from Alzheimer’s disease and their families are liable for the injuries they inflict on in-home health care workers hired to care for them. Caregivers who are injured while performing their jobs in institutional settings, such as hospitals and nursing homes, cannot sue the patient for such injuries.  Noting that agitation and physical aggressions are common with late-stage Alzheimer patients, the Court applied the same rule to in-home caregivers.  

The majority opinion, written by Justice Carol Corrigan, is consistent with public policy that disfavors confining a disabled person in an institution.  The Court reasoned that if liability is imposed for injuries sustained by in-home caregivers, the family would have a greater incentive to institutionalize the patient.  The Court noted its holding does not preclude liability if the in-home caregiver was not warned of a known risk, the defendants increased the risk of injury beyond that inherent in providing care, or the cause of the injury was unrelated to providing care.  It also expressly limited its decision to “professional home health care workers who are training and employed by an agency.”  The Court went on to encourage the Legislature to look into this rapidly growing area to cover subjects such as training and enhanced insurance benefits.  

The California Supreme Court stated:

“Most importantly, however, the idea that tort liability should be imposed to encourage placing the mentally disabled in institutions is inconsistent with the modern policy preference for keeping these patients in their homes whenever possible . . . Support for institutionalization can be found in older cases.  But the public policy disfavoring institutional confinement of the mentally disabled has gained strength in recent years, and legislatures have taken measures aimed at keeping patients in their homes.”

(Id. at p. 11; citations omitted.)

Justice Goodwin Liu wrote a concurring opinion, noting a public policy that such low-paid home health care workers should receive adequate compensation.  He was also concerned that if this rule is applied, it may decrease the willingness of individuals to serve as caregivers, resulting in raising wages and increased benefits.

Justice Laurence Rubin wrote a dissenting opinion, noting tort law compensates a person who is wrongfully injured at the hands of another.  While not laying moral blame on the patient, the justice focused on the husband, who should have weighed the factors in choosing in-home care over an institution.  If that decision is wrong and the patient needs more care, the in-home health worker should not bear that responsibility.  After all, the husband had control over the environment whereas the in-home caregiver has little control.  Justice Rubin also noted that in this case the in-home health care worker was an employee of an agency, and therefore, entitled to worker’s compensation, but if she had been an independent contractor, she would have no such right to compensation.  A similar problem would arise if the family hired the worker and had no worker’s compensation insurance.

Justice Rubin concluded:

“This is a hard case involving sad facts.  As the majority notes, the Legislature and society at large may be well served by turning their attention to the problems associated with caring for Alzheimer’s patients.  Whatever the solutions to those problems, I do not believe they should be at the expense of in-home caregivers who risk a physical injury by working on the front line, typically for low pay and few benefits.”

(Id. at p. 22.)  

This case makes for interesting reading and involves more considerations than can be discussed here.  Since we face or will face these issues within our own families, I urge you take a look at Gregory v. Cott.