Dilemmas: A companion - or con artist?

Sonia's godmother is 80, wheelchair bound, compos mentis and quite dependent for company on a district nurse. This nurse borrows money and doesn't return it. Her godmother's upset, but says if Sonia interferes, she'll never speak to her again. What should she do?
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Let's say Sonia had building work to be done. And let's say a member of the building firm she'd applied to for an over-pricey estimate had come along on the sly and said he'd do it for cash at weekends. OK, it's against the Guild of Builders, or whatever, to which this man's company belongs, but the arrangement suits them both. But if a friend of hers went behind her back and exposed this character to the company saying it was unethical, Sonia would, rightly, be absolutely furious.

Of course, this is a slightly unfair comparison, because Sonia's godmother is, we think, a lonely, vulnerable, immobilised old lady. But just because she's 80, if her mind is as good as ever, does this mean she should be treated as an infant? Perhaps she's got it all completely sorted in her mind. Perhaps she's not vulnerable, but an indomitable person who's thought it all out and has found that though this nurse is a con-artist, she gets enough fun and enjoyment from her company to pay for it.

It doesn't sound quite like that, mind you. I don't feel that Sonia's godmother is swinging round imperiously in her wheelchair, commanding the nurse to sit down, and saying: "My dear, I'm a lonely person, you're a wonderful friend to me. I have more money than you and I'd like to come to an arrangement whereby if we go out on trips, I contribute pounds 25 a time to the petrol, food and so on. This would suit me and I hope it suits you."

No, this nurse is borrowing money, rather than being given it and, when asked for it back, saying she's lost it or it's been stolen. The godmother is upset about it. Sonia needs to equip her godmum with the facts, because if she knows that she holds this nurse's job in her power, it will simply give her spine. Sonia should tell her to keep a log - one which she doesn't have to tell Sonia about in future - and then perhaps sit the nurse down and just tell her that it would probably be better if they came to a proper financial arrangement rather than having everything ad hoc. Just the sight of this bit of the paper in the old lady's hand will make the nurse become drenched with sweat and panic.

Alternatively, Sonia could tell her godmother that in future she should simply say that she's handed over all her finances except for a small bit of money to her, Sonia, and encourage her only to take, say, pounds 20, or whatever she can afford to part with, on her trips out.

If her godmother is frightened of saying this, she could give Sonia permission to have a word with the nurse privately. "You're such a darling to take my godmother out so much," she should say, "but I'm extremely worried that you're going to be out of pocket. If you ever need any money, please always give me a ring or write to me and I'll be pleased to send it to you. Obviously, I know you can't ask my godmother directly for money because it would be unethical, but I'm very happy to pay for expenses and so on and feel you deserve it."

If Sonia goes for the jugular behind her godmother's back at this stage, she'll be interfering grossly. Before taking this step, there are others, the first of which is for one of them to breathe a little fire on to this unscrupulous nurse and make sure she knows the hounds are baying at the gates.


Risk the old lady's wrath

For a district nurse in a position of trust it is highly unprofessional to borrow money from a client - it may even be a sackable offence. How many other elderly, vulnerable clients is this person borrowing money from and abusing in this manner?

Sonia should risk her godmother's wrath and report this nurse to the local health authority before her godmother's assets begin to disappear entirely. Her godmother may be upset but I am sure she will thank Sonia in the long run.


Annan, Dumfriesshire

This is financial abuse

It is the district nurse's responsibility to maintain at all times appropriate boundaries to her relationship to Sonia's godmother. If the allegations are true, she is failing to do this and, as such, breaching her code of professional conduct.

Sonia must report her concerns to the UKCC, the regulatory body for nursing. If the allegations are proven, the district nurse could be removed from the register. Financial abuse is as much an exploitation of the vulnerable patient as is the more common physical and verbal abuse - and is equally unacceptable.


United Kingdom Central Council for Nursing, Midwifery and Health Visiting

The matter must be reported

The nurse must not abuse the client/nurse relationship. Sonia should report what is going on to the nurse's superiors and allow them to investigate.



Next Week's Dilemma

Dear Virginia,

I feel so dreadfully upset because three years ago, at 23, my son discovered his natural father who lives in America. My mother "kindly" told him of his existence, though I had never mentioned it. Since then he's been to visit six times, they ring every week, and my son has all but forgotten about my husband, the lovely man who brought him up as his own. To make matters worse, this American treated me terribly badly when I was pregnant and just disappeared off the scene when I gave him the news. I was so hurt. My son says his father's wife said he cried all night when he first heard about my son trying to find him, so perhaps he does love him. But I can't forget how cruel he was to me when I was 18, and he was 20, and feel so let down by my son who doesn't seem to think about my feelings. Should I write to my son's father and let him know how I feel?

Yours sincerely, Adriana

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