Who should pay for gloves?

[Random]

Am I responsible for providing gloves for my caregivers or should the agency do that? Some of my caregivers use them for everything, some virtually not at all. But I think the hassle of getting them, and the cost of them, should not be my responsibility. I buy them for my own use and they will just disappear if everyone else uses them.

[Danine]

OSHA regulations require that the agency provide its employees the items needed for "universal precautions."

[DA6righthand]

i provide my own. i use independent providers through the state, i guess requirements are different for them.

my ssdi check takes care of getting gloves, betadine, lube, whipes, enemas...and i think thats it. it really isn't too terribly much. it pays to shop around though. lube at one pharmacy costs $5 a tube, at another its $2.30.

i agree though, i don't think we should be responsible for providing or paying for as much as we do. i think insurance, medicaid or medicare should cover almost everything. but...not everything. some things we should pay for, but all cathing supplies i believe should be covered.

[SCI-Nurse]

If you get care from an agency, they should provide them. If you hire your PCAs yourself, then you should provide them to your workers as you would any tool.

Frankly, I provide gloves and hand cleaner as well as a battery powered liquid soap dispenser for the use of my mother's PCAs. Anything I can do to get them to be less likely to pass bugs on to her (or from her to them and then get sick themselves) is well worth the money.

(KLD)

[Random]

Thanks. Yeah, cleanliness diligence -- that's an ongoing battle. I noticed my main caregiver was using only water, not soap, when she washed her hands. So I've made a point of it, asking her to use soap. She says it's not good for her, dries her hands out. I tolerate a lot, but I draw the line there. She'll wash well after doing any personal-care where it might matter to her, but she'll go shopping, or take my trash out, and then cook or handle my medication and not be nearly as diligent as I would like about washing her hands with soap. This dependence thing really wears on me.

[Random]

KLD, mayIask what brand of battery powered soap dispenser, or where you find them? My hands aren't good enough to pump soap anymore. I'd ordered some from Shaper Image but they went out of business, and the few others I found on-line were big and ugly.

[SCI-Nurse]

This is the one we have, but I think my dad got it at Bed Bath & Beyond.

http://www.simplehuman.com/products/soap-pumps/sensor-soap-pump.html

It could also be filled with alcohol based hand sanitizer.

(KLD)

[sjean423]

Thanks. Yeah, cleanliness diligence -- that's an ongoing battle. I noticed my main caregiver was using only water, not soap, when she washed her hands. So I've made a point of it, asking her to use soap. She says it's not good for her, dries her hands out. I tolerate a lot, but I draw the line there. She'll wash well after doing any personal-care where it might matter to her, but she'll go shopping, or take my trash out, and then cook or handle my medication and not be nearly as diligent as I would like about washing her hands with soap. This dependence thing really wears on me.

She definately needs to wash w/ soap, even if it means dry skin.

But, if you supply liquid (pump style) soap, next time you restock, they make it with moisturizer in it. (And it comes in the generic brand .... we get it a walmart, no more expensive than the regular). I find it helps. But in the meantime .... tell her tough! Use it anyway!

[SCI-Nurse]

We use an alcohol based hand cleaner here in the hospital, and also purchase a compatable hand lotion from the same company that does not compromise the effectiveness of the hand sanitizer.

If your PCA is from an agency, and is not following proper hand hygiene, even after you have spoken to them, they should be reported to the agency. This is dangerous for both of you.

If you hire private PCAs and they don't follow your directions on this, you may need to let them know that failure to follow your direction in any aspect of your care may be reason for termination. It states that in our employment contract that we require all our PCAs to sign.

(KLD)

[Random]

My abysmal agency is giving me a hard time about this, insists providing gloves is my responsibility. Can anyone give me an OSHA cite so I can put the argument to bed? I so hope that as the baby boomers age the agencies will be forced to become more ethical and professional.

[dunwawry]

I'm still not clear here. Are your caregivers the agency's employees, or do they belong to a registry? In other words, who is responsible for paying their taxes? If the agency does the background check, bonds them, hires them, and pays their payroll taxes, then they should be buying their gloves. If they are, I wouldn't waste my breath fighting with them, I would be looking for a different agency. I'd be worried about what other corners they were cutting. If these are your employees, as KLD said, you need to not only protect them, you need to be thinking about protecting yourself. You don't know whose colostomy bag they emptied right before they got to your house, or what diseases they might test positive for.

[TheDuder]

My abysmal agency is giving me a hard time about this, insists providing gloves is my responsibility. Can anyone give me an OSHA cite so I can put the argument to bed? I so hope that as the baby boomers age the agencies will be forced to become more ethical and professional.


Hey it's your life, but is this really an issue to make that big of a stink about?

A box of 100 latex gloves can be bought for about 5-6 dollars, basically the price of a frozen pizza. I personally keep gloves on hand for my aides to use if they don't bring their own, but i don't worry about it when they don't and couldn't fathom going so far as to call OSHA over an issue involving such a small amount of money.

[cass]

agencies lie. and they get ppl the same way i do, via newspaper ads. they claim bonding, background checks, etc. i have one word: bull.

i always have gloves here. in 23 yrs, nobody has provided them or paid for them except when i tried visiting nurse services for a bit for cath change. that was a nightmare so went back to my own devices.

[Random]

They are the agency's employees. The agency pays their check and the necessary insurances, though doesn't withhold taxes, so I guess they're kind of independent contractors through them. I don't really understand, but I know they're their employees and not mine. I no longer remember which, but I know either my insurance or New Jersey law requires that I hire certified people through an agency. Though the agency is not bonded and it's pretty much failed me on issues of theft.

Actually getting the gloves and storing them in my house is more work than I can do, and the expense of a box every couple weeks does add up. It's also something of a matter of principle because the agency sucks so much, and I don't have a lot of options. I give them good business and their nickel and diming me, on top of shitty service and a patronizing attitude, really irks me. I'd like just to be able to fax a few OSHA regs to the unpleasant woman, and not have gloves be something I have to think about in my life.

[Random]

FYI – I called OSHA and learned that providing gloves is the employer’s responsibility, and the agency is the employer. At http://osha.gov/pls/publications/publication.AthruZ?pType=AthruZ (http://osha.gov/pls/publications/publication.AthruZ?pType=AthruZ) if you download “All About OSHA” page 11 of the Acrobat document says:

Standards & Guidance
Requirements
In general, OSHA standards require that employers:
• Maintain conditions or adopt practices reasonably
necessary and appropriate to protect
workers on the job;
• Be familiar with and comply with standards
applicable to their establishments; and
• Ensure that employees have and use personal
protective equipment when required for safety
and health.

[SCI-Nurse]

Not necessarily. If they are legally considered independent contractors for the agency, they are not employees. There are IRS regulations that determine if the person is an independent contractor or the employer. Regardless, if you are getting this paid for by your Medicare waiver program, you should be responsible for providing the tools for the attendant to do their job. You don't require them to provide your catheters and dressings, do you???

We always have exam gloves for our attendants, and insist that they wear them. We buy them cheap, in bulk, at Costco.

(KLD)

[betheny]

I get food prep gloves, non latex, about $15 for a thousand, on ebay. At that price, you worry much less and rarely run out. As a bonus, 100 of them fit in a sleeve the size of a cd case! I use galaxy brand, never had a glove failure. I'm on my 2nd box of a 1000.

http://cgi.ebay.com/GALAXY-Clear-Poly-Food-Handling-Gloves-MEDIUM-CHEAP_W0QQitemZ390003459945QQcmdZViewItemQQptZLH_D efaultDomain_0?hash=item390003459945&_trksid=p3286.m20.l1116

I love these for travel, latex gloves were dangerous bulky and cost a fortune.

[zillazangel]

I'm with you Random, they should provide gloves!! KLD, its not fair to say its similar to expecting caregivers to bring catheters, get real. Its more similar to saying that they expect Random to buy scrubs, or pay for orthopedic shoes to prevent backaches from standing on the job. Its something required to do the job, not something that is an implement or tool on the job.

But thanks for the link Betheny, that's a great buy - I have gloves around since I am the caregiver. Unpaid, I may add!

[maryonwheels46]

My agency is suppose to provide gloves but everytime she comes out she says that she didn't bring any. So I called my cath provider and they send me some for free. But I am about to crack down on my agency.
Mary

[chick]

Does anyone know if powder in latex gloves effect how long they last?

I'm curious if powder or powder free would be better for shelf-life.


I switched to powder free due to ex pca complaining she didn't like powder on skin, but was thinking about switching back to powdered. Powder-free can make the gloves kind of sticky and stick together, while powdered gloves can dry out the gloves a bit over time. So, anyone have any feedback on what might be better on the actual latex and wear n 'tear' - powdered or powder-free?

[kkmay]

I pay for all my supplies. Every little thing.

[SCI-Nurse]

Does anyone know if powder in latex gloves effect how long they last?

I'm curious if powder or powder free would be better for shelf-life.

I switched to powder free due to ex pca complaining she didn't like powder on skin, but was thinking about switching back to powdered. Powder-free can make the gloves kind of sticky and stick together, while powdered gloves can dry out the gloves a bit over time. So, anyone have any feedback on what might be better on the actual latex and wear n 'tear' - powdered or powder-free?

I would strongly encourage you to NOT use latex gloves at all. We recommend they not be used for bowel care or for routine care for people with SCI, who are in the top 3 risk groups for development of latex allergy (along with those with CP and SB). Exposure of mucous membranes (ie, the rectum, bladder, urethra, etc.) is a high risk exposure that make latex allergies more common. In addition, your caregivers who use latex gloves are at high risk for developing latex allergies, as many of our nurses did in the past (and had to leave the nursing profession), and the powder (which is actually powdered latex) makes this worse. We have banned their use and purchase throughout our hospital, including the operating room. Use of vinyl or nitrile gloves instead are highly recommended.

(KLD)

[doingtimeonmyass]

KLD, I notice in the hospital they tend to use the nitrile gloves and prescribe the vinyl ones. What's the difference between the two other than the obvious difference in materials? One advantage I would think is that the nitrile ones are a snugger fit.

[dash]

I find I have to watch caregivers espicially when wearing gloves. If they use their oun I've seen them try to wear the same pair from start to finish. They'll try to empty a bedside urine bag, then grab your toothbrush, bathe you, brush hair...
No matter who the supplier is it's best to have your own so they have no excuse.

[chick]

Thanks KLD. I've been using vinyl often, but needed more fitted gloves for some uses and depending on some pca's preference.

I'm curious about the Nitrile vs vinyl also.

[quad79]

I'm glad I read this.I just usually buy the best deal.Thanks for the warning KLD.

I would have to agree an agency should provide them.Even brothels provide condoms.This being that agencies are usually expensive but private pca's are usually paid less & technically employed by you.

[SCI-Nurse]

Nitrile is more expensive than either vinyl or latex, but gives a similar fit and "feel" to latex gloves, so these are best for doing procedures where you need to be able to have fine sensation through the glove. For things like digital stimulation, generally the vinyl work fine and are much less expensive. Vinyl gloves are usually clear (or semi-transparent), while nitrile is usually green, purple or blue.

(KLD)

[Lizbv]

hey good thread, just saw this.

I currently have a private pay only agency for my AM girls who pays them as employees and they make me provide gloves. they cut me a deal on what i pay them per hour (which is nice), but i limit my aides to one pair per visit, unless it gets nasty which is seldom!

my question is: do private pay agencies (they r part of a franchise) and LLC have same standards as Medicare acepting and Medicaid agencies that your referring to ?

btw I buy my gloves from Costco. they are good quality. the one thing i hate is aides carrying gloves in and out of the house!

[thehipcrip]

Do those of you who feel the agency is always responsible for providing gloves also insist the aides bring their own hand sanitizer? I was really surprised to see that the visiting nurse who came to see me when I needed IM antibiotics brought her own bottle of hand sanitizer with her.

If it's important enough for you to have your aides wear gloves for your protection, you'll provide them if the aides aren't bringing their own. For me, $12 every other week, on top of providing soap and water and hand sanitizer, is a cheap investment in my health and well-being.