A recent ruling by a state’s highest court serves as a warning to home-care workers to think twice before taking on patients with certain physical and psychological conditions.

The California Supreme Court decided 5-2 that the family is not liable for injuries inflicted by a patient with Alzheimer’s disease on a home-care worker, as long as the home-care worker was told beforehand that the patient was likely to become physically aggressive. Biting, kicking, and other acts of physical violence are typical of late-stage Alzheimer’s disease, a fact that a qualified home-care giver should be aware of. In this case, the worker in question was given advance warning by the employer regarding the proclivities of the 85-year-old patient.

The court decision is based on the assumption of risk doctrine, which effectively prevents the injured party from seeking compensation for injuries sustained in carrying out the duties of the job while in home care because they are presumed to have known what they were getting into when they took the job. The doctrine is already in effect in institutional settings, and the court concludes that the same argument applies to the home setting.

The ruling restricts applicability to home-care workers that come from an agency, where the worker would have workers’ compensation insurance to fall back on after an injury. However, the two dissenting votes maintain that the reasoning behind the ruling can be used to apply to direct-hire caregivers who would have no workers’ comp or access to civil litigation for personal injuries. In addition, the ruling makes it easy for family members of a patient with certain conditions to disregard the costs of in-home care to others. They are more likely to favor in-home care because it is more expensive to place the patient in an institution.