When Your Sexual Abuser Is Also Your Patient

First, this home care worker says she was harassed by a man she was helping. Then, she was fired for protecting herself.
Carley Perez tried to call for help when a home care client threatened her.
Carley Perez tried to call for help when a home care client threatened her.
Emily Peck

NEW YORK ― Carley Perez, a 26-year-old New Yorker who started working in the health care industry right after she graduated from high school, isn’t afraid of the intimate moments that home care workers must share with patients.

“I have changed adult diapers. Cleaned penises. You have to expect nudity,” Perez told HuffPost recently, talking at a crowded cafe near Manhattan’s Union Square on a rare day off. She emphasized that she enjoyed her work caring for adults with developmental disabilities and started volunteering to help kids with autism back when she was in high school.

But one of Perez’s male patients took that personal relationship too far.

She was supposed to help him navigate the tasks of daily life ― cooking, cleaning, shopping for food ― and to be there just in case. But last year, over the course of several months, he repeatedly made crude sexual comments, exposed himself and even masturbated in front of Perez in his Brooklyn studio apartment, according to a sexual harassment lawsuit she filed Friday. The suit, brought in the U.S. District Court for the Southern District of New York, is directed against her former employer, a nonprofit health care organization called the Center for Family Support.

The man was 6 feet, 5 inches tall and weighed 300 pounds. In the lawsuit, he’s identified only as “T.” He’d hold his penis in his hand and say things to Perez such as “I know you like it,” according to the suit.

“I did not feel safe,” Perez told HuffPost, her eyes wide with the memory of what happened.

Even during this Me Too moment, stories about women like Perez are rarely told. Bold-faced names and companies typically grab headlines. Low-income women don’t always have the time for hashtags.

When asked if she’s been following the news on sexual harassment lately, Perez, who shares custody of her 8-year-old daughter with her former husband, shakes her head.

Before she had her daughter, Perez hoped she could pursue a degree in nursing, following in the footsteps of her mother. But when T was allegedly harassing her last year, Perez was barely getting by, earning around $13 an hour, hoping for 40 hours a week and burdened by an unreliable schedule.

Although she still wanted to pursue an advanced degree, she said, “It’s hard to work full time and go to school full time.”

Paid About $13,800 A Year

Perez was working in a rapidly expanding industry. As the baby boom generation grows older, home care workers are increasingly in demand. Personal care aides and home health aides make up the country’s second and third fastest-growing occupations, according to a 2014 report from the Paraprofessional Healthcare Institute, a national organization that trains such workers and their employers.

More than half of these workers are women of color and one quarter are immigrants, the PHI report said. One out of five are single mothers.

Home care workers typically earn about $13,800 a year, according to a 2017 report from PHI. One in four live below the poverty line.

All of which is to say this is a vulnerable group of workers, often shouldering the triple burden of racism, sexism and near-poverty wages.

“Home care workers come into the workplace with various markers of powerlessness,” said Emily Martin, a vice president at the National Women’s Law Center. “No one is going to believe her if she says anything.”

And lawyers aren’t lining up to represent them.

Still, Perez did not hesitate to complain about T. She repeatedly told her supervisor about the situation.

CFS said it “vehemently denies” all of Perez’s allegations.

Alone At Night With The Patient

After complaining many times, Perez said she was transferred to a different patient in the same building where T lived. But then, over Memorial Day weekend last year, Perez’s supervisor sent her back to T’s apartment to cover a midnight shift.

The sexual harassment escalated into something more frightening.

After she arrived, T turned off all the lights, switched on the TV, sat down on the couch and started masturbating underneath a blanket, according to the lawsuit.

In response, Perez told T she was going to step outside so he could have some “alone time.” She waited in the apartment lobby for a while.

When she returned, T came out of the bathroom naked, penis in hand, according to the suit. “I know you like this,” he said, walking over to Perez and putting his scrotum on her arm.

“Once his skin touched mine, I knew I couldn’t deal with this,” Perez recalled to HuffPost.

“I did not feel safe.”

- Carley Perez

She told T to get dressed and she left the apartment. In the hallway, Perez frantically tried to get in touch with her supervisor, according to the suit. But it was then around 5 a.m. and he wasn’t picking up his phone or answering texts. She waited for word on what to do ― care workers aren’t supposed to just walk off the job.

About an hour passed with no response and Perez decided to leave. Hours later, she was able to get in touch with a manager and told her what had happened.

“What could you have done to prevent it?” the manager asked Perez, according to the lawsuit.

Perez was shocked. “She made it seem like it was my fault,” Perez told HuffPost. “I expected compassion. Or at least some sympathy.”

A few days later, Perez met with her supervisor and a human resources representative from CFS. She explained why she’d walked off her shift.

They fired her.

What Was She Supposed To Do?

Home care workers facing sexual harassment from patients ― or clients, in industry terminology ― are in a vastly different position from women being harassed in an office, factory or many other workplaces.

“The truth is that a home care worker is in a vulnerable situation being in a person’s home alone,” said Susan Misiorski, vice president of workforce innovations at PHI. “They are providing care and services that are personal and intimate. They might be bathing the person, assisting them with going to the bathroom.”

Clients may lack the ability to control their own behavior because of developmental disabilities or other issues like dementia or Alzheimer’s. “You can easily imagine how a person with cognitive impairment could misperceive such a situation,” Misiorski said.

The procedures for dealing with these kinds of situations should be clear-cut, Misiorski said. If a worker complains about the way they’re being treated, the employer needs to take action. The employer should officially assess the situation, interview the worker, send in a registered nurse or another expert to evaluate the client, and then make appropriate changes to the client’s care plan, said Misiorski, who was speaking generally and was not familiar with Perez’s specific situation.

For example, in a case where a male patient is being sexually aggressive to a female worker, the managing company could bring in a male caretaker instead. Or if an individual worker is afraid to be alone with a client, two people could be assigned to care for him, Misiorski said.

And of course, if the behavior of the client rises to the level of criminal conduct, that person should be reported to the authorities, she said.

“It’s five in the morning. What did they want from her? To go back in? See if it escalated further?”

- Daniel Bright, lawyer for Perez

None of this happened after Perez brought the problem with T to her supervisors, according to the lawsuit. “They basically shrugged it off,” she said.

At some point, she was allegedly told, “Don’t worry.” Perez said she wasn’t given any special training or instructions on how to handle T ― a best practice, according to Misiorski.

Perez said she did have training on how to deal with violent patients and how to prevent physical altercations. “None of that prepared me for what happened,” she said.

“We believe that sexual harassment of caregivers is more common than people think,” said Kristina Bas Hamilton, legislative director for the United Domestic Workers, a union representing health care workers in California.

It’s hard to know the scope of the issue for home care workers as there’s not much data on them specifically. However, we do know that workers in the industry more generally are vulnerable. Nearly 12 percent of the sexual harassment charges filed at the U.S. Equal Employment Opportunity Commission from 2005 to 2015 were by employees in the health care and social services sector. It was No. 4 on the list, behind the food service, retail and manufacturing industries.

Hamilton, like Misiorski, emphasized that when an organization is sending out a care worker, it has an obligation to make sure that worker isn’t going into an abusive situation. Yet that’s exactly where Perez found herself on Memorial Day last year.

Disposable Workers

Perez was devastated and outraged at the unfairness of her termination, but she tried to move on and find a new job. The problem was that other agencies didn’t want to hire someone who had been fired. It was a red flag.

Potential employers automatically assumed that Perez had abused a patient, she said. “They have to be cautious.”

She burned through her savings while she looked for work and had to leave the one-bedroom apartment she rented in Brooklyn with her daughter. She closed her bank account. The money was gone.

“I was looking at shelters,” Perez said. She was able to move in with her cousin’s family in Harlem. On the days when her daughter stays with her, they face a 90-minute commute back to the little girl’s school in Brooklyn. Two trains and a bus, Perez said.

A friend helped her find a lawyer willing to take CFS to court.

“Workers in this industry are treated as if they’re disposable, not like human beings with families who need to pay rent and eat,” said attorney Daniel Bright. “What is someone in her situation supposed to do. It’s five in the morning. What did they want from her? To go back in? See if it escalated further?”

In the lawsuit, Perez argues that CFS was negligent and disregarded her safety, exposing her to sexual harassment, assault and a sexually hostile work environment.

Bright said CFS has refused to settle the case and is taking the position it did nothing wrong.

Perez is now working two part-time jobs ― cleaning office buildings and handling security for a music venue in Manhattan. She doesn’t know exactly what she hopes from her lawsuit, beyond a recognition that what happened to her “was wrong,” she said. “I want what’s fair.”

But she hasn’t given up on a future in nursing or going back to her old job. “I miss it,” she said. “I miss being in that community. Helping people. It was like my comfort zone.”

Are you a home care worker and would you like to share your story? I’d love to talk to you. Email me: emily.peck@huffpost.com

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