(Photo: Kacso Sandor/iStockphoto.com)

A home health aide for a woman suffering from Alzheimer’s disease can’t sue the homeowners over a job-related injury, the California Supreme Court has ruled.

The court—possibly the first in the country to address whether in-home caregivers for Alzheimer’s patients can sue under such circumstances—concluded that Carolyn Gregory bore the same “primary assumption of risk” as a caregiver who worked in a hospital or other institution.

“California and other jurisdictions have established the rule that Alzheimer’s patients are not liable for injuries to caregivers in institutional settings,” Justice Carol Corrigan wrote. “We conclude that the same rule applies to in-home caregivers who, like their institutional counterparts, are employed specifically to assist these disabled persons.”

Monday’s opinion called upon the California Legislature to consider laws that would better protect caregivers—particularly since Alzheimer’s patients have been known to become violent.

“The number of Californians afflicted with this disease can only be expected to grow in coming years,” Corrigan wrote, joined by Chief Justice Tani Cantil-Sakauye and two other colleagues. “Training requirements and enhanced insurance benefits for caregivers exposed to the risk of injury are among the subjects worthy of legislation investigation.”

Gregory sued after her client, Lorraine Cott, 85, came up from behind her as she was washing dishes. In attempting to restrain Cott, Gregory sliced her own hand with a large knife. Lorraine’s husband, Bernard Cott, had told Gregory that his wife could be “combative and would bite, kick, scratch and flail.”

Gregory, who worked for a home health care agency, sued the Cotts for negligence and battery. Los Angeles County, Calif., Superior Court Judge Gerald Rosenberg granted summary judgment against her, and was affirmed by an intermediate state appeals court.

The California Supreme Court affirmed both lower court decisions, citing public policy changes in recent years that discourage institutionalizing the mentally disabled.

“The majority opinion walked carefully through some very difficult issues and arrived at a decision that is consistent with prior law and fair under the circumstances,” said Margaret Grignon, a partner in the Los Angeles office of Reed Smith who represented the estate of Bernard and Lorraine Cott, both of whom have died.

Gregory’s attorney, Alexander Petale of the Law Offices of Alexander J. Petale in Los Angeles, acknowledged that the decision was based on public-policy considerations.

“Their primary consideration was staying away from decisions that would discourage in-home caregiving in the future, because the burden on government entities and care facilities is very high these days,” he said.

But the court limited its ruling to professional home health care workers who are trained and employed by an agency—not all caregivers.

The decision does not apply, for instance, to caregivers hired directly by homeowners or to situations in which caregivers aren’t adequately warned about risks, said Matthew Stark Blumin, associate general counsel of the American Federation of State, County and Municipal Employees in Washington, which filed an amicus brief in support of Gregory. San Diego’s United Domestic Workers of America, which represents home-care providers, is part of AFSCME.

“Obviously, we’re disappointed that the court created the rule that it did,” he said. “But we think it’s important to emphasize that the court’s decision was limited in scope.”

In a dissent, California Second District Court of Appeal Associate Justice Laurence Rubin, sitting by designation, concluded that families that chose home health care for Alzheimer’s patients over institutions should bear the burden of potentially being sued.

“I agree society should avoid institutionalization when better alternatives are available,” Rubin wrote. But that goal, he said, should not “be subsidized on the backs of low-paid in-home caregivers.”

Contact Amanda Bronstrad at abronstad@alm.com.