Lots of good advice here Brenda. At the end of the day you are going to need to be the one that takes care of this situation. No matter what the real story is behind your relationship ( or lack of ) with this person - it's toxic for you to be where you are. You need to either remove yourself from the work environment or get 100% assurance that this particular person will not be involved at all. The former would most likely be better. What happens to the woman you care for should not be of concern - her care is a contract between her and the agency you work for, not a contract between you and her. They will find another person to care for her, and if they determine that being in a nursing home is the correct solution then that's what will happen. Nursing homes are very capable of caring for people too -it's their job.