## Facts

- Bernard Cott arranged for in-home caregiving services for his wife, Lorraine Cott, an elderly woman with advanced Alzheimer’s disease.
- Carolyn Gregory, an experienced home health care worker familiar with Alzheimer’s patients, was assigned to provide care in the Cotts’ home.
- While Gregory was washing dishes and holding a knife, Lorraine became agitated and suddenly moved toward Gregory, jostling or grabbing her arm or hand.
- The contact caused the knife to cut Gregory’s wrist.
- Gregory sued Bernard and Lorraine Cott asserting negligence, premises liability, and battery, alleging the Cotts knew of Lorraine’s agitation and aggression and failed to take measures to prevent injury.

## Issues

1. Whether primary assumption of risk bars negligence and premises liability claims by a professional in-home caregiver injured by an Alzheimer’s patient’s disease-related conduct when the caregiver was hired to manage such risks.
2. Whether the rule limiting liability for patient-inflicted caregiver injuries in institutional settings applies equally in private-home caregiving arrangements.
3. Whether, on these facts, the Cotts owed any duty to protect Gregory from the risk that caused her injury.

## Decision

- The California Supreme Court affirmed summary judgment for the Cotts.
- The court held that Alzheimer’s patients receiving in-home care (and those who hire caregivers for them) are not liable under negligence or premises liability for injuries to professional caregivers that result from symptoms of the disease when the caregiver was retained to confront those risks.
- The doctrine applied regardless of whether care is provided in an institution or a private home.
- The court emphasized the ruling is limited and does not foreclose liability where defendants fail to warn of known risks, increase risks beyond those inherent in the work, or cause injury unrelated to the disease’s symptoms.

## Legal Principles

- Primary assumption of risk limits duty: when a risk is inherent in an activity or occupation, the defendant owes no duty to protect the plaintiff from that risk.
- A settled tort principle bars recovery by persons hired to manage a hazardous condition for injuries caused by the very hazard they were engaged to address.
- In late-stage Alzheimer’s caregiving, agitation and physical aggression are foreseeable symptoms and constitute inherent occupational risks for professional caregivers hired to provide such care.
- Public policy favoring noninstitutional care supports applying the same no-duty rule to in-home caregiving to avoid creating incentives to institutionalize disabled persons.
- Liability may still exist where defendants (a) fail to warn caregivers of specific known dangers, (b) increase the level of risk beyond what the caregiving role inherently entails, or (c) expose caregivers to hazards unrelated to disease symptoms.

## Conclusion

The court held that a professional in-home Alzheimer’s caregiver injured by the patient’s disease-related agitation could not recover in negligence or premises liability because the risk was inherent in the caregiving work the plaintiff was hired to perform, so the defendants owed no duty as a matter of law under primary assumption of risk.


Gregory v. Cott, 59 Cal. 4th 996 (Cal. 2014)