Joanne Pinder, of Mastic, is accused of taking the $7,000 Rolex and replacing it with a cheap fake one.
The 86-year-old Bellport Village man for whom she was caring noticed the watch had been switched and called police.
Police say the real watch was found in Pinder's car.
Pinder is charged with fifth-degree grand larceny and aggravated unlicensed operation of a motor vehicle.
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