Those Not-So-Independent Independent People

[Purple_roses]

The first year of my home-care job was cushy, I must say. My agency completely works around my school schedule (such an enormous blessing), and I get to provide one on one care to my clients. I've been able to see people through their good and bad days, and at the end of the day, I just feel GOOD. I feel fulfillment. I've gotten along with every client and every relative, and am often specifically requested. But as that one year mark passed, I feel like the universe said, "Ok, we gave her one good year. Let's stress her out a little more."

I swear, I've lost my mojo. Lately I have had client after client who does not want assistance with anything. They feel they are capable (and most of them truly are), and one of them even has three signs posted throughout her apartment that reads "if you don't lose it, you will lose it!" So I respect these clients' wishes to be as self-sufficient as they can possibly be, while standing close enough to intervene should something go wrong. The problem is, these clients tell their relatives that I am not doing anything to help them. One lady told her daughter today, "She doesn't help me enough." Mind you, I always ask this woman if I can help her (for instance, help her stand when she seems shaky, help her dress, get items off a counter for her), and she almost always says "no, I can do it myself."

So what do you do when you're working with an elderly person who is yearning for as much independence as possible, but also wants to be waited on hand and foot (but won't tell you this)?

[A&Ox6, MSN, RN]

I think that this is a major issue in all areas of customer and client care. It is your word against theirs, and as such you just document offers, and recognize that they may need you to give them a feeling of independence while secretly helping them.

[caliotter3]

Have a frank talk with the family away from the patient so that they know what is truly going on and that you are concerned. If the situation is not able to be dealt with and/or gets worse, then you must make the decision to find another case. Sure, it is fine to stick around until the family complains about you and tells the agency they don't want you back, but the agency really does hold it against you. Sooner or later, leaving cases at the request of the patient/family bites you no matter how much the agency tries to reassure you. Better to leave on your own terms. Yes, they will hold that against you too, but it takes longer for the agency to take it out on you. Meanwhile, get on with another agency, so that you have something going on elsewhere to keep a paycheck coming in. This is all part and parcel for extended care home health.