Vent session..any advice?

[augiebear]

Ok, so I am a home health aide and have been with the same client for over 6 months. The client is an especially difficult one at times but very sweet also. I am with her most often but there is one day that someone else from my company comes and in the past month or so, over 5 different people have tried but none are sticking with it. I stick with it because I empathize and genuinely care about the client and enjoy a challenge.

That being said, home care is also very BORING! I enjoy my job even though the client is very difficult at times but it is very slow paced and I would rather work in a fast paced setting. But, this job has flexible hours which work well with me since I am a student. I plan on quitting when school starts in August to concentrate more on school, but recently I have been feeling miserable about my job and I don't know how much longer I can take it! I know that I will most likely stick with it, it is just a few more months, but if anyone has any advice that would make the last couple of months more enjoyable, PLEASE share. Here are some issues bothering me:

First, the daughter that my client lives with just might possibly be the most irritating person I have ever met. She wants her mom to stay with her but does not want to care for her. She does not spend time with her mom and just has us there so she can work and go out with her husband(they are an older couple). This service is free for her via insurance but she milks it for everything plus some. She acts like she is "stuggling to survive" but truth be told they are well off living in a fancy neighborhood, in a almost million dollar house.

She is also very manipulative. On more than one occasion she has tried to bribe me with gifts to work for her outside of my company so she and her husband can go on yet another vacation(about 7 vacations in the past 6 months). Then, she says she cannot afford my company(the same week, she bought a brand new Mercedes Benz) When I tell her it is against my company policy she gives me a guilt trip.

Her mother has late stage alzheimers and talks a lot and has a lot of hallucinations. The daughter has told me that I need to tell her to shut up or else she will make it a habit.. A HABIT?? She has ALZHEIMERS for godsake..I told her that I do say shhhhhh but it doesnt help..5 seconds later she will be doing it again..

For my sanity, I let her go unless it is really bad or else I'd be sshhhhhhing her ALL DAY, with no progress, which seems pointless to me, it is not like she can help it.

Recently, the daughter said that her mother is getting LAZY to walk..are you kidding me???I could not hold it in any longer, I told her it is not that she is lazy and that the way that she walks is common with dementia patients and that she has a very bad disease, some days are better than others, she cannot help it. That shut her up.

They are constantly rushing my client, going to the commode or whatever. She uses a walker and when we are walking I go very slow for her. But when the daughter is there, she pushes her moms butt and back and tells me to pull, pull, pull (the walker). Last week, her mom fell to her knees because she was being pushed from behind. I was so ****** but I don't know what to say. I am in their house and don't want to be rude and tell them not to do something but I am also responsible for the safety of her mom, weird situation.

Then, she thinks I am her personal housekeeper and assistant, suggesting I iron her and her husbands clothes..HA..yeah right..

Everyday that I come in, the sinks have dishes in and the dish rack is piled high, I cant stand to look at that all day, so I wash and put them away, even though I should be washing and putting away her mothers dishes not the entire family. I do not use the dishwasher but they do and when it has been washed, she tells me, "oh, these are clean, I just washed them" and tells me to put them away. I have never said no I just don't do it. It is not that I am lazy it is just the principle of the matter, to have the nerve to ask me that, they are not her mothers dishes and I am there for their mother not for their personal use!

Recently, she asked me to work a day which I go to school and she knows that and when I said no, she gave me a huge guilt trip. I was sooo mad. I told her sorry but I am not going to sacrifice my grades.She shut up.

I know this is pretty long but the list could go on and on. And yes, these are issues I have with the family not my client necessarily, but in home care, the family is also important to get along with especially when you are in their home. I just feel like instead of being grateful for me and how well I take care of her mom, she is constantly trying to take advantage of me. It is not like I get any recognition or appreciation from her mother which she cannot help because of her disease, which I realize and am cool with, but then to deal with this family who is not appreciative either and has no disease as their excuse, only selfishness and ignorance..I do it for the rare smile and thank you from my client..who by the way doesnt speak english and I have learned their language..

I am so fed up with this lady that I am unsure what will come out of my mouth next, and try with every ounce of me to keep my mouth shut before I get myself into trouble.

Any insight or advice is greatly appreciated..thank you!

[NC Girl BSN]

OMG! You need to be more assertive and communicate more with your home health agency. I would go to the administrator and sing like a bird and tell them they need to talk to the daughter or you are not going back. I am sure that they can find you another client. I think that would be best so you can keep your sanity. I know those kind of people that you describe above. That is the main reason why I did not last in Home health. The ladies family that I was taking care of did the same thing to me a long time ago. They had me feeling so bad for them that they talked me into taking the client to Adult daycare every morning. Talk about being a dummy! And not to mention Lawsuit and breaking every rule in home health. That lasted about 2 months before I came to my senses and got the hect out of there. I recommend applying to a hospital or LTC PRN and leave that family before they have doing something crazy like I did. Good Luck and Congratulations on getting into nursing school!

[APRN., DNP, RN, APRN, NP]

You've described a very toxic work environment.

You've stated that "I am so fed up with this lady that I am unsure what will come out of my mouth next, and try with every ounce of me to keep my mouth shut before I get myself into trouble."

My advice for you is to re-evaluate the situation in these terms; either set limits with the daughter, or remove yourself from the situation.

The third alternative is to continue to endure the situation.

I'm thinking, from reading your post, that you've already determined that you're not going to get the support that you need from your Home Health Agency. However, that would be a most appropriate avenue to explore if at all possible.

[augiebear]

Thanks for your advice..just recently I have started on being more assertive..this was my first job in health care and my first client..so I definitely was not so assertive from the beginning..My home health agency really sucks..they don't ever check on me..I called in sick a few weeks ago because I was having terrible abdominal pain and on the toilet every half hour and all they could say was" oh, no I don't know if I can find anyone to cover the shift". After I said I might go to the ER, they said "why didn't you call earlier?" ..yeah..I guess it is worth a shot to ask for another client, but the agency is having so much trouble as it is filling in one day with my client that I am weary of what they might say. And then to complain and have someone talk to the daughter, and then go back there and would be kind of uncomfortable. I honestly don't think the agency would care that I am unhappy, they just want their shifts covered. I did tell them about the offering of gifts and nothing was done or said. It is actually like I am on my own. I know, if you don't like it quit! I'm not in the position to do that now and I can't start a new job only to quit when school starts in August..I was looking for any type of summer job, but the job market is at a stand still. I will probably stick with the client, and assert myself. But what about the pushing her butt stuff, should I say something when she does that and what should I say?

[NC Girl BSN]

You can say Mrs. X. I will tranfer and walk your mom. Its really not safe for you to push and pull on your mother while walking her. Thanks for trying to help.

[Whispera, MSN, RN]

Do you make notes that go into a chart or some record, about each time you visit? If so, I'd include such things in your notes. Besides the pushing incident being a rather unkind thing for a family member to do, t's possible if something happened to your patient in this or at any other time, YOU could be blamed. Anything out of the ordinary needs to be documented and given to the agency (with a copy kept for yourself). Do you have "incident reports" you can fill out?

As far as doing the chores goes, if you are providing appropriate, caring care for your client, why not do some of the chores, just to have something to do? You said it's boring to be there! Just make sure EVERYTHING you should do for the client is done and that the family knows that the chores will have to wait or remain undone if you need to do something with the client.

Does the client have a visiting nurse? Can you talk to the nurse about all of this, even if your agency isn't responsive? I do think you should talk to the agency people-in-charge too, though, since this is a rather sticky situation. And document things!

[augiebear]

thanks for the advice, next time she is pushing her from behind I will tell her that. A RN did the initial assesment at the start of the care..she did a pretty half a** job, leaving out some paper work. A LPN came 4 months later for MY annual check up, pretty much the only time they visit, and brought the missing paper work. We have flow sheets with the daily required assignments according to the care plan, which is our guideline to what we are supposed to do. We do have some housekeeping assignments which coincide with the care plan, for my client, is laundry, trash, and of course we are supposed to clean up after ourselves after using the kitchen and bathroom. I keep everything nice and clean, and do more than required by vacumming and sweeping and moping the kitchen. I do not vacuum the entire wall-to-wall carpeted house, just downstairs, where the client is. I don't mind the dishwasher stuff but the fact that she acts as if I have to do it is annoying and that is her and her husbands dishes not mine. I will have the kitchen clean with no dishes and everything put away and the husband will come downstairs and put dishes in the sink right in front of me or while I am washing/drying them. To do these things because I am bored, I feel, would make them take advantage even more, I mean, she actually wanted me to iron her and her husbands clothes, c'mon!! And the falling thing, I made a mistake, my clients other daughter was visiting and she did it, but they both push her from behind. The sister did not want me to say anything so I was in yet another weird position, the sister will be here for another 2 weeks. But, the next time I work, I will write it in the journal and hpefully they read it and stop pushing her!! Do you think that I am required to report the fall even though the sister was there?

[augiebear]

scratch that, she leaves on Tuesday!!I will let the other daughter know about the fall and take the oppurtunity to explain that it is not safe to push her from behind and that we need to adjust to her mom's pace..

[Magsulfate, BSN, RN]

oh wow...

I was a home health aide for about a month,, (that's all it took). I had three clients, and all three of them had very healthy family members living with them that could have done the "chores" I was assigned to do. It made me sick. I mean, I didn't mind at all cleaning my patient, feeding her, cleaning her room, etc.. but to wash the windows and dust the baseboards, do the dishes and COOK FOR THE WHOLE FAMILY??? I don't think so.

I think if you start doing things when you're bored, like cleaning for the family,, then they will expect you to do it everyday. Pretty soon you will be busting your butt for those people, and your client will be sitting there ignored while you are playing maid.

Set limits. Even though you get bored, you are there for the client, not her daughter and son in law,, or anyone else.

[Batman24]

Pushing her is abusive. She's ill. I'd be clear that pushing her is completely unacceptable. I'd stop right in my tracks if they did that. If they keep doing it I'd get APS involved immediately. I have to even think about what goes on when you aren't there. Dear Lord.

Sit down with them and have a very frank talk. Not pushing and no verbal abuse. Period. She's ill and can't help it. I'd also provide them with some literature to educate them. Perhaps even see if there is a support group locally. I'd also draw boundaries about the chores. Doing their ironing is absurd. They shouldn't even be asking. You aren't maid service. You need to make it clear you are there for the patient and her needs not theirs. Let them know you'd like to be ab;e to work together so she can have the best life possible.

[augiebear]

thank you..exactly...I feel really disgusted with them and they do make me sick sometimes..but I try to put those feelings aside and just give my client the best care possible. I will address the pushing issue and next time they tell me to do something that is not my responsibility I will address it. If they give me any problems about it, I will notify my agency and hopefully get a new client or have them mediate the situation.

What makes me even more sick is that this daughter she lives with is her mom's POA and has her down as a full code!! She is late 80's with late stage Alzheimers..helllllloooooo...it is just so selfish, but what can I do? Nothing but give her the best care I can, too bad her family doesn't feel the same way. If I were in their situation, I would just be so grateful for having someone who really cares taking care of my mom so well, but no, not them. I just don't get it.

[catlynLPN]

Reminds me of something I got into once. I did some "private duty" with an elderly lady once. Was supposed to sit with her, be there if she needed anything, fix her some lunch, help her with her medications, just a few minor things like that is how it started. She was alert and knew everything, just needed a little help with some things.

I'd been there may be a couple of weeks or so, when they started in on me about doing some "yard work". They wanted me to get outside and "trim" back some bushes.

I don't think so! I quit. I don't intend to do any yard work like that for anyone.....I can't hardly even keep my own yard work done.

Why, that is a man's job and yes, she had a husband.

I could just see myself getting out there and tearing my clothing on those old prickly bushes and possibly getting contact dermatitis from handling the bushes and trying to move them.

That was above and beyond what they had originally asked of me and I didn't do it. If I had done that, no telling what they would have asked of me next. These were "rich" old folks and they could have afforded a gardener to come and take care of the yard work.