Down Syndrome Help!

  1. Hello-
    I posted this also in the development disability forum..so I'll just see how it goes. I just started Home Health Nursing and I love it. My main case is a 9 year old boy with Down Syndrome and Autism. I love him to death but there is a little bit of a problem...behavior. He'svery mentally handicapped but still able to use sign language so I know he somewhat knows what's going on. He's constantly biting, scratching and pinching. He is INCREDIBLY strong for his size. I've left there with bruises that cover the width of my arm and scratches everywhere. We've tried putting him in "time out" but that's becoming ineffective. It all seems to be a big game to him. Another thing...he's his mother's baby...she babies him all the time. Time out is basically the only punishment he has...and then she tells him "good boy" whenever he gets out, which totally defeats the purpose. I will be honest..one time when he pinched me I smacked his hand..not hard or anything, I wasn't abusing him but more like self-defense. His eyes got big and he stopped for a while. So I questioned the mom asking if that was a technique that we could try and she said "Oh no, I don't like that...some people might not know what a light smack is." So basically all the nurses are between a rock and a hard place. He KNOWS what's going on...he laughs everytime he does it and laughs even more when I sign "that hurts!" I know I sound mean, but he honestly knows enough to know the difference between right and wrong. Discipline is the major part..so anyone have any similar experiences or have any suggestions? Any will do...I'm so frustrated...I look like I've been beaten. Some of the nurses have demanded raises for taking care of him, myself included. Any help...please?
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  2. 3 Comments

  3. by   renerian
    For me, I would not stay on the case, even though I like kids. Anyone who starts hitting me, biting, kicking, scratching and such, in a Home Health situation is in for trouble. The violence could escalate and you could be at risk and not only that if your ever there alone with the child, something could happen.

    That is just my opinion.

    renerian
  4. by   ShortyLPN
    Quote from renerian
    For me, I would not stay on the case, even though I like kids. Anyone who starts hitting me, biting, kicking, scratching and such, in a Home Health situation is in for trouble. The violence could escalate and you could be at risk and not only that if your ever there alone with the child, something could happen.

    That is just my opinion.

    renerian

    Thank you for your reply. We are currently trying to get him in with a behavior specialist. The only problem is..noone wants to pay for it. They say my company should pay for the eval because the nurses are involved. My company is "discussing" it..we'll see how far that goes. And medicare won't pay because he has the dx of medically fragile not behaviors. I don't know. I do know that if he does see this specialist and nothing improves. I'm out of there for sure.
  5. by   renerian
    I have never heard of a home health agency paying for patient testing. They are gaming your agency. If he has Medicare they may not pay. Does he has some type of Medicaid coverage? I would think they would but not the agency. NEver heard of such a thing. Be careful.

    renerian

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