Working as an HHAide for a licensed Home Health Agency. Client has diagnosis of Alzheimers. No skilled care in the home. No Medicare licensed Home Health Agency in the home. Client is lucid, firm, and articulate in refusals of Personal Care... shaving, incontinence care, baths, brief changes etc. How should we handle this? Nurse manager states we are to assist and support family, and explains this is not like working at a facility. Family is very firm with, "Go shave him now!" or "Change his diaper now" which prohibits any "go with the flow... pick your battles" type one on one care. Client becomes combative when pushed. He will sweep our hands away, push us back.
Where is the line between abuse and neglect here? We want to provide care but the family makes it hard. Most of us feel more confortable, when we have no support from Nursing Management or family, to accept clients wishes, mark the refusal, and leave him wet and unshaven.