Unsanitary Condtions in Home/Can I refuse to take case

I agree that this client should be referred to agencies that may be able to offer some help. I also agree that you should not be expected to work in these conditions. If you're spending 8 hours a hay with this person, this tells me that they are probably quite vulnerable and may be unable to properly clean their home. Not to mention the risk to their trache. The key though is detailed documentation. I think you should put, in writing, your concerns of this person's living conditions to their health so that hopefully the home help can be swift and thorough. Of course, don't forget to ask the client whether or not they will accept people coming in to clean up for them and document this discussion also.
The reason I say to document everything, is so that if the patient dies of some horrendous infection they've picked up in their home, you can be cleared of neglect as there is proof you've done what you could to help. Also, if your employer starts to mistreat you because you've finally decided to refuse the case, again you have proof that you were put in unsanitary conditions and that it is wrong to be unfairly treated when you have your own health to protect. I hope this helps.

Wow... these cases are always reported at our agency. We hit every agency out there to step in. If all else fails, we try APS... whatever it takes.

The owner of our agency has personally had roofs put on homes that were leaking on the patient, she has personally had repairs done to old flooring which was breaking through... I can't begin to name all the things she has personally tended to for our more unfortunate patients.. just "because" She is an amazing woman.

But as to the sanitary conditions (or lack thereof)... yes... something must be done to protect the patient, first and foremost. Your MSW should be out there checking on the reported conditions and taking it from there.. that is HER job. She knows what resouces are available, what the options are.

This sounds, really, really bad. We've had a handful of bad ones, too...I believe all HH nurses have seen some shockers out there from time to time. Sad, really.

While I do agree with the posts, it is important to remember that some people do not want our help when it comes to cleaning. There is mental illness that expresses itself in hoarding, etc. So, even if you make all of the appropriate calls the patient may not agree to any assistance. Sometimes we are left with either discharging the patient or agreeing to meet him "where he is" and try to help there.