I just got a job working as a home health aid for a lady who has about a month to live. I'm super nervous and have NO experience. I'm working the night shift 10pm-8am... they say she stays up alllll night. her meds keep her awake and make her agitated they said... and they told me she always wants coffee (eeek, I have NO clue how to make coffee.lol)
I'm kinda shy, so I just dont really know what to say and what to do. any advice?
Mar 10, '12
Been there, done that, though not with a terminal patient so close to the "end".
First you need to be well rested, fed and ready to work upon arriving for your shift. Though natural tendency is for most to sleep during the night hours that is not possible when on duty especially in this situation.
As you've been told beforehand the patient likes her coffee contact the agency and find out how it's made (drip, perc, etc..) and learn now. Ask your mother, grandmother or someone, then test a few pots to make sure you've got things down.
Arrive for our shift on time and ask the NA you are relieving pertient questions about your patient. Did she eat and or drink anything? Are there any ongoing problems/areas of particular concern the family or doctor want you to watch for. If vitals are required were they taken and when? Anything abnormal. Were her linens changed that day? And so forth.
If you haven't been introduced before starting your first day, let your patient know who you are and what you'll be doing. Assess your patient visually and the surroundings. Did the previous shift leave everything as it should be? Do you have at hand any supplies you might need for the night? If your agency requires you check in upon arrival don't forget to do so,and at that time voice any concerns you may have that relate to patient care.
The important thing to remember is you are there to do a job. Many treat home health work overnight like some sort of babysitting gig. That is patient will be "put down asleep" and then they (the sitter/NA) will be free to study, do homework, raid the fridge, chat on telephone or sleep.
Mar 10, '12
Is this lady actually a patient of a hospice program in your area, or is she just near the end of her life? The reason I ask is that if she is admitted to a competent hospice program, they would be working hard to manage her symptoms and find a way to help her sleep at night, and they would definitely be trying to manage her agitation, as opposed to just passing the word along that she stays up all night and is agitated. If her meds are indeed what is making her agitated, then why is she on those meds? These are all things that hospice should be addressing.
I think the key here is getting her meds regulated to the point that they manage her symptoms appropriately. If she were sleeping at night, she wouldn't be up asking for coffee.
Also, with both of the hospices that I have worked for, the HHA's don't stay all night, they stop in and provide personal care visits during the day. They would never be expected to make coffee, it isn't their job. That would be something that a hospice volunteer, family member, or ATC paid caregiver would do. Are you a HHA employed by a hospice company or a paid in-home caregiver? That would make a big difference in what your duties are.
I wish you luck. Spending the night with an agitated lady who won't sleep and wants hot beverages all the time sounds daunting, even for an experienced caregiver.