Client's home has rodents and a biting dog

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Hello. This question has to do with home health.  I do respite hours for a young adult woman.  We go out in the community and spend time in her home which she resides with her parents.  Over the course of 3 years the mother has stopped deep cleaning the  home and there is now a rodent infestation.  They got an "emotional support" puppy which they trained poorly and has now bitten my patient,  drawing blood.  Any advice?  I am trying to advocate for some housekeeping help but I haven't mentioned  this yet to the mother.
Thanks

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Specializes in Tele, ICU, Staff Development.

Most home health agencies have protocols for situations involving health and safety risks, including those related to animal behavior, unsanitary living conditions, or other potential hazards in the home. These protocols generally exist to ensure patient safety and staff well-being. 

Reporting Safety Concerns

Reporting safety concerns, such as dog bites, rodent infestations, or unclean living conditions, is standard practice for the agency's case manager or supervisor.

Agencies often have a formal reporting process where employees (like yourself) document incidents. If a dog bite or other serious issue occurs, you may be required to complete a safety incident report.

Involving the Agency's Social Worker

Home health agencies often have a social worker who can intervene when there are concerns about the living environment, such as unsanitary conditions or unsafe pets. The social worker can help facilitate communication between the family and the agency and work on solutions to improve the home environment.

If the issue involves neglect, the social worker might also recommend contacting Adult Protective Services (APS) or other local resources.

Addressing Health and Safety Issues

Home health agencies typically have guidelines for what constitutes an unsafe living environment. These guidelines include infestations, unsanitary conditions, and pets that pose a risk.

If a rodent infestation or aggressive pet occurs, the agency may provide guidance on addressing the situation (such as pest control services or animal behavior training) or recommend that the family seek outside help.

 Protocols for Animal-Related Incidents

Most agencies have a protocol for responding to bites if an emotional support animal or pet bites a patient. This protocol could include first aid procedures, filing an incident report, and contacting a doctor to assess the injury.

If the pet poses a danger to the patient or other caregivers, the agency may recommend temporarily removing it from the home or providing resources for addressing the pet's behavior.

Communication with the Family

Agencies encourage staff to communicate concerns professionally and non-confrontationally, always framing them as patient safety.

The agency may mediate or facilitate further interventions if direct communication doesn't resolve the issues.

Escalation

If the situation doesn't improve after the agency's intervention, it may escalate to Adult Protective Services (APS) or other authorities to ensure the patient's safety, particularly if the environment is deemed neglectful or abusive.

Next Steps

You may want to:

  • Report the situation to your supervisor or case manager, detailing the dog bite and rodent issue. This will trigger the agency's protocols for addressing safety concerns.
  • Request additional resources or interventions, such as pest control, housekeeping help, or a referral to a pet behaviorist.
  • If necessary, suggest involving a social worker or APS to ensure your patient's home environment is safe. Your client may also have a case manager through her insurance, who should be consulted.

Best wishes,

Nurse Beth

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