Not every patient is hard to manage. It is true that you may have some hefty ones, but not always. It all depends on the case. Most times, it is more relaxing and you can give much better care to one patient than many. However, depending on the circumstances and environment, it may not be worth it.
I can give several examples; a home filled with roaches and vermin, family that makes you miserable, the location may be too far, dangerous neighborhood, or the client may be an SOB.
When I was a home health aide, one situation was so compromising that I had to leave within a week. This woman gave the story that she is 'flexible', however, there were several factors that I didn't like. I had two cases, within blocks from each other. One case was 9-1, the other was 2-6, both were Monday thru Friday. The 2-6 lead me to believe she was 'understanding', but she would ask that I come 'early', but it interfered with the first case. Then...and I hate to say it, she was racist. She felt that each time a Black person used her bathroom, it had to be sanitized with bleach, Lestoil and then, sprayed (she actually said this to me). That felt degrading. Then, once, I took her to a doctor's appointment around the corner from her home and we were finished in less than an hour, so, she told me I can leave. The next day, she told me that because she let me leave, I was obligated to come to work on Saturday to make up the time. I declined. When I said no, she faked a fainting spell (almost like Fred Sanford's "Big One"). She told me that she is surprized that I looked decent, because most Black people didn't. After 4 days of this, I called the agency and told them I wouldn't return the following week. She was an ambulatory, independent woman, but it was not worth my pride to go to work feeling like this every day, and I was a young girl...about 19. And, the other client was so sweet, that I knew she didn't deserve for her time to be cut because of this selfish woman. It is one thing to take abuse in a facility, where you can eventually move on to the next person. It is another when you are in their home, their space, and THEY rule.
Some try to get you to do more than you are supposed to, such as painting, move furniture, or shampoo carpets (seriously!)
Each situation is different and unique. When I did home care as a nurse, it was a bit better, but eventually, due to other reasons, it was best that I didn't bother with it for awhile.