Family refuses to put safety measures in place

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Hello, I am new to home health, and work in homes as a home health aide.

Currently registered with a nurse registry, still wondering how this works.

I have a client whose wife refuses or is in denial that her husband needs to have a chair in the shower. Right now when he rinses his hair, he has to do a back bend just to rinse his hair.

I saw that and I freaked out.

Oh my, its just a matter of time before a fall.

They are willing to get him non slip shoes, but so far no shower chair or hose. And when he walks, he hangs onto the bureau and the walls, etc. refusing to use his cane.

The wife said he only uses the cane when he goes outside.. I don't think so.

I think denial is very big here, what do you all think?

Since I am on my own, I have no one to ask.. I am not sure if the nurse registry will work with me since I am a contractor...

Any advise is appreciated.

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Specializes in Critical Care.

Our role isn't to make people as safe as possible, if that were the case we'd all being using shower chairs and for that matter, we'd all being wearing helmets in the shower or better yet not showering or ambulating ever.

Our role is to facilitate safety in the settings of whatever level of independence the patient, or their decision maker, desires. If we're taking away independence to provide a level of safety that the patient doesn't want, then we've failed as patient advocates.

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What is nurse registry?

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I wish I had one if those inspiring magical answers. All I can think of is doing a lot of therapeutic listening. Ask open ended questions, which I can never think of? Listen to the wife (and husband....I am not sure who is making these decisions?). Use I statements, as in I am concerned he might fall, not you statements as in you should be, or you need....

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What is nurse registry?

I think it's like an agency,

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What does his care plan say? Does he have a care plan?

There could be many reasons ranging from denial to fear of loss of independence to not knowing where/how to get a shower chair.

MunoRN is right, we cannot force people to do anything they don't want to do. In other words, this patient has a right to fall in the shower.

As a Home Health Aide, it is outside your scope to intervene here, but what you can and should do is report your concerns to your agency.

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I honestly don't understand. If a family ask for help from a nursing registry, if they want a CNA to come to their house to help. Then the aide helps by saying "you are unsteady on your feet, you may (will) fall in the shower, I will get you, (help you to buy) a shower chair." Then the family says no we don't want that......well what happens when the patient falls in the shower. I think the blaming (suing) will start.

It is fine to not force anyone to do anything against their will. But if a person asks for, pays for, signs a contract for, some help then does not want to do anything the "help" suggests then the "help" needs to say, sorry this nurse patient relationship is null and void and exit the premises.

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Specializes in ortho, hospice volunteer, psych,.

As someone who became severely disabled a decade ago, may I present a slightly different perspective? After I came home from stroke rehab, I still had daily PT, OT, and speech therapy for three years. Each PT told me the same thing. After the cane replaced my hemi walker, once they had determined that I was steady enough, I was to use the cane outdoors and to walk without it inside, holding on to things if I felt it necessary. Now I use the hemi walker during the winter when I'm outside or my wheelchair or my electric cart. In good weather, I use the cane outside and walk holding on PRN inside. Oh, and YES, I use a shower chair!

How about suggesting to your nurse that she ask for a PT consult?

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Thanks for all your advise, I did have another talk with the wife, and we are working on getting a chair and some non-slid mats too.

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Specializes in Medical Surgical.

I think alot of people refuse things in the home, because they feel they can't afford it, and are not aware that sometimes the agency pays for them. I have people refuse stuff all the time, then I say we pay for it, and they say "oh, ok then".

And if your agency doesn't pay for it, then you really can't blame them for saying no.

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Specializes in ortho, hospice volunteer, psych,.

Another reason people refuse adaptive things is because that would mean that their condition is real. I tried to resist but my husband and family pushed back. The patient also needs to have shower bars or handles to grab. Here they're called grab bars.

It's so hard to admit to yourself that you need all that stuff. My cousin who has advancing MS is having that problem now. She and her husband moved into a one story house last year. She will need a shower she can use from a wheelchair eventually, but absolutely refuses. She has a handicapped placard but will NOT use it. She will NOT use a shower chair.

I know, in my case, the resistance lasted about five years then my pride just said the heck with jt. I know, at least with me, some of it had to do with not wanting to feel old. Dumb, but could that be part of your patient's resistance?

If finances are the issue, here the VFW assists when the person is a vet.

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A nurse registry is just where you sign up and after they find you work, you are basically on your own. That's what they told me..

So, I don't feel comfortable working on my own since I am new to Home health.. I need to be able to ask question to a nurse at a home health agency as opposed to a nurse registry..there is a difference.

Nurse registry, you are on your own, like you have your own business and they just send you out as per diem. It was wrong for my school to send me out to this place, what were they thinking?

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