Home Care Aides: Stay busy?

[CrazierThanYou]

• Hello all. I am curious and would like to get some input from other CNA's who do home health care. I currently stay with a lady who gets 6 hours of care per day. The actual care I provide probably takes an hour or less unless it is a day when she wants a bath. The rest of the day I am talking to her, watching TV with her, reading, studying, whatever. I had a client in the past who got 8 hours of care per day and wanted me to do nothing at all. No cleaning, no care for her, nothing. So, I mostly read and talked with her for 8 hours a day. Same thing with every client I have had.
  
• I am finally getting to my question. Do those of you who work in home care actually stay busy throughout the day? I've never had a single client that required me to do more than 1-2 hours of work in a day. Frankly, I feel a bit uncomfortable sitting around reading or whatever. I know some aides who don't even do what is on their client's care plan but those are obviously good-for-nothing aides who are looking for an easy job.
  
• If I ask other aides if they stay busy, they all swear they are working non-stop all day. I always say "Doing what?" but they can never get a straight answer.
  
• So, do you guys find yourselves with downtime? Do you feel comfortable with that (assuming you have done what you were supposed to have done)?
  
• Thanks!
  

[caliotter3]

If you have done everything assigned to you on the care plan and the client wants you to just visit with them and keep them company, then you have nothing to feel guilty about. Companionship is a legitimate part of the job. You might want to have a discussion with your supervisor about this. But be careful because you could talk yourself out of a job if the nursing supervisor takes steps to cut your hours. As I said before, it is ok to keep the client company as long as you perform all the care called for on the care plan.

[dannyc12]

This sounds like some very good feedback for your case managers (not your fellow HHAs). You should be documenting on your visit notes what you did and how you spent your time in the home. Your notes should be a version of what you posted here: "Did cares for one hour. Watched TV with client for 2 hours. Read for one hour. Studied for one hour. Reminisced with client for one hour."

Any care planned activity the client refuses should be noted by you. The case manager reviewing your notes should see the hours of non-therapeutic activity and adjust the care plan accordingly in the next review.

If they just want you there to supervise the client, then make sure they document that so you are not on the hook when someone blows the whistle on the wasting of private or public funds.

One of the very best things about working as a HHA is the autonomy. But this means you also are responsible for spending your time wisely and documenting what you do.

I work as a Home Health Aide and most of my visits are for one hour. After working on a TCU in a nursing home for two years, having an hour to get ONE person showered, dressed, and treated is plenty of time. If I have longer visits (~3 hours), there are additional activities planned: meal preparation, ambulation, xROM, exercises, laundry, cleaning of all types, shopping, medical supply stocking and organization, other housework, etc...

If I had a client refusing so much (or had so few activities planned compared to the time allotted) that I was forced to do ZERO therapeutic work for hours on end, I would call the case manager immediately and ask for direction. If the case manager did not respond, I would contact my department manager, who would be fairly p!ssed off to hear about HHAs doing a whole lot of nothing. She came in a couple years ago to address some of that kind of stuff and she cleaned house.

I am lucky to work for a very good organization that puts in the work to hold employees accountable for their actions and documentation.

Good luck!

[newcnaki]

This was a great find, thank you! I'm a new independent HHA to a senior who watches tv all day, complains and then naps. I'm mostly here as a safety precaution than an aide :/ I feel like I'm wasting the families money. The house is not the clients and it is meticulously clean. I do dishes as we go, but now that shes napping for 2-3 hours....what do I do?

[mvm2]

This can be very common for home care. the times I stay completely on the go all the time are my 2 to 3 hour shifts. Then am there for maybe in the morning getting them ready for the day, breakfast, shower perhaps, and maybe a few household chores, then I leave for the day. We all have some clients that if you are there for a good amount of the day that there is down time. Maybe you could do something with your client to pass the time. Ask if they want to play a card game, or go for a nice walk if it is nice weather. They may even like to get out and go some place with you. Also I always keep asking if there is anything I can do for them around the house. Mention a few different things. You never know maybe most of the time you might be turned down and they will say no, but they may surprise you and say yes that would be nice if you could do this or that. If anything it will show you are willing to do things for them and not be lazy.