Home Health CNA, quit case because my fall risk patient and family refused to...

[cdsavannah59, CNA]

Would you quit a case where the old man you cared for and who has a history of falls because of his Parkinson's refused assistance walking or getting out of chair. My client was always very unstable on his feet while walking and when I tried to help he wouldn't let me, although a few times he let me hold his belt loop in back of his pants so I I could be ready to prevent a fall. When old man had to go to bathroom he refused to let me go in to at least walk home to toilet and he always made sure door was shut and stayed for several minutes sometimes. The whole time I worried if he was ok in bathroom but he didn't like to be asked that. Well one day his son was there ( old man lived alone for a few weeks because his wife fell at home and broke her hip so she was in hospital) anyhow the son got angry when I went to help his father walk, and told me to not ever help him, that his father don't like being helped and said something about his dad wanted to remain independent ( over age 80 I think). I did not like the way his son scolded me so I called my case worker the next day who was previously already aware of situation and I told her that I refuse to watch someone who has a unsteady walk and refuses assistance, why, well I told her I will not allow myself to be put in a situation where I was blamed for the patient injuring themselves and I told my case worker that if he ever did fall while under their company's care that I'm sure the family can sue them if he gets hurt. I liked the old man other then this issue and I feel bad I quit watching him as he liked familiar faces only when the agency sent someone out to his house, so he was a regular client of mine for about three months. So my question is would you refuse to work a case like this?

[hookyarnandblanket]

He, unfortunately, has the right to fall. As long as you have offered help, you have done what you can. Document his refusals and if he does fall, document what took place from a objective point of view and do what you can to keep him safe.

[Jensmom7, BSN, RN]

You can actually get into more trouble by insisting on helping him when both he and family members have specifically told you not to.

As the PP said, he has the right to fall. You run the risk of assault and battery if you touch him when he doesn't want to be touched, no matter how good your intention is.

The prudent thing for you to do is document the refusals, and be prepared to pick him up off the floor some day, if he allows it.

[cdsavannah59, CNA]

Thanks ladies I never thought about he had a right to fall, I was so concerned about it and thought I could be blamed for it if he fell that I did document and report his refusals, and the case worker who seemed just as concerned he might fall while under agency care, she never mentioned he had the right to refuse. This case was a couple years ago and I now work elsewhere, but wanted advise if it ever happened again with another patient. All of my other clients wanted to prevent falls lol. Anyhow I'm still glad I got off that case, I didn't trust the family in who they might blame if he severely injured himself.

[Princess Bubblegum]

You did the right thing. You were at risk for injuring yourself if he were to fall. He has the right to refuse help, but you also have the right to keep yourself safe.

[BBboy]

if a person you assume care of refuses an area of care you wish to provide then you should refrain from carrying out that task. Especially when the family says no

[BuckyBadgerRN, ASN, RN]

What was he purpose of a HHA if he is going to refuse your help? Why have you there at all?

[Ioreth, ADN, RN]

When my grandfather was in hospice, he also refused help. He was also just not able to walk assisted, so he fell many, many times there at the end. This led to all kinds of injuries for him, as well as for me since I was the one to pick him up. This is such a tough situation, because there really is no right answer. I feel like you made the right choice to discontinue his case since you were uncomfortable with the situation. You have to weigh his right to fall against your own right to not be injured. If you can't be certain of being able to pick him up without hurting yourself, then it is certainly time to move on.