How do I deal with this patient's family members?

Specialties Home Health

Published

I am a CNA in FL and would like you nurses opinion on this matter, if you will.

I have been with this Home Health Agency since December, and have had this particular patient for 5 months now. She has Dementia, but mostly independent requiring supervision on a variety of tasks and activities.

We get along REALLY well. She likes me a lot and always tells me "thanks for making my day so bright" everytime I leave her house. I also like her a lot. We have fun together...:yeah:

Anyway, she lives with her son who is bound to a wheelchair because of a car accident yrs ago. He does mostly everything for himself. At first he didn't bother us at all. But lately he's got into a crazy mood (I think he's jealous of us having too much fun :angryfire), and he's doing everything he can to either slow down my tasks or prevent me from doing it. The other day he said I could not wash her clothes, and she had wet her bed really bed. I stuck R (Refused) on my Daily chart for that day (laundry). Then another day he told me to go easy on the paper towels (he doesn't just say it.. he YELLS at me). Then I started using one of my patient's hand towel as a bib, instead of "wasting" his paper towels. He comes around her and SNATCHES the towel out of her chest... to which my patient turned to me in a desperate face...:uhoh3: I told him to leave the towel where it was. He turns to me and yells "WHY?". I told him he had told me to not use the paper towels, he said "for this you can use". I said "I prefer using the towel because it shields it better all the way down to her legs"... because she makes a big mess especially on cereal days!:o Anyway, another day he came around the table, where my patient was sitting and eating lunch and I was sitting on the chair right next to her, he whams her against the table, trying to push her chair closer to the table (it wasn't that far away)... she screamed in terror! The only thing that came out of my mouth was "OH GOSH!". I could NOT believe what he had done. The way he treats his mom. The way he gets in between us.

Well, I told his sister -- my patient's younger daughter who lives 6 houses away on the same street -- all about this, that her brother is being an old fart, he tells me not to feed her this or that (things that she usually eats but now somehow he forbids her!), and the sister told me "please don't call your agency and tell these things, because if you do, I will have to drop your agency". I had told her I was unhappy with the conditions I was having now, all of a sudden her brother puts on a mood and creates a big problem for us. The one who pays for it is my patient and I'm very concerned. I'm there to do my job, whatever is on my aide Assignment sheet by my RN supervisor, I'm following it to the letter. I'm never late, I never miss work, I take my work very seriously, I enjoy what I do and excuse me -- but I do a DAMN good job! :specs: I'm proud of it! But at the same time I don't know how to deal with this old fart that is unhappy about life and is jealous that his mom and I are enjoying the time we have together... we walk, we watch TV, we play games together, we read, we laugh and tell jokes... I don't know why a family member could have a reason for a complaint about this! Anyway, I need the hours too as I am going to start nursing school now in May, and to be honest... I'm not ready to quit my job just yet, because like I said, I'm enjoying it very much. But I don't know how long I can stand this situation with the family members. I don't want to get in their business... the sister keeps telling me that her brother because of the accident, blahblahblah, that I have to have patience with him... I told her "I don't have to have anything for him... he's not my patient... I just want him to leave me alone so I can do my job properly"! Am I asking too much????

Tomorrow I have to go there again in the morning, and after that I'm going to my agency to drop paperwork for the week... but I am very tempted to tell the supervisor there about these things. But at the same time I'm afraid I won't have this patient anymore. I like her and I think she deserves the care I'm giving her. And I count on these weekly hours... I don't know if I can get another patient like her again.

What do you nurses think of my dilemma???? Should I put up with this problem or what?

Thanks a lot for reading... sorry it was too long! ;)

Specializes in OR, HH.

I was just curious, because I always think of Hospice and a dying patient.

Sorry for the duplicate re: the hospice nurse. I didn't realize that the first one had gone through. I think I am just about ready for bed.

Hang in there. You obviously care about this lady and I know that it is hard not to feel bad.

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I don't think she's dying... well, who am I -- only a CNA -- to say something?

Well, at least, she has been stable for 5 months now. Yes, she has dementia and it's degenerative, but she's lost only 1 lb for 5 months (would that be considered as "dying"?). She eats well and walks with me for 30 min a day, drinks plenty of water, and her blood pressure is good, oxygen level as well. She walks without my assistance. I don't think she loses her balance very often (I do more than she does! :D). Mentally I don't think she has gotten worse, just the same things everyday... she can remember a few things and other times forgets. But I don't know why the hospice is involved. I don't ask too many questions. I just try to do what I'm supposed to, the best I can. The hospice CNA goes there every week, I think one day only, and stays for 1 hr only. She just sits with my client and watches tv. I do much more than she does -- assist in showering, dressing, preparing/serving meals, laundry, hair and nail and skin care, etc. Anyway, I just do what I'm assigned to. So, I really don't know why the hospice...

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I'm back after a few days! :p

I went back to my patient's house on Monday and today.... yesterday everything seemed to go fairly calm... Bozo the clown didn't bother us, and he even signed my daily chart (required by my agency everyday). Of course I politely asked him to, because his sister would not be coming back until later when I would be already gone.

Now today.... apparently there were bed bugs on Bozo's bed. He was in a bad mood again. I left my paper on the table for him to sign when he would get up. My patient and I went for our morning walk and when I came back he was outside messing with his tools in the garage. As I went in, I noticed he hadn't signed my paper. I am sure that he saw it, as he HAS to pass by the table and he always looks. I thought "you miserable loser!". Anyway. About 15 min before I left my patient's house, I went outside with my paper and pen for him to sign my paper. His sister had someone over from the state and told me to ask Bozo to sign my paper today because she could not come in time. She said she specifically told him to not create an issue and sign my paper as I would ask him. Guess what? He snaps at me: "I don't have to sign your paper... wait for my sister to sign it." I was enraged!! He knows full well I need their signature daily to comply with agency's policies. He knows I don't get paid if I don't have their signature on my chart.

Anyway, I'm going to call my agency and tell my office manager right now that I do not want to go back to that house anymore. I am sure they are going to make me go there until at least Friday, because they want the money from the client (it's not private pay... ). I feel uncomfortable going there.

I'm so upset with this.

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Specializes in OR, HH.

You could always tell the daughter what your plans are (to quit). Maybe she will get after her brother and he will straighten up. The thing they don't realize is that they could get someone who is rude right back to them. They could be going from the fire into the frying pan, so to speak (I think that is how it is said).

You are so nice I would think that they would really appreciate you. I know the mom does, but not her ungrateful children.

Try asserting yourself, if you have to go back.

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I just called the agency, talked to the office manager.... I told her I don't feel comfortable going back there anymore. I explained the situation, she knew about the issue with the daughter and the son, but didn't know it got so bad like it is now. I told her I'm so stressed out and I feel bad for leaving my patient who I really like, but I can't handle those family members anymore. Anyway, she called the daughter and put me on hold for like 10 min. I'm sure the daughter is extremely upset that the agency called her. She had told me if I would call my agency to complain about these issues (that she said "SHE" can handle better), she would talk to her mom's care manager and drop the agency altogether. I told this to my office manager just now, she didn't like that... she said "oh well, that's her problem if she is upset and wants to drop our agency." So, she told me to go back tomorrow until Friday so that they can find a replacement, I said "I am sorry but I do not want to go back tomorow because I don't want to get into a BIG argument". Knowing the daughter well, she WILL be there early in the morning ready to argue and who knows what else. I don't want to go through that. I told my office manager all this. It already created a hard situation by her (my office manager) calling the daughter, and I'm sure if I show up tomorrow she will eat me up. I told her "I don't want to go back, please". She said she will call me in the morning before I leave (I told her I'm out of the door at 7:45am). What good will that do anyway? I still don't want to go. Should I call in sick? There is a 24-7 line that you can call in sick at least 8 hr before the start of your shift. I don't want to do that, neither do I want to go back into that house. WHAT NOW????

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Hi Muffin, thanks so much for your kind words!

I hate to say that... but I DO hope they get a mean CNA. Those who don't put up with crap. I mean, good to the patient, but don't take crap home from family members, you know.

I don't want to quit my job!!! I also have another wonderful patient, and the family members are really really really nice to me. They have called the agency just to tell them how much they appreciate me.

But about talking to the daughter and her straightening Bozo up... I doubt that would happen. She winds up taking his side... she said he's handicapped, hasn't had a woman in a while, etc. Like really.... what have I got to do with all this???

To me, they have the sick abuse pattern in the house, and they don't understand why I don't fit in. Clearly, I'm different from them. I don't tolerate abuse and mistreatment and lack of respect.

I just want to disappear right now. I'm fed up with them 2.

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Can the agency fire me for refusing to go there when I have clearly stated my reasons why?? I have been telling them the environment isn't good... I don't feel safe.

I want to stay in good terms with the agency, but at the same time I don't want to take any more crap!! I know if show up there tomorrow I will only hear crap. I don't want it!!!

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The agency may not formally fire you, but they may stop calling you for work, thus "constructively terminating" you, in the jargon of the employment department. They will hope that you don't catch on quick enough to think to apply for unemployment benefits. Do not go back to that house after what has now transpired. You have done all you can do. Call the number right now and say that you can not work at that house and state you will be seeing your doctor today for "job related" stress. That will shut up the agency, because they don't want to be paying for your short term disability. That is what I would do. If your manager had any thought for your well being, she would have not pushed you to finish the week. They knew this was coming. They aren't dumb. Good luck.

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I don't have a doctor and can't afford one right now. I don't have health insurance. If I say something about seeing a doctor, they will want to see doctor's paperwork confirming that. I can't afford it.

Then I also have another patient in the afternoon, I did not want to miss going there. It would be weird to call them right now saying I don't feel good for the morning, but I will be better for the afternoon. Or that I won't be feeling good until Friday evening when I'm done with my week for that particular patient.

I don't think they would be paying for my short term disability... based on what ? My 6-month anniversary is coming up in 2 weeks or so anyway. I'm sorry, I don't know how these things really work.

I agree that she should have thought about me, in the situation I'm in now. She probably had a taste of "poison" and rage over the phone with the daughter a while back.... does she think that tomorrow she will be hugging me good morning??

I'm scared of going there. I know she'll be there waiting for me. She's that type that waits for you sitting on the couch and makes you sit and have a talk. I hate that. I'm not there to argue or talk to her. I'm there for her mom. Since this is no longer possible, I don't think I belong there.

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If a doctor says you are too stressed to work then you are too stressed to work. You can't claim you are sick for just part of the day. You have to call in and just state straight up that you will not be going back to that case. Stand your ground. If the agency holds this against you, you are not dealing with a good agency. The only time an agency gets upset with an employee is when they are so picky that every other client is a 'no go'. Then, they stop bothering with that employee. Call in, reiterate that you won't be seeing the problematic case, but you will be seeing your afternoon client. Continue to look for a new case with another agency.

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I know I can't claim that I'm sick just for half a day. The thing is, I can't say I'm going to see a doctor because 1-I'll be lying and 2-I really don't have the money; therefore, they would require me to present a doctor's note that I'm too stressed to work.

well... The agency is closed. I mean, the office I report to work every week. The 24-7 line takes emergency calls and call-in-sick, etc. I don't know if they would accept "I am no longer going back to this case". They will tell me to call the office after 9am next morning and tell them that. Thing is, I would have to be at this patient's house at 8am, 1 hr before the office opens. If I just don't show, I'll be fired for not calling in. You know what I'm talking about? I'm just so confused, I don't know what to do right now... i just know I definitely won't be going back there. Either I call in sick... which really I am getting so nervously sick my stomach is turning. If I just call in sick with this patient, I know the office manager will be ringing my house at 9am after getting the message from the 24-7 line, and will be asking me how I'm doing.

It's just all so confusing. All I want to do is be a good help to my patients. Why do things get so complicated like that??

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Specializes in OR, HH.

This is ridiculous. I feel so bad for all of this unnecessary stress that not only the family has put you under, but your manager. She does care if they cancel her agancy. Who is she fooling, by telling you to go back for the rest of the week.

At this point it is really not safe for you and you should call APS. Every APS has an after hours line.

Cali-Isn't there something Morango can do with re: to the safety issues and the fact that she has been telling her manager for a couple of weeks. Seems like there should be some sort of labor law against putting an employee into a dangerous environment.

You sould say that you are sick to your stomach over the your physical well-being and that you are sure it is from the stress of this family and the fact that you are not being backed up by your employee.

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