Need advice about a patient is extremely needy / manipulitive

[Jade Harley]

i have this home health patient who doesn't understand that i work for 8 hours a day and I am not allowed to go over my hours. by the time it is 7:00 i already want to go home and no longer care about the patient's needs. I WANT TO GO HOME. IF YOUR NEEDS ARE NOT MET BY THE TIME IT'S 7PM I AM LEAVING AND YOUR HUSBAND CAN DEAL WITH YOUR ******* PROBLEMS.

I have no idea of her medical history nor do i know what is wrong with her. ( as home health employees are not allowed to legally ask ) She did tell me that she has anxiety attacks / separation, mini strokes as well as arthritis..she can walk with assistance and isn't really bed ridden..she is also incontinent.

First thing in the morning when I am with her she needs to be changed and expects to it to be done immediately or she will have a fit. This is how she is, if she doesn't get her way she'll have a fit. If it's not done right, she'll have a fit. This is in the morning before she has taken her meds. She is "get me this, get me that, "pay attention to me!" if she get frustrated she'll start hitting her bed and have a fit or she'll scream / start crying. once she's dosed up on her meds, she'll talk and talk and talk and talk for the rest of the day unless she starts to have an anxiety attack or mini-stroke any time throughout the day. Barking orders, making me feel like a slave / maid.. "CAN YOU DO ME A FAVOR", sometimes saying please or sometimes just barking a command without saying please.

Oh and did i forget to mention the neediness. Yeah. The neediness. I am not one of those people who are touchy feely with patients and i am definitely not someone who will get close to a patient.

This patient is so freaking needy, and everything of the above that I DO NOT do. She wants attention every second of the day, will talk non stop bark orders and treats me like a slave / maid. She's cool when she's all dosed up on her meds but I really can't stand her neediness and being treated like ****. I can't take working with her anymore and I am going crazy. LITERALLY! I can't even get a day off to do what I need to do at home and my patient doesn't want anyone else who isn't Filipino. I was supposed to get some days off when my employer found someone to work with my patient but my patient turned the other home maker away because she's spanish / mexican. The home maker before me was with this patient for a few years and so my patient is always saying, "blah blah blah and I used to do this", " when blah, blah, blah and i was here, she used to do this.." I DON'T CARE WHAT HER AND HER OLD HOME MAKER USED TO DO. IT'S SO FRUSTRATING TO HAVE TO HEAR IT. Her husaband is hardly around because he cannot handle her neediness, crying and sobbing, depressive / manipulitive behavior. It is getting to the point that I can't stand it anymore either and I am so tired of working with her. She needs to know that I do not do hugs, i do not do the "getting close thing", she does not get to bark orders at me because i am not ur ******* slave or maid. I do not do massages either. She DOES NOT get to speak for her husband and say that her husband wants me to do this, that, etc. I don't know or understand why she does that but it's really annoying. I also HATE her cat. I don't like cats, i like DOGS. I like animals but I just don't like cats. I cannot even get to do any cleaning like cleaning her / her husband's kitchen or bathroom. Or at least clean up a bit in the living room where her husband sleeps and lives. I feel bad for her husband because he has to put up with her and cannot live his own life and get to do what he wants to do. Yet she complains that he doesn't touch her, hug her kiss her, etc. It's not wonder because she is so freaking needy.

BUT at the same time I don't want to quit her because she is so cool and we share common ground aside from the fact that she likes to color and do art projects and watch tv shows intended for children who are under 5 years old. She says she is an adult who likes children's shows and she doesn't care..

I don't know what to do. Pay is great but I just can't stand the patient. Help? It's either this or going back to working as a receptionist + less hours. If I have to hear my patient ask me to do something and it starts with, "Can you do me a favor?" I will go nuts.

[darkbeauty]

You sound burned out. Does your agency offer a support system? Is there a licensed nurse that comes out atleast once a month to check up on your patient and you? Does the office know of her behaviours and your feelings towards this patient?

If I were you, I'd demand a day off before you end up hurting the patient, because from the sound of your ranting, you are about to do something you'll regret.

[Jade Harley]

I am burnt out. I don't know if my agency offers a support system. I doubt it since all they seem to care about is making money. My boss the one that goes out to see patients and checks on them but she doesn't go like she's supposed to. She's in her 60's and I think she's going to retire. I have tried and tried asking for a day off but as I had said, I asked for a day off, my employer found someone to work w/ me so she can fill in for a few days but the patient didn't like her because she's Mexican and turned her away.

I don't get a choice to have a day off. It's either this patient or work as a receptionist for 4 hours for a couple days a week. I don't know what to do. I can't quit because it's really hard to find a job. I can't go to school because I can't afford it. I can't take the CNA class my employer offers because I don't have the money to pay. I have bills to pays, you know? >_

[SDALPN]

How about looking at what you can do vs what you can't do? Maybe the problem is your frame of mind and how you approach things. Look at the positive things and start from there. Maybe the pt is feeding off of your negative energy. People can be needy, but your approach and attitude can make all the difference in the pts behavior. Talk to your supervisor as another person suggested, evaluate options and come up with plan b. You aren't in this situation forever. When things aren't working for you, change something...the change could be for better or worse but eventually you will find the changes that make things better. Good luck.

[Glycerine82, LPN]

Wow. You're in a pickle. Sometimes when a patient has no control over thier lives they start to control the little aspects of what they can control. Which in this case is what seems to be happening. She can't control if she wets the bed, she can't control if she falls down or needs help walking, she is mostly stuck in the house. When a patient loses control like this and can no longer make most major decisions about their health or anything else, really they can become control freaks in all the little aspects. I have to remind my self of this when I come across a patient like you describe.

I would try to set boundaries with her. Let her know 30 minutes before you are leaving that you're shift is coming to an end. Maybe say something like "Its time for me to go home soon, is there something I can do for you that time will allow?" When I get yelled at I usually ignore it and try to pretend its not happening until the patient calms down. I feel like If i reward that behavior with attention it will continue. If it gets bad and they are alert and oriented I'll remind them that I don't talk to them that way. Most of the time it will stop with a couple of one word answers as I move on to doing something else while they are rambling......

I suggest you get to know her routine and get it down pat so that this stuff happens less and less. If she freaks out about being changed right away, just make sure you change her right away. If she barks orders at you remind her you're still doing the first thing she asked and you'll add it to your list.....that kind of thing.

Sometimes, when a patient is just over the top like this I'll just lay it right out for them. "I'm here to help you, but I can only do one thing at a time" or something like that. Maybe coming here and venting will help you. I definitely think time off is due!!