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I have been working with some very mentally disturbed individuals that I am not aware of until I am working with a client. I have dementia clients, but I find that some days, I feel less grounded after interacting with them. I want to show empathy, but I do not want my mental health to suffer when taking care of them. Also, I have some clients with mental illness layered on top of their physical comobidities. These clients fake their symptoms to their doctors and when an aide is placed in their homes, they want housework and repairs done instead of what is on the actual care plan. I found myself putting together chairs for one couple. If you say no, they will call the agency and have you removed from the case. I find these types very difficult to deal with and have tried using me as a sounding board for their unresolved issues. They have social workers who can plug them into therapy, but they prefer to trauma dump their issues.

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What moved me out of being taken advantage of was learning how to say no.

I was there to do some tasks. Not 26 others. Or there for 2 hours, not 6.

It is not wrong to say no.
It is not unkind to say no.

It is reasonable to stay within your designated role, by arrangement, by training or experience.

You also must adhere to safety & OHS policies.

To use your common sense is fine (because your client may not be able to).
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Scampie1 Mar 3, 2024
I agree. Thank you on this one.

My policy for now on is if it is not on the care plan, don't do it. Call the office immediately when some weird request is made.

These clients I had were in their right minds and avoided the care plan altogether. These were young elderly.
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I haven't had a case in over two months. I've been doing some soul searching and realized that I am putting to much of myself into these cases and not taking care of myself. People ask for more and more, and will get angry if they can't manipulate me into taking on extra responsibilities outside of the regular care plan. I had one client cancel because I wouldn't stay in their apartment while they went off to visit with neighbors. Another client wanted extra time because they were having a bed delivered and the client needed to be moved from the bed to the wheelchair. These are not private pay cases.
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Beatty Mar 3, 2024
A friend of mine swapped from home care to hospital & nusing home care for this reason. An obese man wanting to be pushed up a steep hill to the shops in a manual wheelchair, client's tantrums to have alcohol or cigarettes bought (by her), having to pick up dog poo inside houses.

She prefers the defined job structure working for an large
organisation provides. There are some staff who try to manipulate but these can be managed.
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I take my hat off to you. I can’t imagine how difficult the work is
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Scampie1 Mar 3, 2024
The patient care is on the care plan. These people have their own set of rules.
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"If you say no, they will call the agency and have you removed from the case". Perhaps you call the agency yourself, and ask for their advice about how to handle it. Then if the client does call, at least you have got the story in first.
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Scampie1 Mar 3, 2024
Hi Margaret,

Believe it or not, I called the agency. They act dumbfounded. I called my recruiter, and she is such a sweetheart not a mean bone in her body. Now when I get a clinical director, it is taken care of.

Most of these clients are young elderly, had been on drugs and alcohol in the past, getting free housing, food and medical. Most of them are on SSDI (free money) claiming they are suffering from mental health disorders and claiming health issues. I had one obese woman who cursed at me all day, lay up in the bed and eat fried chicken. She would get ready to leave when it was time for me to go. They had a truck that offered free food, so she wouldn't have to cook.

None of these clients wanted the nursing care but more or less needed me to take out their trash, do the housework and cook. It was more maid service while they laid in bed and watched tv.
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When clients ask you to do something that is not in their care plan, say "Just a moment and let me call my supervisor to let them know I'm being asked to do something I'm not supposed to do." Call right in front of the client. Fake the call if needs be. Let the client know what will happen if they insist (the incident will be "reported", you will leave, they may lose this service, etc).

My MIL worked for a caregiving agency as a companion aid and driver. She wasn't supposed to clean their home but they asked her and she did. She got up on a stool to clean something, lost her balance, fell off backwards hitting her spine on the corner of the wall and breaking several vertebrae (she had osteoporosis). It changed her life. She had to go to court to get Workers Comp for something she wasn't supposed to be doing. This bad decision never stopped costing her.
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Scampie1 Mar 3, 2024
This is terrible, but it happens a lot in this line of work. My latest complaint are these clients who want to leave the aides in their homes while they run errands. The point of having an aide is to either run the errands for them or accompany them to these places. The agency is aware of what is going on but still sending aides to these clients. However, if a client falls while out and the aide is left back at their home, this is a liability for both the aide being charged with negligence even though the client caused the situation.

I like this answer. Thank you!
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Scampi,

It’s odd that these people expect so much from you as their caregiver because the clients know exactly what they are signing up for.

When I hired an agency caregiver to help me with caring for my mom, the agency told me what the caregiver’s responsibilities would be.

They were there to help mom with bathing, tidying up her room if needed and serving a meal to her. My mother has always been very organized, so her room never needed any tidying up.

I would never have even thought about asking the caregiver to do anything extra. I had a caregiver offer to do more but I told her that I didn’t expect her to do extra.

If mom was napping, I would catch up on housework while the caregiver was there.

One day, I started mopping my floor and the caregiver offered to mop my kitchen floor for me. She said that she didn’t like being idle. I told her to just relax, have a cup of coffee and a snack, read or watch tv until mom woke up.

Other times, I would go shopping or meet friends for lunch while the caregiver was there. She would tell me to have a good time and not to worry about mom. She took great care of mom.

Mom and I loved her caregiver. They had lunch together, enjoyed a cup of coffee and a snack, played cards at the kitchen table and chatted about different things.

They watched tv together, talked about mom’s favorite soap opera characters and so on.

Have you discussed these situations with your agency? What does the agency say about their client’s expectations?

I suppose that I would tell the clients that the agency has strict stipulations that you are expected to follow and that you are not allowed to make any exceptions for them.
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Scampie1 Mar 3, 2024
"I suppose that I would tell the clients that the agency has strict stipulations that you are expected to follow and that you are not allowed to make any exceptions for them."

This is true. When I get to their home, these folks already have their agendas ready. Sometimes they have someone living with them who calls the shots. Most of these people are playing the system since the majority of them are on some type of public aid getting free housing. I'm a threat to them because they know that they won't be able to pull this nonsense but for so long.

Home health has changed when I first started years ago. They have more riff raff on the roles now.
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I'm thinking of in house myself because it is more structured. We are not there to take care of pets.
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Needhelpwithmom, I saw your comment. Yes, you are right. The list the agency gave me last week has a bunch of people that they can't find aides for because of their difficult and explosive natures. They need mental health care in order for them to be receptive to the nursing care. They won't adhere to the care plan because when an aide goes in there with a set plan, they refuse to cooperate.

This agency does meet and greets. Which is fine to a certain point, but I'm quite sure that after an aide gets a taste of the real deal with these clients like I did, they get the hell out of there for their own safety. After awhile, people lose patience with these types. The agency acts dumfounded, because they are actually recruiters recruiting home health aides for another company.
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NeedHelpWithMom Mar 3, 2024
You can’t blame anyone for losing their patience in these situations. It’s a frustrating experience for any caregiver.
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Hi Scampie, you may not be interested in public policy or law reform, but you might like to read the following comments. This strikes me as the result of a service delivery method that lends itself to rorting. Public body A assesses client as deserving services. Private body B contracts with A for service provision as a fee per client, so wants clients. B sets out a list of services that seem reasonable and hires carers to deliver services. Carer C (you – a private individual) is contracted to deliver services. Client wangles for extra ‘inappropriate’ services. If C refuses, Client complains to B, then up to A. That upsets relations. B loses clients, fee and even contract. C (you) are in the gun. None of the others in the chain want complaints.

I got flicked one of these a while ago, because it happened in a similar situation in Australia, with the National Disability Insurance Scheme. The NDIS (A) funds services to people with disabilities, through private bodies (B) that in their turn contract with individual carers (C). The carer was supposed to support the Wife with genuine disabilities, the bombastic Husband wanted the carer to be a servant and to clean his car (among other inappropriate tasks). Carer was facing the sack if he complained and upset the apple cart. If B went against the client (actually the client’s husband), the fuss (spurious complaints of rudeness etc) might result in cutting off B’s contract with A, and jeopardise the jobs of the other carers. Carer is in a very difficult spot.

As a matter of interest, the NDIS costs blew out big-time and we have just finished a parliamentary review of the whole thing. Even without 7% of boys being assessed with ADHD (!!), my take is that the structure doomed it to fail.
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Scampie1 Mar 8, 2024
MargaretMcKen, this is exactly what has been happening to me. I ended up putting together chairs for my last client because I needed the case. By that time, I was just tired of the treatment from the other clients. Even this case wasn't perfect because the proper procedure was not being followed. However, I was crazy about the couple because they were fun to work with. I spoke with my recruiter and she told how this policy and procedure was supposed to be done. It is a drawn out process. I told her that I had been there for the assessments, but I did not get a call from anyone to tell me what type of treatment plan was established and me being called ahead of time to go over it. So, in other words, I had been going in these situations without knowing what was actually needed except for the electronic care plan that was given on the day I'm to report to duty. I've never worked with an agency like this before.

My stomach was so messed up from the stress of it all that I showed up at my gastro appointment three hours early. LOL My stomach is much better now that I'm actually creating a strategy to finally exit a bad situation. The nurse practioner gave me a lecture like she would lecture her nurses. She told me if the job is causing me this much stress to quit. Also, she told me I just need to find where my interests are. I trained on a SNF for my clinicals. So, I was offered a position at the home for retired veterans down the street from me within walking distance from a recruiter I talked to back in the summer. They need people to work. I would just need to get used to the routine, and I would be within walking distance from my home. I figure three shifts a week would do it for me and it pays more too. I can take shifts as needed. I am more open to exploring my options.

I have to be honest, during my job search, I didn't know what the hell I was doing. Now, I'm a little more aware of what is going on especially now since I've been on the board and have gotten excellent advice here.
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Update: I'm at the point now that I filled out some of my information in my profile for our employment office here in the city where I live.

As for this agency, they are now dragging their heels on giving me work. They said they had cases on this list but when I called yesterday, I'm told that one lady was leaving the country, and the other they could not get a hold of.

I picked another case, but haven't heard back from them.

It is a shady way to handle things, and I'm in the process of looking for other jobs now. I've started my search. If I don't hear anything from these people on Monday, I am going to consider it a done deal and move on from it.

I've checked out a lawyer because I'm definitely would be needing one if I am denied my unemployment.

I was completely honest during my evaluation, and told them the truth which they probably didn't want to deal with for. I can't get with this nonsense of phony care plans, and I left there with more questions than answers. They preach about this compliance and integrity, but I don't see anything that is worth me staying around for. I refuse to work for a company like this any longer where they don't look out for their personnel and it is a lot of underhanded bs going on. I saw one client that is back on that list again, and she was a holy terror to work for.

I can see why so many leave home care because it is a terrible place to work or earn a living.
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