I'm a caregiver, and deal with people with dementia and some people with mental illness. How do you form strong mental boundaries?
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.
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).
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.
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.
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.
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.
I like this answer. Thank you!
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.
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.
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.
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.
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.
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.