Health Information Management

There may be more to the difficult patient than you think!

Homecare Insider, August 19, 2013

As a home health professional, you must deal effectively with a countless personality types, cultures, and needs on a daily basis. Unfortunately, this also means that you must occasionally work with difficult patients—including those who are hard to along with, combative, argumentative, hostile, and/or those who need but refuse care.

Working with a difficult patient cannot only be stressful, but it may also lead to safety risks for both you and the patient. To work effectively in these situations, it is important to consider the reasons why a patient does not want to cooperate—they may be different than you think. Next time you are faced with a difficult patient, keep these factors in mind:

  • Embarrassment. The patient has taken care of him or herself for his or her entire life, so it may now be embarrassing to ask for or accept help, particularly with items such as personal care.
  • Control. We all strive to maintain our independence and our right to make our own choices throughout our lives. However, changes may occur over which we have no control and repeated demands or admonitions to do better can create feelings of mistrust and isolation for the person who may have a fragile self-image and who also needs assistance.
  • Fear. Our behaviors always make sense to us whether good or bad. Most patients will do better when they have the skills and support to do better. But trying new ways to do a task can create fear of the unknown. Help patients transition to new tasks and offer as much encouragement as support as is appropriate.
  • The patient does not recognize you as the caregiver. Depending on the patient’s condition and metal status, it is possible for them to either confuse you with someone else, or not recognize you as a home health provider.

Take some time to consider those factors that trigger adverse behaviors. What happens to “set the patient off?” Could it be one of the factors listed above? Finding the root cause of the behavior can help you develop the appropriate strategy for working with the patient.

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