For live-in carers, having to be with a client going to hospital after a fall can be a nightmare. While no-one wants to be in this situation, sometimes it is even worse when your client comes back home after a hospital stay.
Your client may return with a heap of new medication, depending on why they were admitted. They will also come home with instructions as to what to do and when to do it.
After any surgery there will be procedures to follow – and that may be where your problems begin.
What can go wrong?
Depending on the reason for being in hospital two things are going to change right away for your client, namely medication and movement.
Medication
Most client will adapt quite easily to any new medication which has been prescribed, although some will question you about extra tablets. Normally it will be enough to state that ’the doctor said to take it.’
Often this figure of authority holds more ‘clout’ than a carer ever will, so if you need to play this card, then do so. If you need your client to take different medication, then persuasion is your best option when it is queried.
Movement
This is where you may run into issues, particularly if your client is used to ‘doing their own thing.’ They may need to become used to walking with a walker – every time they get up. They may need to call you to assist them to stand, and possibly be next to them while walking.
Your client may become more reliant on you to help them with personal care and be unwilling to do this.
With movement restricted even simple things which they would have done before may become an issue, leaving them frustrated and possibly angry.
How do you deal with this?
Administering medication is something that will normally work itself out. If your client adamantly refuses to take new meds, then talk to the doctor. Perhaps he can prescribe in a liquid form. He may also suggest that you crush tablets and mix with a food such as yogurt.
If crushing tablets becomes a possibility, make sure that you do have the doctor’s permission to do this – preferably in writing to cover yourself.
Walking with assistance can be very difficult with a client who has previously been independent. The key here is tactfulness, gentleness, and patience. Remember that your client is frustrated about their lack of independence.
Try not to ‘make an issue’ out of your assistance. Shouting for you makes it appear to them that they are calling for help because they cannot do something themselves.
Rather than calling, place a bell close by so that your client can call you when they need help. This is more like summoning you and can appear impersonal. It will also make them feel less dependent on you.
Accept that in many situations your client will return to better health and try to walk unaided eventually. If you can help them to achieve this then you will have formed a closer bond with your client.
Final thoughts
As with everything in live-in care, it is important that you cover yourself. If your client refuses to call and battles to stand by herself when you are out of the room, it may be just a matter of time before another fall happens.
Make sure that you document this reluctance to call. Let both your agency and the family/next of kin know the situation. Assure them that you are doing your best to be close at hand but cannot be there 100% of the time. This is when another fall will happen.
It is only natural that a mentally capable client will want to be independent again, so you can expect them to try to get around on their own. Sometimes they may listen and call you, and at other times they may simply forget, try on their own and hopefully not fall again.
Whatever happens, you should make sure that family and agency know exactly what goes on and what you expect to happen. Keep yourself covered at all times.
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