Crossing those blurry lines....

More and more, our Community Health Workers and Nurses as well as our Mental Health Workers working out in the community are dealing with people who are very challenging to work with due to complex medical issues that until recently would have ensured their quick and possibly non-consensual placement in a facility.
Good news for the clients is not always welcome news for those who work with and alongside them.

In my client base I have two outstandingly difficult situations in which I am placed.
There is nothing I can do to make things better: only my own attitude and client-focused care are on offer. There are times I can hear a big sucking sound in my head, as I am bombarded with negative energies. Mostly I ignore such things, but every now and then it is not possible. Today was such a day.

It is a difficult thing to be younger than mandatory retirement age and wheelchair bound. It is even worse if you are dependant on others to keep you clean ie: changing your attends. Many stroke survivors become incontinent. Many more are forced to use incontinence systems (pads or adult diapers) because of the difficulty transferring them from wheelchair to commode/toilet. All this on top of a brain injury. Not very pleasant. When the damage is to the frontal lobe you can just bet there are additional behavioural issues that are hard to control.

I have a client who is deemed competant. This client can pass the test for such measurements. This client, deemed competant, chooses to lash out in anger during care moments. This client, although wheelchair bound is very capable of connecting jabs and hits. Today it was the sling straps. As I am leaning in to remove the leg sling, whap--- he whips the strap off and flicks it in my face. He had previously been jabbing at my co-worker.

It is hard to have to say to someone that you know would really rather not have anyone, let alone two someones, that because of their behaviour, you have to have an assistant. Eventually, if this continues, this client will wind up in restraints in a facility somewhere. It is just a question of time. Someone will be in the wrong position and one of those kicks hits jabs or flicks will connect in a way that harms rather than hurts. I have done my time there. I am done after today. Perhaps someone else will be more successful. More likely, someone else will not document nor report because of fear, shame or general careless-ness. Not that they won't care, just that they care not to report.

Does my client choose to be difficult?
Can I remove the trigger to the behaviours?

Sure I can: I could leave my client sopping wet and not changed.
I could choose not to transfer my client leaving them in bed.

No win.

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