How can I effectively communicate with in-home caregivers?
If you are talking about getting assistance in the hospital as an outpatient or at a clinic, I recommend you call ahead to the department you will be interacting with and explain your needs. They should be able to verify your condition and be prepared to help you when you are there, assuming you're going to a facility with a broad range of services. Also, don't ask for assistance, state your need clearly, with confidence, and don't be apologetic. You are not in this position for your own amusement. However, be polite and considerate. Who wants to be treated rudely on the job. On the reverse, you are not the only one with personal hygiene issues related to other disabilities. Any professional health worker should take it in stride and not be shocked, surprised or embarrassed by your request. That would be remarkably unprofessional, and about then I would be angry and justifiably so. At that point you start going up the chain of command. Also, most, if not all, health service providers in my state have a Patient Advocate available to assist with many problems, from paperwork to your patient rights. You might have the same available where you live. Ask for the social worker at any hospital, or at the info counter at any other facility and they can put you in contact with one. Allowing a patient to maintain their dignity is high on the list of any facility's list of patient rights. Also, most, if not all, health service providers in my state have a Patient Advocate available to assist with many problems, from paperwork to your patient rights. You might have the same available where you live. Ask for the social worker at any hospital, or at the info counter at any other facility and they can put you in contact with one. Allowing a patient to maintain their dignity is high on the list of any facility's list of patient rights.
If you are having this problem with a home care agency, my experience with home health aids and nurses has been that the agency/provider has guidelines and rules governing what either health worker does for a patient. It is not a matter of picking and choosing what they feel comfortable with. A certified home health aid doesn't interact with your meds, dress wounds or take your tempeature. A nurse does not do dressing, bathing and toileting unless this has been arranged through private contracting directly with a nurse. Your doctor(s) should have provided your home health agency with the particulars of your physical condition and services you require to remain in your home safely and maintain your health. They can't accept management of your case and then pick and choose what they feel like doing. That said, the workers don't have to put up with sexual harassment either (just mentioning it because you seemed concerned that the health service workers might think you were harassing them). Home health agencies provide incontinence services for geriatric patients (my father is currently receiving such assistance during the certified home health aid visits, three times a week; he manages on his own in between). I would think with the extent of your injuries and ongoing disability, you should be receiving at least a daily aid visit. My advice is to talk with your doctor's staff about what you require, and have them forward instructions to your agency. Equally important, call your agency and speak with your case manager about your needs and written orders from your doctor. This isn't supposed to be adversarial, it should be cooperative, calm and clarifying. If for some reason your present agency can't provide the services your doctor has written an order for (yes an order, not a request) you can either find another agency to provide all are some of the services you need, or you can ask your doctor(s) for assistance. My father had used one agency contracted through our county Office for the Aging for years. After a recent hospitalization and rehab at a nursing facility, the Social Worker recommended and implemented a home service plan through a different agency (no difference in insurance coverage) which has been head and shoulders above the other agency in quality of personnel and services provided. Perhaps you may find another agency more responsive to your needs as well.
