“Well, I can’t FORCE him to get up to eat. IT’S HIS RIGHT!”, the second shifter indignantly whined. I took a deep breath and bit back the snarky response that was desperate to escape my mouth.
“It’s his right” is the most often repeated phrase in this biz and for the most part, it is used inappropriately.
I never hear “IT’S HIS RIGHT!” when a particularly persnickety resident wants a ride to the office to discuss his finances for the fifth time during a shift. No caregiver self-righteously exclaims it when a resident requests a unscheduled shower. No. It’s seems that their “rights” only becomes a concern when it means having to work outside of the routine in order to effectively get the job done.
The problem, as I see it, is that for too many caregivers the only two options they are willing to consider are force or neglect. As if the concepts of persuasion, redirection, different approaches, assistance from their partner on the floor or simply revisiting the situation later in the shift never crossed their minds.
When I look in the paper work and see that a resident hasn’t been bathed in two months because he refused, what I am really seeing is a caregiver who is either unwilling to do his/her job or in need of more training. That is neglect. Period.
When a resident who can be challenging but will work with you if you gain his trust and take the time to explain to him what you are doing, suddenly drop in weight and his paperwork states he is refusing to eat dinner for weeks on end, what I am really seeing is a caregiver too tired to be bothered with taking the time to persuade him, comfort him or advocate for him in order to get a doctor to check him out.
I know we don’t have an easy job. Not everyone is suited for the floor. It is not a world of black and white. It’s takes a certain talent to be able to create and implement a consistent routine without being so married to it that it won’t bend when needed. It takes creative thinking to do this job well! It takes patience and empathy. We have to persevere.
We work with sick people whose first instinct is often to give up. It is OUR job to use every tool in our arsenal to prevent them from doing so.
If you know your residents well, you can usually talk them down from a refusal. You get to the root of the problem. Sometimes, all they need is to be heard. Sometimes, they just want to feel they have control over SOMETHING in their lives. Sometimes, they only need five extra minutes of our time. Five minutes. On a hectic day, it’s a small inconvenience for us, but can make all the difference for them. It’s not too much to ask of us. After all, don’t our residents have the RIGHT to a decent quality of life?