How to Deal with the Unpleasant, Unexpected, and Unsanitary.

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In home health when you are sent a new patient you never know what you might be walking into. Will the patient be friendly? Will the neighborhood be safe? Will the home be clean and tidy or is an APS (adult protective services) call awaiting your arrival due to the conditions inside the home?  There are so many questions that can arise before even meeting your potential patient. This initial encounter can be daunting for someone new to home health. A fear of the unknown.

As a home health clinician, I have been into my fair share of cluttered, disgusting, dirty, roach infested, and stinky homes. So, what do you do when you arrive in one of these situations? Who can you call for help?

When entering a home like the ones in the photos above, remember  never to  let your inner disgust or revulsion be apparent to your patient. You don’t know why they are in the situation that they are or what they are doing to change it. You need to maintain your composure and professionalism. If necessary, you can find a way to excuse yourself. For example, “oh… I left something in my car. Would you mind if I go grab it?” Or “I need to take this phone call. Would it be alright if I stepped out for a minute?”.  These phrases can buy you a minute to compose yourself before returning to the patient.  

                        Pro-Tip: rub some mint balm under your nose prior to
                                       entering a particularly noxious home.

What To Do...

• If you are unsure, call your supervisor or co-worker for a second opinion
• Discuss safety risks associated with  filth and poor sanitation with your patient and provide suggestions to address each issue
• Notify family members and ask for their assistance in dealing with the situation.                                                     Sometimes they aren’t aware of their family members’ living conditions
• Get a Medical Social Worker involved, if they aren’t already. Social Workers can help to file APS reports if necessary and they are often great at helping to navigate through difficult situations and conversations with patients and families
• Refer to Behavioral Health if necessary due to patient resistance and potential psychological causes (e.g.. Dementia, anxiety, bipolar disorder)