Home Health Aide Training Part 3: Working Effectively With Mentally Ill Home Care Patients

I was disentangling myself piece by piece, severing my obligations. I wanted less and less to be asked of me. You sometimes hear stories of people who fall into icy lakes and survive drowning because their metabolisms slow to the barest possible level of functioning. That’s what I did with my life, a kind of icing down to the survivable minimum.

 

Caroline Kettlewell, Skin Game

 

Working as a home health aide with mentally challenged patients requires a special sensitivity to the needs of the mentally challenged. Too often, people tend to think of the mentally challenged as being somehow inferior and as such, they tend to talk down to them. However, what the mentally challenged really need is what anyone else needs – they need someone who will take them seriously and make sure their needs are met while giving them as much freedom as possible.

Just what is Mental Illness?

Before we can begin to discuss how to work effectively with mentally ill home care patients, it’s important to understand what mental illness actually means. Let’s start with the most basic definition and then go into a more detailed explanation. At its most basic, mental illness means that someone is incapable of functioning independently in society due to some kind of problems with how they experience the world emotionally. Exactly how this manifests itself and what the issues are do require additional explanation however.

Some indicators that a person may be mentally challenged include:

·         Inability to Develop and Maintain Healthy Relationships – Many mentally challenged people find it difficult or impossible to create healthy interpersonal relationships.

·         Lack of Impulse Control—Another common problem for mentally challenged individuals is a lack of impulse control. Many mentally challenged individuals will for example do things in public or even in private that mentally sound people won’t do (i.e. scream out loud at no one in particular, cause damage, public urination, etc.).

·         Inability to Tolerate Anxiety and Frustration—We all deal with anxiety and frustration on a daily basis. However, those who are mentally challenged often find that they cannot handle any (or very little) anxiety and or frustration in daily life.

·         Inability to Respect Others—Finally, many mentally challenged people find it difficult to respect others, in terms of private space and or in terms of regular verbal abuse.

It is important to realize that the above list includes things that even mentally healthy individuals experience from time to time. The key difference is that mentally challenged individuals will experience these things on a regular basis and will lack the impulse control to display normal behavior most of the time.

Cause of Mental Illness

Mental illness is a disease and typically a chronic disease just like diabetes, arthritis or RLS. In other words, mental illness is not the fault of the person experiencing it and the mentally challenged should not be made to feel bad for their disability. Some common causes of mental illness include:

·         Physical Factors – Trauma to the head, either in childhood or adulthood can cause permanent mental illness to occur.

·         Chemical Imbalance—Many mentally challenged individuals have a chemical imbalance in the brain which can sometimes be corrected through the use of medication.

·         Environmental Factors—Finally, mental illness can be either temporarily or permanently caused by environmental factors. For example, children who are exposed to severe trauma often grow up to be mentally challenged individuals who may experience lifelong problems. Victims of terror attacks or violent crime also sometimes develop either temporary or permanent mental illnesses as a result of their experiences.

Types of Mental Illness

Mental illness typically takes on a number of different forms. These include:

·         Anxiety – We all experience a certain amount of anxiety in our daily lives. However, those who are mentally challenged may experience severe anxiety which is disproportionate to the problems they happen to be experiencing.

·         Fears—Similar to anxiety, fears in the mentally challenged will include severe, crippling phobias which are not found amongst ordinary people. For example, an ordinary person may be repulsed by the idea of being near an open sewer. However, the mentally challenged individual will have such paranoia from being near the open sewer that he may refuse to leave his home for fear of the possibility of passing by an open sewer.

·         Depression—Again, while we all feel a normal amount of depression from time to time, someone who is mentally challenged will experience severe depression, often for no reason other than being depressed.

·         Paranoia—Finally, mentally challenged individuals may experience severe paranoia to the point where they are unable to function in society.

It is important to note that many of your home health care patients dealing with mental illness will be able to recover and lead normal lives, either through therapy or medication and sometimes through a combination of the two. Thus, they may need help only on a temporary basis rather than on a permanent basis.

Your Responsibilities

As a home health care worker with people facing mental challenges, there are a number of things that you need to do in order to ensure the safety and development of your charges. These include:

Record Keeping

You will need to keep careful track of your patient’s emotional states. This means observing changes in behavior and noting what may have precipitated them. You should also note whether or not the change lasts for a long period of time or if it is a short lived change.

Your mentally challenged patients may also experience changes in behavior which are of a positive nature. Thus, it’s important to note when and if such changes occur and to note changes in personality, either for the good or the bad.

While you should note environmental factors surrounding such changes in behavior, it’s important not to draw conclusions on your own as to what precipitated these changes. Instead, you should note only the facts and allow mental health professionals to make such diagnoses.

Making Sure Patients are Cared For

It’s important as a home health care worker working with mentally challenged individuals to make sure that they are complying with their treatment regimen. This means for example that you need to ensure that the person is taking their medication on time and in the correct doses.

You must also watch carefully to ensure that dangerous behaviors do not put your patients in harm’s way. When danger does present itself, you should call 911 to get emergency workers to help deal with the problems rather than attempting to deal with it on your own. For example, if your mentally challenged patient overdoses on sleeping pills, you should call 911 immediately rather than try to induce vomiting on your own.

Provide Patients with a Path to Recovery

Finally, your role as a home health care worker is to facilitate the patient’s path to recovery. This means that you work with them to ensure that they will have the right kind of support to deal with their problems and that you help to keep the family involved as well in the recovery of the mentally challenged patient that you work with as a home health care worker. 

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