When creating a safe living environment for elderly people, the first step is to assess their needs. Physical and cognitive impairments must be taken into account when providing home care. During the home visit, it is important to explain everything you are doing and ask before touching someone. In a tense or increasingly tense situation, keep in mind that asking too many questions can be overwhelming and that patients and their families can become irritated.
In that case, ask questions that refer only to the reason the person entered the service and save any other questions that refer to the patient's general condition for another visit. If a patient's or family member's behavior begins to worsen, stay calm and take care to dissipate anger; ignore threats or give orders. During the visit, take basic safety precautions, such as being alert to your environment and watching for signs of possible violence. These include yelling, verbal abuse, threatening gestures, weapons, or signs of drug or alcohol abuse.
Kindly but firmly set and maintain professional boundaries and recognize your own limits and abilities. The National Council of State Boards of Nursing has additional information on how to set professional boundaries. While not all nursing home incidents are preventable, staff members still have a duty to care and take responsibility for knowing what the main safety concerns are for older people. In addition, set priorities for care for each home visit, try to schedule visits during the day, and let your agency know when you plan to return from each visit.
Healthcare organizations with a mission to care for people in their homes provide a valuable service. This allows older people to maintain a level of independence and receive the necessary care in the comfort of their home, rather than being placed in a nursing home, long-term nursing home, or specialized facility. In addition, studies have shown that between 5% and 61% of home care workers have experienced some type of violence in the workplace. Home care helps older people stay safe and protected while maintaining their independence from the comfort of their home.
In the United States, home care workers are more susceptible to verbal abuse and assault, threats, and sexual harassment. Employee safety policies and procedures must include personal safety measures when making home visits, zero tolerance for all incidents of violence, and specific measures that staff must take if they are concerned about their safety or experience violence during a home visit. Labor Office statistics show that home care workers suffer more than double the national rate of workplace injuries across all sectors. And because the home care staff may be the only provider who cares for the patient, they must be comfortable working independently but also recognize that they are part of a larger team of care providers, including the patient, other doctors and informal caregivers such as family and friends.
The comforting environment of home care may be a more attractive option for many; however, safety could become an issue in this situation. Home care requires providers to enter the homes of people they don't know personally. More research is needed to better determine the extent of the risk and safety of home care workers and to identify recommendations for improvement. The Centers for Disease Control and Prevention (CDC) developed a free mobile application (CDC Homecare Safety) that includes tips for safely managing threatening behaviors when providing home care.
Other safety items to consider in home care include nightlights, making sure walking trails are free of cables and carpets, and ensuring that smoke detectors are regularly replaced with new batteries. Agencies could also inform local police of the presence of home care employees so they can increase patrols in the area.
