I'm a personal support worker seeking out advice: Resident wants to leave the nursing home. Should I help make it happen?

So you've told his wife about this plan? What does she say?

Not surprised the wife is resistant. She probably put him there in the first place, right?

I think it would be very awkward to bring him home against her wishes, with you moving in to take care of him. Depending on her condition, sounds challenging.

Sad that he seems so capable yet is stuck in a nursing home. For him, could be better to be home, and could work if he lived alone. What about that? An independent apartment? But then the costs would be prohibitive.

Either you are a very inexperienced care worker in your early 20s or you have taken leave of your senses.

If you have genuine concerns that your resident's rights are not being respected, report your concerns to your line manager.

If you can't do that, or it doesn't go anywhere, go to your state's care standards regulator and find out how to report potential abuse.

If you, as a support worker in a nursing home, take any steps to assist this man to leave the nursing home, or to undermine his wife's legitimate decisions made in his best interests, you will be in more trouble than can be easily explained.

I suspect you also have a lot to learn about dementia.

Look. By all means continue to have enjoyable conversations with your resident about the road trips he'd like to make, and encourage him to talk about his memories of travel, and then other aspects of his life too. That is fine, that is good work, that is enriching his quality of life.

But taking at face value what somebody with a progressive brain disease says about what he wants to do and acting on it would be so unbelievably irresponsible I can't think what you're thinking.

Where are you Gonzalez? I'm curious because PSW is a term I don't hear used often outside of my province. The way it works here is that getting a space in your preferred nursing home is no easy task, in urban areas the wait list can stretch into years. There are also several people living at my local nursing home who are really only there because of a sleight of hand that has ticked all the boxes that allow fully funded care, technically they probably could live outside a nursing home but they would get less care and it would cost them more.
IF you and his wife were working together to help him fulfil his bucket list I would say go for it, but this really just sounds like a wonderful fantasy to me... aside from his physical limitations you have no idea if he (and his wife) could even afford it.

You are so wrong, young and naive. Actually you should leave this job and leave your patient alone. You are going to do nothing but cause trouble for the patient, as well as get yourself in trouble in regards to this type of work. Go get a totally different type of job and don't even think of messing with this family.

Gonzalez,

You don’t mention the type of Degenerative Brain Disease this man has. That info could help you get some specific information from members that have experience with specific conditions. For example, Alzheimer’s, Lewey Body Dementia, Vascular Dementia, PSP, etc.

You are very young. You probably have a huge heart but, you have to understand, any plan you try to implement to get this man moved out of the NH will be looked at as very suspicious.

If the man is in a NH he requires 24 hour care. Are you prepared to provide 24 hour care. Alone. No days off for the rest of this Man’s life.

You would not only be interrupting a care plan that has been put into place you will be looked upon with great suspicion as to your motives.

No. Do not get involved.

OMGOODNESS... You need to remember you are there to support not to take over. I'm sure the wife has taken measures of not letting her husband out of the NH. I'm sure this patient has cognitive times and at other times he is not very cognitive. Please step back and look at the full picture there are a lot of factors that you need to consider, legal, moral, medical, ethics.
blessings
hgn

Go for it. Resident wants to enjoy whatever time he has left his way, not being cooped up in a NH room. NH are a business plain and simple. The goal of many is to make as much off a resident as possible, until the resident passes, plain and simple.

NH the resident is in is probably depressing and lousy, with the only bright spot being the resident seeing the young man. If Gonzalez is willing and able to be his 24 hour caregiver and the resident agrees, which seems to be the case, then again, Go For It. The wife may be glad that it is the NH responsibility for care at the moment and not hers.

As far as NH concern, only concern would be liability and money. Outside of that, they could probably care less what Gonzalez and the resident does as long as it could not be traced back to them.

Hello Gonzalez. Have you considered having a sit down with your patient’s wife outlining your offer? Perhaps if she knew she’d have 24/7 help in her home, she’d be willing to consider hiring you to live with them. Please remember that a person is sometimes placed in a nursing home, when the person who is their caretaker (his wife) can no longer be the caretaker due to her own physical health and limitations, burnout, and mental capabilities dealing with watching their loved one decline. If the gentleman was not married and had been living alone with no family to help and was placed in a nursing home, that would be different. However, he is married, his wife is responsible for his well being as well as her own. There may be a lot of dynamics you aren’t aware of that have your patient residing where he is. Unless you feel your client is being abused or neglected, it’s best to leave things as they are as I’m sure a lot of thought and conflict went into placing him in the nursing home in the first place. Best to you as you continue on keeping your caring side caring.

You don't say how old this man is? That would make a big difference in our answers.

"Wife is resistant" is your answer. She holds the purse strings. You have no idea if he can afford to do what he would like to do. He is where he is because he has been evaluated and found this is where he needs to be. Maybe he is there because his wife could no longer care for him. Couldn't afford to place him in a Assisted Living so this is where she could afford to put him.

Here in the US a LTC facility costs on average 10k a month. If you are able to get Medicaid (State help) its because you have no money but maybe Social Security and that goes to offset ur care. Spouse will not be made impoverished but there will be no extra money for trips.

Sorry, this will seem condescending, but step back and look at the full picture. Your profession does not allow you to get this involved. You are going to have patients that you can't stand and you are going to have ur favorites. Thats OK. But as a professional, you cannot get involved with their personal life. If wife is resistant that means you have already talked with her. I think you have gotten your answer. If you want to keep your job, I would back off.

A PSW is Canada's version of a CNA.

https://www.stonebridgecs.com/stone/latest-news/what-is-a-personal-support-worker-psw-and-what-does-a-psw-do

I think you heart is in the right place but.....I don’t think you have any idea what you would be getting yourself in to. I also find it extremely inappropriate that you would even consider undermining the mans wife and the medical professionals that have determined he needs to be in a nursing home. That’s just a personal opinion though. I just have serious concerns with a PSW thinking they know better. If you have concerns over the care and treatment of a resident, report it. Don’t make matters into your own hands and try to “bust them out” of the facility.

have you considered that what you experience with him is just show timing? I think it’s reasonable to assume you aren’t with him 24/7. Even if he is still at a mild stage. Do you understand what is to come? Are you trained to deal with violent outbursts? You will be his sole caretaker. Are you aware that your physical well being may be put at risk? Not to mention the emotional toll this will take on you. Like I said, I think your heart is in the right place but this is a terrible idea. Not to mention the ethical and moral aspects.....

Something else to consider - you don't say where this holiday destination may be, but there is no way in heck this man will ever get affordable health insurance to leave the country.

I imagine that because you work at a NH and have been to school you think you know all the ins and outs of caregiving and placement in a nursing home - I doubt you do, I was often amazed at how ignorant many of the employees at mom's NH were. Other than rescuing him from the NH, how do you expect this to pan out?
The community supports available are never adequate, the hoops necessary to get into a preferred NH are often a formidable barrier. At the NH you work an 8 hour shift (with breaks) and then go home. You get days off, holidays and vacation time. You likely get a benefits package. It is nothing like caring for one client one on one 24/7.
Lets pretend he moves with you to an apartment - There will be no RN down the hall if there is a crisis, no doctor who makes house calls. Meals won't be provided in the dining room, that will be on you also. What about Lifts, grab bars etc? How will he pass his time, there will be no other residents and staff to visit or entertainment?

Ok, some here are saying you are a female, and some a male. Not sure which. Then you say he wants to go on a trip.. then mention being his full time caregiver. I don't mean to sound suspicious.. but how often on here do we read about some "young thing" trying to take over "elderly dad or mom's care" over family wishes.. ALL the time!! And the responces are never good or happy.. it's always about financial or elderly abuse. I am assuming that wife has POA and financial control, so even if he has buckets of money.. cough... how do you assume he will get ahold of it ? I doubt she will just happily hand over cash, when she has already had him placed somewhere she feels is providing him proper care. Perhaps she won't let him come out because she really does love him and want the best for him? I just feel something is off here. Sorry if I am wrong...

If I found out that a caregiver was making plans with my parent to abscond from a facility to take a dream vacation or live independently, I’d call the police. Your seeming concern for your patient aside, you need to know your place.

Just to be blunt: Don't get between a husband and wife. At any and all jobs now and in the future, don't encourage married men to run off with you. If this patient starts blabbing about how you and he are planning to run away, it won't look good for you. It will in fact look quite bad and you may find yourself suddenly no longer employed and without a good reference for a future job.

Gosh. You are such a blessing. Every one of us should be so blessed if we have no one to advocate for us. I so love your enthusiasm, your caring, your dedication and especially your advocacy to make sure your patient's rights are protected...but so many issues are raised by this. Reality sucks.
So, let's try to sort through it all.
You probably don't want to communicate about this possibility to coworkers or administrators and supervisors. Most nursing homes want the $$$ so they won't want to let go of someone who has the $$ especially if they are not problematic residents.
You must be cautious about professional conflicts/ethical boundaries etc.
If this even happened, who is going to pay you? If the spouse is opposed you're not likely to get very far...but, that said...
I wonder if his rights are being violated, presuming he has the cognitive abilities you say. Can you suggest to him (since wife is probably not present all the time...) that there be an elder law attorney consultation? Someone who could make a visit to the facility...maybe under the guise of getting important papers set up/reviewed?
Do you feel like he is being kept there against his will? Does he? Then I wonder how helpful, if nothing else, it might be to check in with Adult Protective Services....but perhaps first....if you have a local Long Term Care Ombudsman...that would be my first or second call as they are probably more familiar with the laws in your state.
By your age, you do not have as much experience under your belt...my guess is this is going to be that one case you will carry with you forever as you will learn much...just be careful and watch your own back:-)...We need more people with your spirit and dedication to advocate for the best interest of their patient. But the question is, is this the best decision for your patient? And what roadblocks will other family put up? It would be far easier if the spouse went along with the plan...Good luck...post a note and let us know how it all goes!

Just WONDERING...if nothing else, if the wife did know...might it be possible for all to go on a journey for the patient to ultimately return to the NH?

I am adding to my previous post. If the NH gets a whiff of this you will be dismissed immediately. And you should. Unethical and unprofessional. The liability to you and the nursing home could be substantial.

This person is contradicting themself. (We have no idea if male or female. I thought I read male.)

#1... "Also did I mention that his wife is resistant to him leaving the NH and going on the trip?" His first response to a reply earlier on was wife didn't know.

#2...Responded there was no Dementia but says in OP "My resident has a rare progressive brain disease that basically kills brain cells." I googled this and found it may be Huntingtons. Here is what the article said:

"Huntington's disease is a relatively rare fatal inherited condition that gradually kills off healthy nerve cells in the brain, leading to loss of language, thinking and reasoning abilities, memory, coordination and movement. Its course and effects are often described as Alzheimer's disease, Parkinson's disease and ALS rolled into one, making Huntington's disease a rich focus of scientific investigation."

It may not be Dementia but it looks like its worse. I know a man who had ALS. Near the end he was wheelchair bound. His wife was a nurse, not an aide.

We don't really know this patients history. There is no way this poster knows the patients finances. He is only going by what the man tells him. A man who has a rare desease that kills brain cells. I don't think he/she should be encouraged. If he feels there is abuse, then go up the chain of command.

Speaking from experience, I am completely against nursing home residence if it can be avoided at all. I have seen too much patient neglect and the dismay and unhappiness they too often experience. Be sure that his wife has not been assigned as his health care proxy before proceeding because she could stop it completely. He has the option to withdraw his assignment of health care proxy at any time, and probably you should be assigned as the health care proxy instead. Check to see that his wife doesn't have more legal rights to stop you. Make sure you are on solid ground, and make sure the nursing home hasn't taken over guardianship of the patient. As far as the mechanics of removing him, I am sorry I am not familiar with the process. I hope someone else here has some useful input in that regard.

You need better boundaries. It is not your place to insert yourself between this husband and his wife in this decision. Does your work have any access to Employee Assistance Programs? You could use a few sessions with a therapist to discuss where your responsibility for this patient's life choices begin and end.

You sound like you really are a caring person. However, if you are going to work with ill people, you have to have better boundaries. You need to know what you can and can't control. Where this man is placed is not under your control. How you care for him in his current placement is completely under your control.

This is something you need to stay out of

Please explain “completely cognitive” as you have determined because you and he “have full on conversations, he can walk a few steps, stand”, then state “everything a cognitive person can do except ADLs”.
I have never read the word “cognitive” used in this context. I am also unfamiliar with the phrase “full on” in relation to conversation.
From my perspective someone with the behaviors you have described might or might not be “cognitively intact” if that is what you are attempting to refer to, but in the absence of responding to adaptive aids or readily to hands on help regarding ADLs, such a client COULD be quite significantly limited.
You speak of “a rare progressive brain disease that basically kills brain cells”, but Iwhether “rare” or not, most if not all dementias result from some damage to the brain that reduces brain cells, and thus reduces brain functioning.
Bottom line, absent much more information from you, it is very difficult to make any sort of helpful recommendations about what you should decide to do.
If the person responsible for this gentleman’s care disagrees with your thoughts, and is legally responsible for his welfare, I could see your conversations with him being considered questionable.
Unless there is more to the situation than you have chosen to reveal, I would stop where you are, keep the conversations to general topics, and spread your enthusiasm and concern among all of your patients.
I must honestly tell you also, that while I would be glad to discuss my LO’s situation briefly with you, especially if you were a good caregiver, I would still feel compelled to report anything that in my judgment was overstepping of professional boundaries to appropriate supervisory staff.

This is the sort of story that makes Law and Order such successful, long running show.

Perhaps there is a troll in the room?

Not being familiar with the job description personal support worker, I googled it: "Personal support workers (PSWs) care for people who are ill, elderly or need help with daily tasks. You make sure your clients are comfortable, safe and enjoy emotional and physical well-being."

You provide care for a resident in a nursing home setting. How long has he been your client? Is he your only client? Which shift do you work? How long is your shift? How many others care for him in a 24 hour period? Are you the worker responsible for your client's bathing, shaving, dressing for the day? Can your client toilet by himself to include transfers? Does your client feed himself? Does he eat in the dining room?

I ask these questions because it sounds as if your resident has a big old case of cabin fever! His physical abilities have declined ahead of his mind. He is fantasizing a larger more exciting life! And really, who hasn't had the same thoughts one time or another? A dream trip with a personal aide & no financial worries: the line forms behind me!!!

Seriously, your client needs more stimulation every day! You say he is completely cognizant. He needs to be out of his room & interacting with others as soon as he is up & ready for the day. Even if he is just saying good morning to the housekeeping staff, get him out of his room & interacting with others! He eats in the dining room, he attends activities & even suggests activities that interest him!

Work with the rest of the staff to find jobs he can do: pass around craft supplies, read to another resident who has vision issues, pour juice, pass around snacks, play cards with another lonely guy.

As for experiencing a new location, have the activity director see if his wife is open to getting him a virtual reality device & travel videos.

One of the saddest things about neurodegenerative diseases is the unpredictability of progression. Your client's cognition has remained while his physical abilities have declined. Tonight, tomorrow, next month, his cognitive status may decline incredibly quickly, without warning & without returning.

Put your care & concerns to work right now on quality of life measures for your client that can be implemented in real time & real life. Don't waste his precious cognitive time pursuing a pie in the sky project.

This person only responds to those who approve of what she/he is doing.

NO, NO, NO!

GonzalezJ, what you are thinking of and considering doing with this Elderly, Married, Disabled Gentleman is Extremely Innapropriate, Dangerous, Unethical, and a Violation of your Professional Services!

First off, you are in your "Early 20's", so you have Very Little if Any Real Medical Experience, and Very Little Life Experience for that matter! This Man is Disabled, or he would not be Qualified and would Never been admitted into a Nursing Home in the first place, and You have No Right to "lead him on" into believing he could just "waltz off into the distance" with this "Young Thing" who isn't a Medical Professional, Isn't a Family Member, and Most Especially without his Wife's knowlege and Complete Authorization and Approval, Even if it Were a Healthy and Safe Idea in the First Place. Plus, what you are even considering doing with this Gentleman is bordering on Financial Exploitation and Kidnapping, so I would think Twice before putting any more thought behind such Medically Dangerous, Unethical and Immoral "Adventure"!

If I were to ever hear of such Cokamamie Scheme in my workplace or otherwise, I would Immedietely Report You to the Police and to your Supervisor's! You would be putting the Life of this Poor Disabled Man in Serious Jeopardy.

That some of the more Mature and Experienced Caregivers on this site have given you Any Encouragement to proceed on this Dangerous and Childish Plan has Completely BLOWN MY MIND, an I for one am going to Report this Thread to the Agingcare Administrators in request to Shut This Thread Down, as it is so Completely Disturbing to Encourage such a Display of Unsafe Caregiving Practices, on So Many Levels!

Come on People! I pray to God that the thought process of the OP can be written off as innocence and ignorance, if not big heartedness and kindness, But you older, more experienced folks here need to think before encouraging this young persons ideals, and THINK of the REAL HARM that Could come to the Both of Them if this Farce of an "Adventure" ever Truly got of the ground! My God, Think People!

I'm Reporting my own response in hopes that the AC puts a Stop to this Dangerous Thread, this "discussion" should not be encouraged any further!

So agree with Staceyb.
Actually I think this is a troll...