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

A quick answer NO.

We can report single responses but not to ask to stop a thread.

I can't believe this thread is still alive 🤯

I think original poster has left. She felt she was "jumped all over" for asking a question. She also responded to one of my post that she also has LPN training. So she has medical training. I told her she should have said that in the beginning and the answers may have been different.

I really think we should just stop the thread.

By the way if you were working with me you are a red flag. Part of your duty is to watch for any person who might cause harm or take advantage of a vulnerable person and I know you have been taught what not to do, so I would have to make my DON aware. We have workers who take advantages of our residents like steal, abuse, have sex etc. So don't think us older CNA and Tma are not watching the new ones. Even if not new and even if many don't tell there will be someone like me that will tell. I have no problem to report. No problem to report to state or police cause my number one concerned his my residents.

No you should not. I know your heart is in the right place but you would be opening a can of troubles.
He has a wife who makes decisions. You are a hired worker which your employer would say that isn't the best thing for you to do for many reasons.
You will have a client like this but rarely. This here is none of your business and you will make it much harder on him feeding him hope. You could get written up or lose your job. Remember it was a hard decision for wife or family to make and you know nothing of the situation. You were hired to do the job caring for him there. This would be unprofessional conduct.
Your young and inexperience. So do your duties and give him the best of care and make him apart of his new home and new friends. For all you know he could be there just while she's out of town. Just because he said he will pay you don't mean he has that say. His health is a need to know and a nursing assist. Knows very little only what you need to perform your job. So don't do it! The wife would have to approve it and no you don't want to ask cause it wrong! This was probably a very very difficult decision with a lot of reasons. This is also probably based on insurance many other things! Customer service is for you to make him comfortable to his do home. Sorry that I'm going on about but only because your young. Now you can go to your head nurse and tell her what he is saying and ask her advice on how to handle it. He will in time be ok about it but he will always miss his homes. People go through the grieving process when they enter a facility. Some will be angry and maybe feisty which is rare. Some will cry etc but they except it.

Having been a care provider who worked for clients at home, I completely understand your desire to help give this client freedom and quality of life based on your personal assessment of his situation. However, it is VERY easy to become emotionally attached to a client and lose perspective. As a caregiver, we see a lot of situations we may not agree with but your job is to provide the care you were hired to do and leave personal feelings out of it which can be very difficult to do - especially in your 20s.

That being said, you indicated the wife was “resistant” which implies you have had a discussion with her about her husband’s wishes? If yes, talk to her again and discuss finances, game plan etc - it’s often considerably less expensive to have around the clock care at home than paying a nursing home assuming your patient is self pay. You cannot offer 24 hr care - it’s unreasonable and unhealthy for you. Are you able to put a team together? Is your clients home set up to accommodate his living back at home ie separate bedroom etc? There are lots of things to consider and do not rely solely on the patient’s answers to these questions.

if the wife does not want him home, for whatever reason, you could request permission to take him out occasionally for day trips, the movies, a meal . . . (Assuming again as a hired care provider).

Lastly, provided you stay in this field, you are going to see situations similar to this many times in the future. You must find a way to maintain a somewhat emotional distance without compromising your compassion. You cannot save the world but you do have the power to brighten lives along the way! No matter how this turns out, your patient knows you care and that has great value!

Good luck!

My Mom had PSP.

We started seeing changes in Mom in 2005. Things an outsider would never notice.

My Stepdad passed away in 2010. The stress of his diagnosis, treatment and death seemed to escalate Mom’s symptoms. During my Stepdads illness I realized how much they had been hiding.

My Mom could no longer pay bills, keep up with her doctors appointments, follow a recipe. But oh man, she could talk a good game.

She was buying every magazine ever published, entering every sweepstakes, falling for every scam, and donating, donating, donating.

When my Stepdad became very weak from chemo he asked me to take over their finances. I can’t begin to describe the mess. He also asked me to keep Mom at home as long as I could.

Mom’s Doctor could never put Moms illness in a specific box until the last year of her life when the final symptoms appeared.

I had never heard of PSP. The Doctor described it as mimicking Alzheimer’s and Parkinson’s.

My Mom weighed less than 70 pounds when she passed away. She was still eating and drinking. It was explained to me that her metabolism was in overdrive.

This thread is particularly hard for me. My Mom was in a NH the last 2.5 years of her life. I could not handle her at home any longer. The entire 2.5 years she was in the NH she was plotting her escape.

The controlled environment of the NH was absolutely necessary in my Mom’s case to keep her mentally stable and safe.

The Aides, LVNs, and a couple of RNs were a godsend as well as Hospice near the end. One particular LVN that was studying to be an RN, she was my eyes and ears, even after she was transferred to another wing. She checked on Mom every day she worked. If there was anything she thought I needed to know, she called me.

I visited my Mom often. The last 1.5 years my sister hardly visited at all. It was truly devastating to watch.

My adult children, late 20s, early 30s, at the time, still can not wrap their heads around what happened to their Grandmother.

The OP asked for advice. Advice was given. Experiences were shared. It’s emotional.

I hope the OP hangs around this site. There are countless stories of caregivers struggling to keep their loved ones in their homes, stories of the grueling decisions to place their loved ones, and vast medical knowledge.

All of us jaded former caregivers were once young. I can only speak for myself but being young used to get me in a lot of trouble.

Good evening friends:
It was only tonight I discovered the link to private messages and found a few for myself. Someone signing in as Anonymous594015...I'm unable to send a private message back to you for some reason, so I wanted to take the opportunity here to have a word.
First of all, when I re-read my original post, it seemed, to me, that I NEVER condoned what the original caregiver was asking about doing. NEVER. I pointed out the multitude of issues from a variety of concerns. For those who jumped to the conclusion, that I was condoning it, you were /are mistaken. I have been so tired from my own caregiving that I was quick to defend/apologize and explain...but this highlights the dangers as well as the good of a forum like this.
More specifically, I am not weeding back through all the posts to find the original comment suggesting the caregiver seek out therapy. Anonymous594015 has leapt to the conclusion that I think therapy is only for individuals who are a danger to themselves or others or psychotic types. NOTHING could be further from that. MY point was/is that this particular, singular situation didn't mean someone needed to seek out therapy to have insights into their own behavior and desire, let alone considering if the person had funds for a therapist. The caregiver could potentially use some guidance from a supervisory person or from a more seasoned professional colleague...but suggesting they needed therapy was a bit of a reach IMO. And as I have reminded people more than once, this poster came here for feedback, they cared enough to ASK before acting. They are learning. They knew enough to ask.

On a more personal note I have experienced therapy myself over some time, years ago. Once with a therapist that did some harm in the name of doing good-- because of his own belief system that I was too young and naive to recognize at the time; another was a true blessing in my life. I have also spoken on the stigma of mental illness at an annual meeting of the American Psychiatric Assn. Therapy can be a godsend if one has coverage for it and/or can afford it. Not everyone can. It seems this topic really struck many nerves for many followers. Hopefully everyone has learned something from it.

The decision to put a relative into assisted living, memory care or nursing home is not made easily as it is very expensive and emotionally draining. I am dumbfounded you would even consider this idea of yours. There certainly must be other ways you can enhance the quality of life for this person you have bonded to, working with the other staff at the NH. But as a professional, you need to have boundaries.

Thank you Gdaughter.

Now the OP has come forth and stated that they are a SHE, and that the Patient "Older Gentleman" has PSP, which is NOT Only Degenerative Brain Disorder, but a Full Blown Autoimmune and Neuromuscular Complete Body Disorder much like Parkinson's Disease, but which unfortunately does not respond to the Parkinson's Medications, I KNOW, AS MY OWN FATHER HAD THIS RARE AND HORRIBLY DEGENERATIVE DISORDER!!!

Thankfully, we as a family did not ever have to put our Dad into NH except 2 short post hospitalization stints as he recovered from Aspiration Pneumonia, which ultimately did take his life. I would not wish this Diagnosis on Anyone, as it is so incredibly painful to watch someone die of this, and the OP has No idea what she would be getting into, it is that horrid.

However she is correct, my experience with my own Dad was that he had full cognitive functions right up to the end, although I am not sure this holds true of everyone with PSP. Caring for our Proud, Wonderful Dad was exhaustive and so Painful to watch him decline, which was an 8 year process, the final 2 years he was unable to walk unassisted, bathe, shave or even feed himself as his shoulders were blown out from so many falls. Luckily their were 6 dedicated kids to care for him, plus the employ of PSW's who came to the home to assist near the end. Let me tell ya, a few hours shift caring for him and you were shot! Most definitely not a 24/7 job for 1 single person, no matter how young or how fit!

The OP needs to back off and set up Professional Boundaries on this and Every Patient in the NH, it simply is not their place to interfere into this family like this, especially with someone with this Debilitating Diagnosis!

Your latest post suggests that I look down upon the "lowly Nurses Aide/PSW", and nothing could be furthur from the truth! In fact, both of my parents spent short stints in Nursing Homes in recovery from various illnesses, extended post operative recoveries and hip and knee replacement rehab, and all were positive experiences, mostly due to the Nursing staff's good care!

The Nurses Aides are a very important part of the convalescent and rehab team, and were instramental in both my parents care! Most assuredly appreciated and in my opinion, overworked and underpaid! So please don't go making assumptions on my part!

Gdaughter, thank you for your f/u response, clearly some of us, myself included, sometimes need to step back and truly think of the ramifications of a situation, and not respond until we've thought things through.

Oh how Wonderful it would be if we could indeed "break out" some of these lovely people from NH, who on face value do Not Appear to need to be there, but who unfortunately do. We Think how nice it would be to save them from the boredom and the daily grind of living there, but it isn't our place and they ARE there for a reason, even if it doesn't appear so to us at the time. They Are the
Paid Help, and are only there to do their jobs.

The OP is Young and Fresh, and doesn't have a clue of the real reason why the old man is truly there for, but he has made an impression on her heartstrings, perhaps a Granfather like feeling in that together, they can ride off into the sunset and fulfill his bucket list, just like in the movies, but we all know that this is not how the real world works now, isn't it?

I do "get" the OP's desire to "save him", as he is kind, intelligent, well spoken, so interesting and unfortunately very very sick. It may well be that his wife is all he has left in the world, and together he and the OP found a kinship that seemed Fantasmical, Unstoppable even, but it is a house of cards that would soon come crashing down upon them if the OP even thought twice upon acting on such an endevor.

Oh to be young and un-jaded by the ravages of Degenerative brain disease, and think that we could save the world, one Wonderful Elder at a time.........

And yet, We who have been in the trenches of Elderly Care for Many, Many, Many Years do know better now don't we? We do need to be the voice of reason, and not encourage this sort of behavior, no matter how kindhearted their intentions might have started out now, don't we.

I do wish the OP well, I hope her spirit goes on to make Wonderful and Positive Changes upon the world of those stuck in the NH system, as we all know how sad and lonely it can be, through no fault of their families, sometimes, there are just no other options for long term care, when families can no longer care for them at home. I wish the OP all the best, and may their kind spirit never be broken!

GonzalezJ: What put this patient in the NH? Certainly something happened that he needed Nursing Home care. Going on a trip is a no.

I was Extremely Heated when I read this post and responded in the middle of the night last night, so if my response was Elevated, my apologies! I felt that this discussion was bordering on Elder Abuse, and it affected me severely! I felt that many people were acting irresponsibility in their idea's and their suggestions in support of the OP, and could not believe what I was reading!

Gdaughter, as a LSW, You Especially should be "Teaching" (as you so appropriately stated) this Nursing Home Aide (as they are called in the US) or PSW to be doing the Right Thing, by suggesting that they Shut Down this Inappropriate line of (Not) thinking, and set them straight in that their Idea of encouraging this Gentleman any further into believing that they could leave the facility on a "Wild and Wonderful vacation" an then "living his life to the fullest" is nothing more than a pipe dream, that borders on Criminal, and is unduly Unfair and Cruel to encourage such inappropriate actions. I mean, how do they know that "money is No Problem" for this Gentleman, or that they could even fulfill such a position outside of the NH, it is just Naive and Magical Thinking on their part, and should never be encouraged to entertain such idea's!

The OP is Way Overstepping their Boundaries of their Medical position there at the NH, by ever even entertainingly such a notion, and while they may be young, caring and compassionate, their actions in filling the patients head full of the possibility "breaking out" of the NH is so incredibly immature and in appropriate, let alone beyond the scope of their Caregivers position there at the NH, they should be reported, let alone terminated if they continue on this line of thinking.

The patient has been placed in NH for a reason, which the PSW/OP Is Not and Should Not be Privy To, they Are Not a MD or even a Family Member, Therefore the OP/PSW should be encouraging their patient to utilize the facilities in-house entertainment, or show interest in creating other LEGAL outlets of creativity and entertainment for ALL of the patients in the NH, and if they are such Great Friends, could even be done APPROPRIATELY, off the clock and on their own time, and With the Wife and Families Permission and their Blessings. Honestly is Always the Best Policy!!!

If travel is what is interesting to the patient, they could bring in some Great Travelog type viewing, and make a regularly scheduled "Movie Night", including snacks and make it enjoyable for all to enjoy.

There are Many things that the OP could do to brighten the Patients life both on and off the clock if that is what they desire to do, but they should work within the legal boundaries of their License, and not over step their role in this patients and his families life.

From reading the initial post, all of 3 or 4 paragraphs, a lot of people made some pretty wild assumptions of this PSW's and this patients position there, and Few took in account that they did not have the Legal Authority to carry out such a potentially Criminal Act, let Alone even consider that the patient is likely Show timing in front of this Innocent and caring employee of the Nursing home.

The OP is in NO POSITION to Diagnose the Patient, and has NO Authority to Act or Encourage this poor patient. He/she was Clearly overstepping their boundaries and should have been discouraged from the start, and Gdaughter as a LSW should have discouraged the OP from the start!

Gonzale has not responded since 1/19 and that is because he had a negative response. He only responds to people who agree with him.

I think its time to shut down the thread. His original post and his responses have been contradicting. Man has a brain desease that kills brain cells but in a later response man has no Dementia. I looked up mans desease. It may be Huntingtons. This is a very debilitating desease. This man needs a professional to care for him. If a PSW worker is like our CNAs they have no medical training. What they learn is from on the job experience. They cannot administer meds unless a medtech. They can't give shots, put in catheters, etc. Their job bathing, toileting, cleaning up messes. Yes, the dirty work.

As a healthcare worker he is being very unprofessional. He is not suppose to get that involved with a resident. Like I said, if he feels there is abuse, he goes thru the chain of command.

WOW, this really opened a huge can of worms!
I agree with everyone that this is completely inappropriate and crossing major boundaries.
My experience with NHs is most of the residence with dementia are always asking to go home. I have heard the staff saying to them that they are home and move onto another topic. If the person gets agitated I have seen the staff calling a family member for the resident to talk to. Nothing but positive results - so far as I have seen.
There is so much ethically wrong with this. If you are so concerned for this man's well being:

1) Have you talked to his family. Does he have children?
2) Have you talked to the social worker at the facility, charge nurse,, anyone?
3) Knowing his condition is only going to worsen, how will you deal and provide his care when the bomb drops?
4) What steps have you taken to FIND out EXACTLY what his TOTAL medical condition/complete diagnoses is. Not sure you are privy to that info.
5) How will you go about getting educated and fully trained to make this commitment?
6) Are you trying to get on the will?
I am sorry if this is offensive, but it was the first thing that came to mind. I admire you if you are truly looking out for his well being, but you can't just do what you are proposing to do period. You are interfering with a situation that is outside of your job description. It is also obvious you do not know enough about his entire situation to even remotely go along with this, much less do it.
Do the right thing and be his Personal Support Giver at the NH which employs you. If I was in your position and truly cared about this person, I would go to the proper support for him and voice my concerns.

Actually, your age does matter here. It sounds like you’re very compassionate with this one resident.
Two suggestions:
1) update resume
2) find a good lawyer
Responsible NH and families will not extend patience for long.

That decision belongs to the family or POA. Period. There is no mention of legitimate abuse but if so report it. If one of my mom’s psw’s atempted a vacation without my knowledge I would be furious and I’m sure I would have multiple options for legal remedy and hold the facility or care service responsible.

Otherwise this sounds like a movie not real life but maybe his family has concerns about his care and him traveling.

Have you thought about creating a travel business/service suited to fragile seniors and their families. Find medically appropriate trips/ make all the arrangements including advice on emergency services. Start with one facility. If someone had that service I would have used it to take my Mom more places before she passed.

If not a full fledged business, offer your services to travel with families as a caregiver. Just be sure you have an attorney write your contract to minimize your liability.

Your compassion for your resident friend is admirable. You must have a kind heart.

Please stop considering taking him on a trip and removing him from the NH. Since you work there, you know a NH will not qualify someone who isn't eligible. I appreciate that he may be higher functioning than those around him, but experience demonstrates it won't last. You should be out with people your own age and enjoying YOUR life to the fullest. If he is a true friend, he would not want to burden you and saddle you with his wants and desires. NO ONE wants to live in a NH. My MIL asks me every day to help "get her out."

Consider the legal ramifications you may face if you pursue this. I would definitely pursue legal action against someone if they took the actions you propose.

Turn your kindness and compassion toward other pursuits and enjoy your 20's. Trust me, the decades fly and you'll wake up in your 50's before you know it.

This is a decision for his family to make.
Obviously if he were cognizant he could check himself out, call a cab (Uber, Lyft...) and go where he wants. Since he can't do that he is not competent or someone has declared that he is not competent. If that is the case and he can legally fight that he is competent.
As for you I think you have crossed boundary's that are established for a reason. If you were to take this man for a ride, even to McDonald's for coffee without permission you could be charged with kidnapping and your hopes of maintaining a job in healthcare would be slim to none.

You can't Get yourself involved as a Personal Support Worker who is Getting paid there. Tell him although this all sounds very Nice, It is Not in your own Hands. Let yourself Off the Hook today and Breathe Easy. He is there for a reason, dear....

Gonzalez,

Your caring and dedication are admirable. Even if the man could move out of the nursing home, as his brain disease progresses you'd become exhausted caring for him 24/7.

The man's wish to live elsewhere is valid and he should discuss this with his own attorney and physician before proceeding. Maybe it can work out with you in the picture somehow.

Thankfully he has you as a confidante and ally.

I applaud granddaughter's comments on this matter.

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

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!

NO, NO, NO!

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

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

Perhaps there is a troll in the room?

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.