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Aide expectations - Am I being unreasonable?

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  • #16
    No, I am in CA, not NJ. There are no standards for training PCAs, although there may be state-by-state standards for training of HHA (which is what I suspect your aide is) or CNAs, since they are state certified. We developed our own course, which does not count for either HHA or CNA, but we do provide a certification of completion of the 40 hour class specific to SCI PCAs. Over the years we have refined and revised our program, and it is now being used as a model for several other VA SCI Centers in developing similar programs (including the Bronx VA).

    Find out where she trained and offer to give a free class on life with SCI for their students....a good way to get your message across for both students and instructors. We include such a panel presentation in our course.

    (KLD)
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

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    • #17
      SCI nurse: Can you please tell me what HHA & CNA stand for? How do they differ from PCAs?

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      • #18
        HHA = Home Health Aide
        CNA = Certified Nurses Assistant
        PCA = Personal-Care Assistant

        A CNA is, from what I understand, a higher rating than a HHA. They have some medical training. Minimal, but some.

        An HHA is, again from what I understand, more for taking care of your house/laundry/cooking.

        Raccoon
        4/6/97, car accident, C5. http://raccoon-kathleen.blogspot.com/

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        • #19
          Originally posted by clueless
          SCI nurse: Can you please tell me what HHA & CNA stand for? How do they differ from PCAs?
          lol, we need a dictionary for all the acronyms on this site imo!
          thx kenf, just read it
          Last edited by mimin; 09-08-2007, 11:18 AM.

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          • #20
            Mimin , there is one somewhere.
            oh well

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            • #21
              HHA = Home Health Aide. They generally have 80-120 hours of training from a state approved program. This varies by state. Some states require a minimum amount of additional training annually. They work for home health agencies (HHA), must be supervised by an RN, and have limited things they are allowed in do. This does not include "skilled care". In most states they are NOT allowed to do bowel care, catheterization, administer meds, or do any other invasive or sterile procedures (such as suctioning, tube feeding or changing sterile dressings).

              CNA = Certified Nursing Assistant. They generally have 80-120 hours of training from a state approved program. This varies by state. Some states require a minimum amount of additional training annually. Most work in nursing homes or hospitals, must be supervised by an RN, and have limited things they are allowed to do. This does not include "skilled care". In most states they are NOT allowed to do bowel care, catheterization, administer meds, or do any other invasive or sterile procedures (such as suctioning, tube feeding or changing sterile dressings).

              PCA = personal care attendant. No training is required, there is no state certification or legal designation. There are few if any training programs. You usually find and train your own, so you can have them do any care you require (bowel care, catheterization, suctioning, ADLs, transfers, etc. etc. etc.). In some states they are funded through Medicaid/Medicare waiver programs. Some states allow them to be friends or family. Many are private pay since insurance rarely will pay for PCA care.

              Here is the glossary by the way. I just added the above:
              /forum/showthread.php?t=85062


              (KLD)
              The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

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              • #22
                Aides:Here's a link to the Aide's Bible

                http://saratoga-publications.com/

                written by a C-5 quad.

                Random:

                Your spelling and grammar are impeccable. Do you use your hands or voice-controlled software?

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                • #23
                  Originally posted by Random
                  MaryEllen, thanks, as always, for buoying my spirits. I need you to write my singles ad ;-). Oh to still be in grad school… I’m a bureaucrat now. But I will be an author one of these days.
                  Hooray for leaving grad land, Randy! Yay!

                  As for the buoyancy of spirits, you lift mine as well. Never think otherwise.

                  Looking forward to seeing your personal ad. Knowing you, the gentlemen are responding well and often to your words, to you.

                  As for your writing, I'll attend your signing when it's a fait accompli. **thumbs up**

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                  • #24
                    Uncle Peter,
                    I am soon to be Aunt Randy myself.

                    I retain a fair amount of hand function. Sometimes I can do pretty normal if modified typing, and almost always can be pretty accurate with two fingers pulled out (at least in better windows--sometimes I just wait for tomorrow). But I am aspiring to voice recognition; I saw Naturally Speaking demonstrated and it made me drool.

                    Also, since with my antique computer I often lose what I write on line, I usually write in Word first to save continually. So I get the little red squigglies and correct typos if I have time.

                    It doesn’t like ‘squigglies.’ ;-)

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                    • #25
                      I use NaturallySpeaking 9. Fantastic software.

                      I hired half of my staff away from nursing agencies. Means I just have trained them to me, they already knew how to do everything.

                      Hiring people just out of CNA/HHA school helps as well. They haven't developed bad habits yet.
                      4/6/97, car accident, C5. http://raccoon-kathleen.blogspot.com/

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                      • #26
                        how dare an aide, of any classification, presume to know what you need. they are employees. i've used agencies and never had them tell me what i need. out the door they would be.

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                        • #27
                          Random, would it be asking too much for you to fill out your Profile? Thanks.
                          "The world will not perish for want of wonders but for want of wonder."
                          J.B.S.Haldane

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                          • #28
                            Originally posted by cass
                            how dare an aide, of any classification, presume to know what you need. they are employees. i've used agencies and never had them tell me what i need. out the door they would be.
                            '

                            I've often heard "The customer is always right."

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                            • #29
                              Originally posted by cass
                              how dare an aide, of any classification, presume to know what you need. they are employees. i've used agencies and never had them tell me what i need. out the door they would be.
                              I'm an STNA - State Tested Nursing Assistant. I was an HHA, but Ohio laws changed and I was required to take a course to become a CNA. The only difference between CNA and STNA was to take the state test, so I did and got the STNA designation. Just FYI as far as Ohio goes for the curious.

                              Cass, we have inservices at my home health care agency each month on different subjects pertaining to caregiving. One aspect that is regularly addressed is to absolutely respect the needs and wants of the person we are caring for. Another is to do our best to keep the client as independent as possible by encouraging them to do as much for themselves as possible. Needless to say, these two approaches do not always go hand-in-hand, and how this works out in any client's home has much to do with the aide's personality and attitude as well as the client's particular situation. We have care plans that are made by the case manager nurse in conjunction with the client to ensure that all the client's needs will be met (e.g. bathing ,dressing,etc) and are supposed to follow them. Certainly, we are never ever supposed to force a client to do anything that they do not wish to do, though we are told to encourage a client to do all activities listed on their care plan, and must document any refusal. Obviously, this is a gray area between "encouragement" and pushing beyond the rights of the client's needs ,wants, limitations, or just plain good or bad days, and how an aide handles these situations is individual depending on their attitude, work ethic and personality. I think it's better to have an aide who cares enough to say something vs. the ones who are only too happy to take the easy way out, but often there needs to be communication "tweaking". This is when a client needs to pick up the phone and call the agency. It doesn't have to be a fight, just a discussion about the issue and how to resolve it. If that doesn't work, it's time to go higher up the food chain or switch agencies.

                              P.S. I think I will bring this up with my agency. It's an issue that needs more discussion.
                              Last edited by Kendell; 09-14-2007, 06:44 PM.
                              Reality is merely an illusion, albeit a very persistent one.
                              - Albert Einstein

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                              • #30
                                Originally posted by marmalady
                                So would I - and I'd love to have someone do my dishes, and clean my house, and sort out my closets, lol - but that ain't the way life is. Sorry - just feeling a little 'tough love' here this morning.
                                ugh... PUH-LEEEZE -

                                The purpose of an aide is to help you live life more efficiently and reduce the "disability factor". Random can clearly do these things on her own if she has no choice. An aide has ABSOLUTELY NO place in telling a client they have to do it themselves simply because the aide feels the client is capable.

                                Speaking from experience, every time I struggle dealing with the most menial tasks, it is a constant smack in the face reminding me of my disability. Who needs to start their day off that way? It has nothing to do with laziness. I'm not some high-school kid taking advantage of moms good graces, I'm an adult who knows what they wish to have assistance with. Having this assistance helps me bypass all that crap and helps get me on my way to face the day w/ a positive attitude.

                                Random, if there's a lesson in any of this it is in assertiveness. Years ago I would have tolerated it too, and dwelled throughout the day how I wished I would have given her a piece of my mind. When something like that happens these days, I stop what I'm doing, look them straight in the eye, and firmly/professionally say something to the effect of, "look, you are here assist me in what I choose to have help with, not YOU. If this is something you cannot respect, then say so now and I'll let the agency know things aren't working out between us." And don't break your gaze until they do. You'd be surprised how quickly her ass will fall in line. And, your day will be a whole lot brighter knowing you didn't take crap for anyone.

                                One other bit if advice for ya, if I may. No matter how cool/great an aide is, do not let them know that all the other aides you've had suct till them, and how hard it is to find a good aide. If they know you are afraid to get rid of them, 9 times outta 10 they will end up taking advantage of this - possibly without even intending to do so.
                                .
                                "If ya don't have it in the hips, ya better have it in the lips..." ~ Charlie - Villa Dulce

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