Obese client, too much for my back.

[Cucumberpitta]

I've just started work for a company as a carer delivering personal care in clients' homes.

One of the clients has no mobility in her legs and is morbidly obese. She is gantry- hoisted from her recliner chair to her bed to receive a bed bath.

Firstly, she is extremely heavy and even with slide sheets I struggle to assist her onto her sides, and in any case it is very difficult to clean her sufficiently due to the fact she is very overweight.

When lowering her back into her recliner chair using the hoist, she requests that we push her as far back into the seat as we can so that she is upright and doesn't start to 'slide' or 'slouch' in the chair. Unfortunately the foot rest of the recliner is extended to stop her from sliding down, so I literally have to bend over it at 90 degrees and push with all my strength as she is lowering.

I have only been to her twice and each time I feel my lower back suffering afterwards.

My managers are chasing the OT to reassess and have said they will make sure my shifts only include her alternately to give my back a break.

Two other carers have stated similar concerns.

The client refuses a male carer and a residential home.

Has anyone got any advice for me? I don't want to rock the boat too much as I'm new. I really feel for this client too and not sure what the solution is.

Can they send 2 people to her instead?

It sounds like she needs 2 people and the local authority or whoever is paying will need to fund that or she can’t have care

For the client and staff’s health and safety it sounds as though 2 carers would be required. Has a risk assessment been carried out? Has she always had 1:1 care? Has her mobility deteriorated or weight been gained since the last review and RA was carried out?

Your manager really mush prioritise H&S, so many back issues are caused in care work.

I would refuse to do anything that compromised my own health and safety. You're there to assist her, not risk your own health. Let the OT do his/her assessment, but in the meantime I would refuse any request that puts you at risk of injury.

@dementedpixie

Can they send 2 people to her instead?

The council fund her care and would only pay my company for two carers if this was requested by an OT. In any event I don't think my company are in the position currently to be able to co ordinate two carers so would probably have to drop her contract. She was assessed by the OT in the summer having come out of hospital with no mobility in her legs. She has stayed around the same weight apparently so I am really confused as to why she was assessed as being suitable for one carer.

@DowntonCrabby

For the client and staff’s health and safety it sounds as though 2 carers would be required. Has a risk assessment been carried out? Has she always had 1:1 care? Has her mobility deteriorated or weight been gained since the last review and RA was carried out?

Your manager really mush prioritise H&S, so many back issues are caused in care work.

I presume a risk assessment was carried out yes. I'm new to care and the company so I don't know the full history. I just know that she had some mobility before she went into hospital in the summer. Her mobility and weight have stayed the same since she was discharged and was assessed by the OT.

Your company is responsible for your health. Three carers have flagged the same issue. They need to deal with this inside the company or they will leave themselves open to legal action. Make sure you have all flagged the issue in writing.

Your company needs to send two carers and then recoup the money from the LA. How they finance this is not your problem as an employee.

If they can not get the extra money from the LA they can stop providing care for this individual. They have a commercial relationship with the LA.

Your company finances and the LA finances are not your responsibility. Your health is.

Thanks so much for your advice. Just spoke to one of the staff and apparently this happens a lot in care...the OT's often will say one carer OK for morbidly obese patients because of funding cuts. They don't often take carers advice?
I'm happy to quit over this client to be honest.

@Cucumberpitta

Thanks so much for your advice. Just spoke to one of the staff and apparently this happens a lot in care...the OT's often will say one carer OK for morbidly obese patients because of funding cuts. They don't often take carers advice? I'm happy to quit over this client to be honest.

I think you are in a position to refuse that client There's a carer shortage The job is clearly a problem and you mustn't damage your back

You aren't a troublemaker, it's clear.

I don't think you need to quit over this.

In the company I work for, we are only allowed to go in pairs to clients who need hoists. I thought this was the norm. Do they genuinely expect you to do the call on your own?!

I expect that even if she is down to be reassessed then it's going to be a long slow process.

All I can advise is to be really careful with your back. Once it's damaged, it's never the same. Can your patient be encouraged to help with her arms when being moved into the chair? She could push against something to position herself in the chair to take the weight off you?

Are there any other options for washing her? Does it have to be a bed bath? If it's too much for you, then could she be washed in her chair until OT can reassess?

@Fantails

In the company I work for, we are only allowed to go in pairs to clients who need hoists. I thought this was the norm. Do they genuinely expect you to do the call on your own?!

Yes! The occupational therapist says one carer so the council will not pay for any more. Apparently this is really common and a big fuss has to be made to get funding for two carers, but I'm new to all of this.

Have you had any training around respect and dignity? It's completely unprofessional to post about this lady, this is a real person you're posting about. Even if we don't know her name you're sharing sensitive information.

Please think about how you would feel if you were that lady, or she was a member of your family. Have some respect for your clients.

I'm genuinely horrified! So you're rolling an obese client to wash her?
You need to look for a better company, but in the meantime refuse this client.
I work for a private company. Everything is better: pay, hours, mileage and conditions
This is awful no wonder there is a care crisis if this is what's going on!

@SmileyClare

I expect that even if she is down to be reassessed then it's going to be a long slow process.

All I can advise is to be really careful with your back. Once it's damaged, it's never the same. Can your patient be encouraged to help with her arms when being moved into the chair? She could push against something to position herself in the chair to take the weight off you?

Are there any other options for washing her? Does it have to be a bed bath? If it's too much for you, then could she be washed in her chair until OT can reassess?

I already have a damaged back in that it's always lower left side that 'goes' when under strain (I suspect a bulging disc).

@CorrBlimeyGG

Have you had any training around respect and dignity? It's completely unprofessional to post about this lady, this is a real person you're posting about. Even if we don't know her name you're sharing sensitive information.

Please think about how you would feel if you were that lady, or she was a member of your family. Have some respect for your clients.

Oh come on GC it's hardly identifying info and op is clearly struggling

@CorrBlimeyGG

Have you had any training around respect and dignity? It's completely unprofessional to post about this lady, this is a real person you're posting about. Even if we don't know her name you're sharing sensitive information.

Please think about how you would feel if you were that lady, or she was a member of your family. Have some respect for your clients.

Yes we have had training around confidentiality, respect and dignity. I do respect this client and I feel for her. I'm conflicted between protecting my back but not wanting to just walk away. I feel for her having to have multiple new carers she doesn't know too. Perhaps you're right and this is too identifiable. Will ask for it to be removed.

I’m disabled and I’m first to say don’t damage your health for goodness sake. You can’t physically push her back enough so she has to stay in her bed until there are carers to position her properly. The only alternative is not pushing her back and risk a fall but either way there needs to be extra support. But unless you kick up a fuss it will be assumed you can manage. Could you ask client to complain that she feel unsafe not being left fully pushed back and she’s afraid she will fall? They will have to record her concerns may help Kick something starting.

You shouldn't be hoisted single handed! No client should ever be hoisted by a single carer it is always a double. Nor should you be rolling someone alone. Shocking that this is being allowed! I've been a carer for almost 12 years and wouldn't dream of hoisting someone alone.
You need to refuse to provide care until you have a second carer in place.

The company are doing all they can do get her reassessed. I think either way I'm going to have to refuse to keep going.

I knackered my back at the grand old age of 26 doing care and retail work. Herniated my L5 disc. I regularly get crippling episodes of sciatica and something else is going on to be investigated if the NH S ever recovers.... Anyway- not a cat's chance in hell would someone with those mobility and weight issues be a single person job in a care home OR a hospital ward. I also worked in the community and that would have been a two person call. That's a piss take.

In your boat I would put in writing to your company your concerns- the client is simply too heavy to move safely for one person. As such you are not able to attend to them as you would not be confident to maintain either of your safety. Explain in writing you are already experiencing back pain after calls with this client. Cover yourself and refuse to attend alone. My mum used to care coordinate for a home care provider- in circumstances like these she would meet the carer at the house to be the extra whilst all the bureaucracy was being dealt with.

Really feel for you both.

@Dobbysgotthesocks

You shouldn't be hoisted single handed! No client should ever be hoisted by a single carer it is always a double. Nor should you be rolling someone alone. Shocking that this is being allowed! I've been a carer for almost 12 years and wouldn't dream of hoisting someone alone. You need to refuse to provide care until you have a second carer in place.

It is a free standing gantry hoist if that makes a difference. Are there legal guidelines on this?

@Teaandcakeordeath83

I knackered my back at the grand old age of 26 doing care and retail work. Herniated my L5 disc. I regularly get crippling episodes of sciatica and something else is going on to be investigated if the NH S ever recovers.... Anyway- not a cat's chance in hell would someone with those mobility and weight issues be a single person job in a care home OR a hospital ward. I also worked in the community and that would have been a two person call. That's a piss take.

In your boat I would put in writing to your company your concerns- the client is simply too heavy to move safely for one person. As such you are not able to attend to them as you would not be confident to maintain either of your safety. Explain in writing you are already experiencing back pain after calls with this client. Cover yourself and refuse to attend alone. My mum used to care coordinate for a home care provider- in circumstances like these she would meet the carer at the house to be the extra whilst all the bureaucracy was being dealt with.

Really feel for you both.

But by the sounds of it the council is incredibly reluctant to pay for double-ups....so I'm quite confused about the funding these other home care companies are getting for two-carer handling on anyone with a hoist.

Yeah I worked in care and it was always 2 carers for any calls with a hoist

I'm a nurse. We don't move any patients alone and especially not one who is obese.