By June Price
Q: I just began hiring PCAs, and I can't seem to get them to do what I need. If I'm too nice, they don't do anything. If I put my foot down, I sound like a slave driver! What's the solution?
 June Price |
A: I firmly believe that the single most important element in developing and keeping an effective working relationship with a PCA is good communication. Since this is a huge topic, let's just focus on the most basic communication styles, how they differ, and examples of each:
PASSIVE: Indirect communication; failure to clearly ask for what you want or need; asking in an apologetic, begging, or fearful manner.
EXAMPLE: "Um, if you want, can you maybe take out the kitchen garbage ... sometime later ... if it's not too much trouble ... and if you really don't mind?"
AGGRESSIVE: Communicating in a harsh, over-powering, demanding manner with little or no regard for the other person; shouting; harassing.
EXAMPLE:"That kitchen garbage stinks! I don't know what you put in there, but take it out!"
ASSERTIVE: Expressing your opinions and needs in an honest, clear, and effective manner while acknowledging the feelings and rights of others.
EXAMPLE: "Josie, please take out the kitchen garbage after you have finished your lunch break."
Most people with disabilities are passive or aggressive. Some spent years in a nursing home where CNAs, RNs, or other staff may have made them feel they were a "bother" if they asked for something. Often understaffed, the patient's needs may have been marginally met. Some staff members have been fired for spending too much time on an individual patient--fixing their hair, painting their nails, and doing other grooming tasks--performing tasks which should be a right!
Caregiver abuse--in or out of a nursing home--ranges from verbal threats ("If you call me once more tonight, you'll be sorry!") to physical abuse. Recently, the husband of one quadriplegic woman I know repeatedly hit her after she had a bowel accident in bed. One can only imagine her fear, intimidation, and passivity when she needs to ask this man (her primary caregiver) to do things for her. Keep in mind passive behavior includes avoidance--avoiding conflicts, avoiding responsibility, avoiding consequences.
Other disabled folks find their role as employer to be the first time they have authority over others. Their demands (not requests) may end with, "...because I told you to!" or, "...because I'm your boss!" A newly-injured person may be carrying around excess anger which might easily be vented at a worker. Aggressive responses can also include blaming something on another, or threatening or intimidating them.
By being assertive, you take full responsibility for yourself and your needs without criticizing or blaming others. It's not the easiest way out, but it's the best way to get needs met with your PCA or anyone else.
Developing skills aimed at changing your behavior through the use of effective communication is within easy reach for anyone through an extensive array of books, workshops, classes, the Internet, and seminars.
Q: I have been dating a man for several months. I just got a new female attendant, and I sense that there is sexual tension between the two of them. She is a great attendant, and they are hard for me to find, but I am not comfortable with the charge between her and my boyfriend. They are not actively flirting now, but I could see it escalating. What should I do?
A: This is really no different than if your boyfriend's new secretary is an absolute knock-out to whom your man seemed attracted. What CAN you do? You're not going to insist he fire his secretary anymore than you should fire your attendant because the two are exchanging sparks.
The only thing you can do is to initiate open and honest communication with each separately. Approach your attendant by saying, "You seem to be attracted to my boyfriend. I'm not comfortable with that. What do you have to say about this?" Maybe she will surprise you by apologizing, saying she already has a boyfriend, and promising to never let this happen again. Then again, she may tell you she's quitting you immediately and plans to run off to Acapulco with your man at midnight.
The point is, there's not a helluva lot you can do about the situation if they are going to hitch up, but you won't know anything for sure unless you broach the topics with each of them separately. Threatening is seldom effective, but open communication can be. TRUST is, of course, key--especially with your boyfriend. By talking about your fears and feelings, you may gain his commitment and trust. But the attendant has only a job to lose but a boyfriend to gain, so she is the one you have the least "control" over (if either).
Talk to them--letting each know that you know what's going on--and then, as much as possible, limit the time you three are together. Other than that, you can do nothing. If you fire her, the two might still get together, leading you to still breaking up with your boyfriend and also not having her! Leaving your boyfriend first (if the two begin to spark TOO much) might lead to him to dating her anyway, in which case you might end up with her as your attendant, but you might then have to listen to her talking about what a great guy he is!
The bottom line is that there's simply not a whole lot you can do here. Que sera, sera.
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