Four Lessons To Removing Your Clients Shoes (Or Anything Else They Can’t Have)

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Four Lessons To Removing Your Clients Shoes (Or Anything Else They Can’t Have)

Working to serve and protect the elderly and disabled population, Guardians have to regularly make difficult decisions regarding the safety of their clients.

Sometimes these decisions are easy, such as the decision to move a client from a facility when they are receiving substandard care. Other times, the decision can be downright difficult. Sometimes we have to make decisions that the client doesn’t want to do, like giving up something they have loved for years.

We once had a client who loved high heeled shoes. For her, these shoes were a part of who she was and how she presented herself to the world. She simply could not imagine wearing any other kind of shoe.

One day during a podiatry appointment, the podiatrist informed us that, due to fall risks, our client would no longer be able to wear high heels. Judging by our client’s reaction, you would have thought that we told her we had to remove her foot (and maybe to her it felt this way).

After the appointment, the battle to remove the high heeled shoes ensued. For a while, it truly was a battle. No matter what we tried, the client always found a way to get her hands on the shoes she loved the most.

We tried removing all the shoes from her room. She convinced her caregiver to take her out to buy more. We informed the caregiver of the issue with heels, and the client quickly realized she had lost this ally. Still, she found other ways to buy them, like during facility outings. She even tried to reason with us, “these aren’t heels; they’re platforms. That’s different.”

In the end we were able to switch the client to flats, and help protect her from fall risks. It was not easy and took every trick in the book to finally get the change to stick.

clientshoesImage Credit: SPERA.de Designers

FOUR LESSONS FOR BIG CHANGES

Here are the four big lessons we learned from this client and others about making big changes easier for all involved.

  1.   IS THE CHANGE REALLY IN YOUR CLIENT’S BEST INTEREST?

When removing potentially harmful items from the client, the first thing you should assess is whether or not the change is really in the client’s best interest.

If you are removing something because of a known and eminent danger, such as with an increased fall risk with high heeled shoes, you are probably acting in the best interest of the client.

If you are removing something because of your own beliefs, you may not be acting with the client’s best interest in mind. A good example of this is with clients who smoke.

It has been proven that smoking poses long-term health risks. But if your client has smoked a pack a day since they were 15, and you’re making your client quit because you don’t like that they smoke, are you really acting with the client’s best interest in mind?  What would your client choose if they were still able to make these decisions on their own?

  1.   TRY TO EXPLAIN THE SITUATION.

Regardless of the client’s mental or legal status, it is important to remember that your client is a person with their own needs, wants, and desires. It is common, human decency to have a conversation with the client and explain why the change is necessary, particularly when they are able to have such a conversation.

A conversation also allows you to gauge the client’s reaction about the change and could give you some important insight into how difficult the change will be for the client. You may find that the issue is a hot button that causes them to react every time it’s mentioned, or you may find that they readily accept what is happening. Every client is different; as such, every reaction is different.

  1.   CREATE REMINDERS.

Removing something your client loves and has always used (like high heels) can be a daunting and difficult task, particularly for Alzheimer’s or dementia patients. Creating signs and reminders can be a good way to help clients remember what they cannot have, and why.

Signs are helpful for clients who mostly accept the change. They can act as gentle reminders, guiding them to what they should be doing.

Signs can be problematic for those clients who are angry and upset about the change. Use your best judgment when determining if signs and reminders will be helpful to your client.

Signs should be direct and to the point. A sign with too much writing or unnecessary information can confuse the client. Keep it simple!

  1.   GET THE SUPPORT CIRCLE INVOLVED.

One of the most important aspects to ensuring a smooth transition is to make sure that everyone in the client’s support circle is aware of the change. The client’s support circle includes their caregivers, facility staff, physical therapists, family, friends, and anyone else who spends time with the client.

It is important to inform people within the support circle of the change, what it involves, why the decision was made, and how the client feels about it. Giving them this last bit of information can be particularly helpful when the change is a hot button for the client. When the client’s support circle is in the know, the transition becomes smoother. As they are aware of the potential issues the change could cause, it also prepares them on how to react when the client brings this issue up.

 

For many clients, guardianship often brings big changes into their lives, including changes they may not be prepared for. As care managers and guardians charged with their care, it is our responsibility to help make these changes as painless as possible when we can. It is our hope that these tips can help make the change a little easier for someone out there.

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00a7e40This blog is shared by Theresa Barton, the expert behind The Guardian Network with more than 25 years of experience in the field of Elder Advocacy, Care Management and Guardianship. Learn more about Theresa’s work and resources for families, caregivers and health, support and legal professionals here.

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