Staying Safe in Homecare: Identifying Risk Factors & De-escalating Tense Situations in Home Care

Home care and hospice clinicians provide vital care to patients in their homes. However, these clinicians also face unique safety challenges, including the risk of violence from patients, family members, or others. Let’s explore how home care clinicians can identify potential risk factors for violence, how to de-escalate tense situations, and how to recognize the warning signs of a potentially dangerous situation.

Identifying potential risk factors for violence

One of the most effective ways to prevent violence is to identify potential risk factors for violence. Some of the most common risk factors include:

1. History of violence: Patients with a history of violence or aggression may be at a higher risk of acting out again. This is especially true for patients with a history of drug or alcohol abuse.
2. Mental illness: Patients with mental illness, especially those with a history of schizophrenia, bipolar disorder, or personality disorders, may be at a higher risk of acting out violently.
3. Medication: Certain medications, such as antidepressants or anti-psychotics, can cause agitation or aggressive behavior in some patients.
4. Environmental factors: Patients who live in high-crime areas or have a history of domestic violence may be at a higher risk of acting out violently.

De-escalating tense situations

Once potential risk factors for violence have been identified, home care clinician should be trained on how to de-escalate tense situations. Some effective de-escalation techniques include:

1. Stay calm: Speak in a calm and reassuring tone, and avoid using an aggressive or confrontational tone.
2. Listen actively: Listen carefully to the patient’s concerns, and show that you understand and empathize with their feelings.
3. Validate the patient’s feelings: Acknowledge the patient’s feelings, and let them know that you understand why they are upset.
4. Use non-threatening body language: Avoid crossing your arms or standing too close to the patient, as this can be interpreted as confrontational or threatening.
5. Identify common ground: Look for areas of agreement with the patient, and try to find a solution that meets both of your needs.

Recognizing warning signs of a potentially dangerous situation

Home care clinician should also be trained on how to recognize warning signs of a potentially dangerous situation. Some of the most common warning signs include:

1. Verbal threats: Patients who make threats of harm or use aggressive or threatening language may be at a higher risk of acting out violently.
2. Physical signs of agitation: Patients who become agitated, restless, or pacing may be at a higher risk of acting out violently.
3. Noncompliance with treatment: Patients who refuse treatment or become noncompliant with medication or other treatments may be at a higher risk of acting out violently.
4. Sudden changes in behavior: Patients who exhibit sudden changes in behavior or personality may be at a higher risk of acting out violently.

Violence against home care clinicians is a serious and growing problem. Home care agencies should provide comprehensive training to their staff on identifying potential risk factors for violence, de-escalating tense situations, and recognizing warning signs of a potentially dangerous situation.  Agencies should implement policies and procedures to address and prevent workplace violence, including reporting and documenting incidents, providing support and counseling for affected staff, and taking appropriate disciplinary action when necessary.

By identifying potential risk factors for violence, de-escalating tense situations, and recognizing warning signs of a potentially dangerous situation, home care clinicians can reduce the risk of violence and protect themselves while providing quality care to their patients. By being proactive and well-prepared, home care clinicians can continue to provide compassionate care to their patients while staying safe on the job.