hha abusive patient

How a Home Health Aide Can Handle an Abusive Patient

As home health aides (HHA), we are not just providing a home care service. We are also responsible for the emotional well-being of our patients. This is why it is important to know how to handle an abusive patient who lashes out at home health aides verbally.

In this blog post, you’ll learn what you can do if your patient starts screaming at you and insulting (or hitting you) you every time you show up for work.

Violence against home health aides in the workplace is nothing new. From verbal abuse to physical assaults, nursing literature contains a lot of information on HHA abuse and reactions to it.

Workplace violence is generally defined as an act or threat of violence ranging from verbal abuses like name-calling or yelling at a worker all the way up through physical assault with weapons such as guns, knives, sticks etc.

Violence and abuse in healthcare settings has been a topic of debate for decades.

Experts have found that there are many forms of violence, including: physical assault by patients or their loved ones; robberies from the person being cared for; verbal harassment as well as mental/emotional trauma.

The best way to prevent these issues is through education and prevention–starting with home health aides who need training on how to identify risk factors before an incident occurs!

HHA Abuse Examples

Examples of home health aide abuse by patients include:

  • verbal abuse
  • patient threatens home health aide with a knife
  • physical assault or attempted sexual assault

Home health aides are not the only ones who experience workplace violence, and it’s important to note that many home care patients themselves have been victims of domestic violence, bullying in school, violent crime etc.

When a patient is abusive towards their home health aide, it should not be tolerated.

They are considered to have committed violence and can result in serious consequences for the abuser.

Why Me?

Reasons may vary as to why patients abuse home healthcare aides but they all generally lead back to one major issue: powerlessness of elderly people who feel like they’ve lost control over what’s happening around them or within themselves because of dementia or other such illness that limits mental faculties.

These feelings may turn into anger which leads – often unconsciously – up until when an event occurs where there might be some type of conflict with care staff; this could include anything from refusing treatment due out-of-control behaviors (elderly rage) leading up till physical assault on the HHA or PCA (personal care aide).

Knowing The Effects

HHA’s who have been victims of patient abuse and harassment are affected in a number of ways, including:

Worrying about their own safety as well as the health care workers’ ability to provide quality care for themselves if they come into contact with that patient again.

Experiencing feelings such as anger or guilt over not preventing this from happening when it did happen and wondering how they could better prevent these situations going forward.

Feeling as if they are locked in a power struggle with the abusive patient and feeling powerless.

Worrying about how to tell their boss when home health aides have been verbally abused by patients on more than one occasion, home health aides may feel that they’re not able to concentrate or focus on their work while providing home care for these types of patients.

Things A Home Health Aide Can Do to Prevent Abuse

The most important thing is understanding why abusers act this way so we can better prepare ourselves for what it means to manage those situations.

We need to understand that there’s often an underlying reason behind out-of-control behaviors (elderly rage) leading up till physical assault on the HHA.

You and your fellow home health aides play a pivotal role in preventing an abusive patient. All it takes is one person to help prevent abuse- you just need to know the signs of when someone needs help, even if they don’t want you there!

HHA’s are entrusted with many responsibilities; but how important are some of them? Preventing abuse by patients can be done simply by knowing what types or behaviors may indicate that something bad has happened recently, and following through on those suspicions.

You play an active role on this front line: whether it’s monitoring potentially abusive situations or assisting with communicating what is going on during medical procedures that might be difficult for someone who cannot speak – like when they need help breathing through various respiratory treatments- there’s never any shortage of ways that home healthcare aides can lend support while ensuring safety!

Handling an Abusive Patient

If home health aides don’t know what is triggering their patients or themselves it may be best for them to get additional counseling help if possible.

To break down what home healthcare aides can do when faced with an abusive situation, here are several key ways home health aides can handle verbal abuse.

  • Remove themselves from the home or room as soon as they feel that they are in danger
  • If the home health aide feels unsafe, they should leave.
  • Calmly explain to your patient why you want them to stop verbally abusing you and then offer a compromise: “I’m not going anywhere until we figure out how both of us can feel safe.”
  • Call for assistance and contact their supervisor. If this is not possible, call 911.
  • Get a family member to help them if the situation escalates past verbal abuse
  • Use soothing tones of voice when speaking with the patient
  • Report it to their supervisor and document in the medical record.
  • Keep personal safety in mind at all times. For example, have another person monitor an interaction between you and this patient when possible.
  • Report any signs of impending violence such as raised fists, clenched jaw etc., which will give time to assess what triggered them and use professional communication strategies afterward. (This can also be used by other home health aides before going into a home visit so it’s always best to prepare ahead!)

If you’re patient is getting frustrated and consequently violent towards you, then make sure to contact the registered nurse that oversees the client care. Communicate everything that’s happened so far in detail as well.


It is a difficult situation when your patient starts screaming at you and insulting you every time they see you. But, don’t let that get to you! I’ve given some advice on how to deal with an abusive patient. Remember these tips for the next time someone gets angry and yells at you during their home care service visit.

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