Recently, I was asked to speak to some of you about working with challenging clients in a home health and hospice care setting.  I hope you were able to try out a few new strategies!  This is a summary of the discussion.

Things You Can Do For Yourself:

1. Be aware of your own mood, thoughts, and emotions before you meet with a patient.  Change them if necessary.  Develop a mental game plan or purpose statement before meeting with the patient.
2. Develop trust with the patient. Be accountable, professional, and fair.  Speak the truth.
3. Practice good communication. Listen.  Find a way to connect with them.  Validate their feelings and points.

Things To Do With the Client:

1. Acknowledge that they don’t want to be there.  Make it okay for them not to like you or that they have to receive your services.
2. Ask for permission; it gives the other person a sense of control.
3. Give the patient clear knowledge of the situation.  Enroll them in the goal-setting process.  Make goals in small specific increments.  Create fun rewards or make it a game.
4. Identify the source of the resistance.  Find out what beliefs are driving the problem behavior.
5. Recognize that denial is largely an unconscious process and serves a protective function.  Shift the focus away from the losses to what they can still do for themselves.
6. Love ambivalence as this is a space for change.  Meet resistance with reflection.  Roll with resistance; it’s not personal.  Offer choices.  Develop discrepancies (“You said that you want this; but this is what you are doing.”)
7. Express empathy and compassion.  This goes a long way to getting someone to do what you want because they feel heard and understood.