5 Steps for Personal Support Workers Dealing With Difficult Patients

Updated January 2023

Personal support workers play a central role in the lives of their clients. They provide the assistance patients need to maintain independence, cope with debilitating medical conditions, and achieve the highest possible quality of life.

PSWs help with important everyday tasks, like administering medication, providing assistance with grooming, planning and preparing healthy meals, coordinating social activities, monitoring changes in condition, and supervising prescribed therapeutic exercises.

The PSW-patient relationship is, by definition, close and personal. And as with all close relationships, conflicts can arise.

How should PSWs deal with patients who push them away or resist help? How can you maintain professionalism and serve your client's best interests, when faced with disruptive and upsetting behavior? 

Start with these five steps. These are the approaches front-line health care providers often use when dealing with difficult patients.


1. Don't take it personally

It's crucial to remember that when a patient lashes out, it's rarely about you, the PSW. Many of your clients will be facing challenging circumstances, such as the death of a loved one, a frightening medical diagnosis, or a dramatic change in lifestyle—such as relocation to a nursing home.

Some patients will be dealing with chronic pain, or a frustrating loss of mobility or cognitive ability, which may cause frequent outbursts or periods of withdrawal from socializing.

PSWs must strive to remain calm and compassionate, and resist taking any harsh words or actions to heart. Your role is to provide a stable centre; someone the patient (and family) can rely on for support and clear thinking, even when times are tough.


2. Take note of behavioural changes

Has a formerly talkative patient suddenly become quiet and withdrawn? Has your normally pleasant client suddenly become defiant and angry? There could be a medical reason for the difficult behaviour—such as depression, or a side effect of medication—which should be evaluated by a supervising health care professional. An alternative medicine or change in dosage could be enough to resolve the issue.

Focus on documenting changes in attitude and behaviour, and report those observations to your manager. Approaching the difficult situation as a health challenge can help PSWs stay focused on patient care and maintain a healthy degree of professional distance.


3. Demonstrate empathy, not impatience

Arguing with a patient who is refusing to take a bath, complete an exercise, or eat a meal will only escalate tensions. Rather than showing your impatience, focus on communicating empathetically. Show you care that your client is going through a difficult time and that you're willing to listen to their grievances.

Sometimes patients feel they're being ignored, and simply want the PSW to stop, hear them out, and respond with an act of kindness. In many cases, demonstrating empathy and patience can affect dramatic improvements in mood and behaviour.

See what you can do to help the patient feel better. Something as straightforward as a five-minute chat or an extra cup of coffee could completely change the tone.


4. Talk with family members & other staff

Can't figure out why a patient is behaving destructively? Try learning more about them from their family members or friends. Get to know how people close to the patient interpret the negative behaviour, and if there's a history or story behind the outbursts.

You may pick up on some helpful insights that enable you to connect better with the patient—or at least understand more fully where the negativity is coming from.


5. Know when to draw the line

No PSW deserves to be abused by a patient. If you've tried every technique you can think of, and the situation becomes toxic/dangerous, don't hesitate to report the problem to your supervisor. It's crucial for personal support workers to set (and enforce) clear boundaries with difficult patients.

Your commitment to self-care is very important, and certainly includes protecting yourself from verbal and/or physical abuse.

In order to serve others well, PSWs must prioritize their own mental and physical well-being. As best as you can, let patients know what behaviours you will not tolerate, and seek help when you feel the line has been crossed.

Feel you have the drive, commitment, and compassion to become a personal support worker? 

Your next step is to speak with admissions. An admissions advisor will guide you through the PSW program, costs, financial aid, how to apply, and more.

Chat live with an advisor now. Or click below to explore the program in more detail. We're here to help!

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