Supporting the Client but not the habit.

Take "Rob" for instance. He is often so stoned or exhausted after several days drug binge that it can take twenty minutes to get him ready for a dressing change. We must wake him up, get his pants or shirt off, etc. As incapacitated as he is, he usually resents our helping him with such simple tasks. Nonetheless, he would certainly get angry if we went away and didn't do the care he needs - the next visit would be even more difficult. So we stand there and wait for him in his 8 x 8. For a single caregiver, this situation would make one feel very anxious. For two, it would be just the task at hand.

If your attitude is "My time is so valuable, I can't be wasting it waiting for you," the justification is "It's ok. She made a choice to shoot up now or go out to hustle money for drugs, so I chose not to come back to give her care." It's the 'War on Drugs' mentality shifted down to the healthcare field.

"Different strokes for different folks." Really? We spoke to a nurse who worked in a suburban area nearby who refused to take referrals on known, actively-using addicts. However, a large population of addicts lived in that general area near the local subway station. The nurse had no information or experience to base decisions on except fear of the unknown. Her lack of experience with drug use - and users - seals their fate. If we had gotten our message out sooner, if she had heard what we are telling you, she might have had a different way to look at this group's needs.