Personal Care Assistants for those with disabilities.

Dealing With the Set in Their Ways PCA

As this blog has covered off and on, many people like myself who have a disability require the assistance of personal care assistants (PCAs) to help with our personal cares throughout the day. For better or worse it just comes with the lifestyle. And as I once wrote, good help is hard to find as far as that goes. But my other post only covered the topic from my perspective in general. When you step under the PCA umbrella it reveals a few different layers. One noteworthy aspect is that there are very unique types of PCAs, good and bad, that all of us “in the biz” have had to work with. For example, a year ago fellow blogger Tiff Carlson wrote an interesting piece that hit the highlights on how to deal with the flaky PCA, which thankfully I have hardly any experience with.

On that subject I thought I’d shed some light on one of the specific types of PCA that I find challenging to work with: the set in their ways PCA. Unlike flaky PCAs, PCAs that routinely show up late, PCAs that aren’t skilled enough, that lack common sense, that don’t listen well, and do other related things that justifiably lead to me replacing them after a short period of time, many set in their ways PCAs can be good to great and are therefore worth it to hang onto but they often put their own twist on your personal care routine. And in some cases that can become an ongoing frustration. It’s been my experience that they tend to appear in three forms.

The first type of set in their ways PCA is the one that by and large does things in my home the same way that they do it in theirs even though I prefer that those things get done differently. For example, all I want people to do when they make my bed is to just neatly throw the covers up over the pillows. I put myself to bed at night and loose bed covers allow me to scoop my arm under them and fling them aside easily. But others make the bed by tucking all the sides in, placing the sheets under the pillows and the comforter over the pillows, or other such ways that make it a lot harder for me to get ready for bed. Another example is that I prefer that my shirts, sweaters, etc. get folded by folding them in half down the middle of the front of the shirt in what I’ll call the half fold technique. But many do the “store fold” style instead, which is when the shirt is folded with the whole front facing out like you see in department stores. But I don’t like my shirts folded that way in large part because they come unfolded a lot easier when either I or my PCAs pick through my shirt piles, and next thing I know I have an annoying bunch of half folded shirts.

Personal Care Assistants for those with disabilities.Ultimately, the first type of set in their ways PCA comes around to doing things the way that I prefer either because they notice how I do things and adapt without me having to say a word or I ask them to do things the way I want instead. Some make the switch right away while others need some reminding, but in either case things typically improve.

But that isn’t always the case with the second type of set in their ways PCA, who despite me directing them to do things the way that I want, on multiple occasions even, they continue to revert back to doing it their way anyway. Going back to the bed making example I’ve had one that always left half of my pillows and the top few inches of my sheets exposed. I could never tell if she layered them exposed that way on purpose or she did a tug at the bottom of my comforter to straighten out the wrinkles and it got pulled down too far as a result. Either way, having my pillows and sheets exposed makes the bed look unmade to me so I would ask that the comforter get pulled up all the way to the headboard to cover everything. Then a few weeks later the bed would start getting made the other way again and I would remind her again, and then some time period later again, and so on and so forth with a handful of things. Repeated reminders often lead to awkward exchanges as well. About the third time that I ask that something get done a certain way I tend to get a “Yeah, you already told me that” type of reaction, while I’m thinking “Yeah, I DID already tell you that, so what’s the deal?”

The second type of set in their ways PCA can be a catch 22 to work with, because on the one hand they can have good PCA characteristics (e.g. trustworthy, reliable, prompt, skilled) that make for a good long-term partnership. But on the other hand, the semi-regular reminders about how I want things done when they routinely revert back to doing things in a way I don’t like can be frustrating. In some cases they are small things that aren’t too big of a deal but it’s how I prefer nonetheless. And as frustrating as it can be day in and day out it seems too harsh to fire someone who is good in other areas but still folds my shirts a different way than I do. So I can get stuck in a bit of a PCA vortex that way, because I’ll say it again: good help is hard to find.

The third type of set in their ways PCA simply doesn’t make the necessary changes to do things the way I want out of sheer ignorance. One of the highlights of my last PCA post is when I mentioned the PCA with the bad language who would frequently ask me what kind of mother f-ing pants I wanted to wear, etc. She was a prime example of this ignorant PCA type. For example, on the front of my apartment door is a lock box with a key inside that my PCAs use to get into my place. They punch in a code, pop the key out, unlock the door, and then put the key back. This PCA hardly ever put the key back right away. Rather, she would bring the whole thing in and set it on the counter and then forget about it. Then I would have to put it back myself or my other PCA couldn’t get in the next day. I would repeatedly remind her that she needed to put the key back right away and she would usually just dismissively wave her hand and say, “Oh I can never figure that thing out.” Her attitude was similar in relation to a handful of my personal cares as well, but it was her true ignorance about the simple task of putting my apartment key back that ultimately led me to firing her.

So that is the breakdown of the set in their ways PCA. Some are good and can change, some are good and don’t change very easily, some can’t change because they are too ignorant, and sometimes you just end up folding most of the shirts in your closet yourself.

Have you had a set in their ways PCA? How did it turn out?

1 reply
  1. Jeff Ehmann
    Jeff Ehmann says:

    Shawn, I feel for you Dude.

    I am fortunately a fully functioning T11/T12 with Type A personality and a lovely and caring Wife. I have the same types of issues with her and my kids, but unlike a relationship with a PCA, my kids and Wife are hopefully forever.

    Might I suggest you write out your guidelines and provide it to each PCA? I’ve done that with my kids…but of course that didn’t work, because the don’t listen to me either.

    Anyhow, give it a try.

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