The nominated staff is was assigned to her home care client in March 2024. Her client is diagnosed with Mixed Type of Dementia and other comorbidities, Hypertension, and DM Type 2. Her client, although with Dementia, it was not in the progressive stage. The client was able to recognize all her children by name and face, was able to remember events, and also the client could do everything by herself, including taking a bath, eating, and even walking. But staff put her under very close observation and sometimes guidance because she had a history of a fall 2 years ago.

The patient never at one time accepted that she was sick and needed a nurse; therefore, she was not receptive to the nurse's presence in her house and kept on repeatedly saying that she was okay and didn't need a nurse. The daughters of the patient had explained to the staff that although their mother doesn't see the need for a nurse, they as a family strongly want their mother to be under the observation of a nurse because of the client's history of falls and this new diagnosis of Dementia.

The staff time at her client's house was difficult, but she had to stay focused on providing compassionate nursing care and ensuring safety at all times. In the morning, as she came in, if she found my client awake, she would greet her, but she would not answer back. If she offered a hand for support as the client was ambulating, the client always declined the offer, and if the staff insisted, the client would ask for a towel from the patient's maid so that she could hold her hand with the towel. 

Whenever the staff offered Mama anything to take, the client would not take it and even if she gave her a cup she would call the kadama and tell them to go and wash again.

Sometimes, the client would ask the nurse not to report for work again and say that the client was fine and didn't need her. But the staff would go stay in the kitchen for a while then go back to her because she understood the importance of providing compassionate care to a demented patient.

The client did so many things to discourage the staff from taking care of the client, but she still maintained my focus on continuing to create rapport and providing compassionate and holistic care to her client.

The client's daughters were very good and understanding, and they would see how their mother was treating the staff. Sometimes, they would make noise for their mother, and they would tell her how she was treating the staff as 'haram' (Arabic word for "not good"). The staff never thinks of it negatively as she always considers her client's condition and the care she requires. Even so, the staff never let the immediate heads have a knowledge about it as she worry that it will become a concern and the service will be put to hold.

The staff relayed to the immediate heads that the patient preferred the care partner to assist her and didn’t need a nurse; the operations team called the family, and we agreed with the daughters that we would give the client some time, and she would adjust and accept the staff help; and it was under monitoring for a month. The staff stayed with Mama (the patient) for 3 months, but she was still the same. The daughters were ashamed of her behaviour- how the client was treating herthe nurse, although there was no harm physically yet the family thought it bothered her emotionally, so they decided to end the care.