--- title: Maintaining Your Safety & Independence with Caregivers description: Relying on caregivers may be one of the most frustrating aspects of living with paralysis. It puts you in a vulnerable position, which in turn leaves you open to a whole barrage of individuals who could work for you. This is where you need to get smart. Learning how to hire, communicate, and fire... image: https://www.spinalcord.com/hubfs/Stock%20images/Disabled%20elder%20woman%20on%20wheelchair%20with%20nurse.jpeg --- [![spinalcord logo desktop](https://www.spinalcord.com/hubfs/Logos/spinal-cord_png.png) ![spinalcord logo mobile](https://www.spinalcord.com/hubfs/Logos/spinal-cord-white_png.png) ](https://www.spinalcord.com/) MENU ** ![spinal cord logo slide out mobile](https://www.spinalcord.com/hubfs/Logos/spinal-cord_png.png) ** [![Dale Swope](https://www.spinalcord.com/hs-fs/hubfs/dale-img-min.jpg?width=100&name=dale-img-min.jpg) The Purpose Behind Spinalcord.com ** Play Dale Swope's Story ](https://www.youtube.com/watch?v=C1kPXDw_CQU) [For Advice Call: (877) 336-7192 ](tel:8773367192) ![Spinalcord Logo](https://www.spinalcord.com/hubfs/Logos/spinal-cord-logo-icon-svg.svg) - [About](https://www.spinalcord.com/about-us) - [About Us](https://www.spinalcord.com/about-us) - [Our Team](https://www.spinalcord.com/our-team) - [Trusted By](https://www.spinalcord.com/trusted-by) - 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Digital Resources - [Frequently Asked Questions & Answers](https://www.spinalcord.com/frequently-asked-questions-and-answers) - [When To Get A Lawyer](https://www.spinalcord.com/your-guide-to-knowing-when-to-get-a-lawyer) - [Organizing Life From A Hospital](https://www.spinalcord.com/blog/traumatic-injury-digital-tools-organize-from-hospital) - [Free Brain and Spinal Cord eBooks](https://www.spinalcord.com/spinal-cord-resources) - [Spinal Cord Infographics](https://www.spinalcord.com/infographics) - [SCI Life Uncovered Podcast](https://www.spinalcord.com/sci-life-uncovered/episode-1) - Local Resources - [Florida Spinal Cord Injury Resources ](https://www.spinalcord.com/florida-sci-resources) - [Local Assistance](https://www.spinalcord.com/florida-personal-injury-claims) - [Map of State Resources](https://www.spinalcord.com/state-programs) - [Community](https://www.spinalcord.com/spinal-cord-injury-community) - [Trusted Organizations](https://www.spinalcord.com/trusted-by-the-spinal-cord-injury-community) - [Events Calendar](https://www.spinalcord.com/events) - [Podcast](https://www.spinalcord.com/sci-life-uncovered/episode-1) - Recognition - [Best of Awards](https://www.spinalcord.com/best-of-awards) - [Trusted By Designation](https://www.spinalcord.com/trusted-by-the-spinal-cord-injury-community) - [** ](tel:8773367192) - [** ](https://www.spinalcord.com/blog/maintaining-your-safety-independence-with-caregivers#) - [** **(877) 336-7192** ](tel:8773367192) - [** **Contact Us** ](https://www.spinalcord.com/contact-us) # Maintaining Your Safety & Independence with Caregivers Author: [Tiffiny Carlson](https://www.spinalcord.com/meet-our-authors) Publish Date: January 14, 2019 Relying on caregivers may be one of the most frustrating aspects of living with [paralysis](https://www.spinalcord.com/paralysis). It puts you in a vulnerable position, which in turn leaves you open to a whole barrage of individuals who could work for you. This is where you need to get smart. Learning how to hire, communicate, and fire caregivers, when necessary, is key. Unfortunately, too many people find themselves stuck with caregivers who are taking advantage of their situation [in all kinds of ways](https://www.spinalcord.com/blog/what-to-do-when-your-caregiver-ghosts-you). When you rely so heavily on a handful of people to literally take care of everything you need in order to stay alive, you find yourself looking the other way when it comes to bad behavior by your caregivers - and this is not good. Take for example the well-written article by Hannah Soyer, a woman with a disability attending the University of Iowa. In her article, [she talks about how she was too afraid](https://www.rootedinrights.org/i-needed-my-caregiver-to-keep-me-alive-she-exploited-that-power/) to let go of a caregiver because of their hostile personality, and instead had to devise a way to get the said caregiver out of her life by waiting a year and slowly cutting down her hours. It was a situation that should’ve never happened. This is not the right way to do it if you have options. Unfortunately, many people with disabilities do not have them, which is why they stay with caregivers who are abusive. Especially in states where caregiver assistance is [barely covered by Medicaid](https://www.spinalcord.com/blog/tom-wade-quadriplegic-hs-teacher-suddenly-loses-caregiver-coverage), these individuals are less-empowered and frequently will keep a caregiver on-staff when they shouldn't. These stories are told time and time again online. As a person with a spinal cord injury, you have to "put yourself out there" with a caregiver, both mentally (trusting) and physically. This can take a toll on your mind without you even realizing it. Some people call this “forced intimacy” and it can lead to a lot of anxiety for a person with a disability, especially if they do not like the caregivers taking care of them. To remedy this, try to hire PCA you feel truly comfortable around. Setup your own interviews. Do not forever allow a home health care agency to staff you. In many states, they will allow this and your agency will simply add whoever you hire to their roster. Sites like Indeed, Facebook neighborhood pages, and Craigslist can be great locations to find PCAs as well. Ask for a resume and ask casual, fun questions to make sure you’ll get along. [![How to Hire an Amazing Team of Caregivers](https://no-cache.hubspot.com/cta/default/575040/26f82c99-55e3-4bb9-8f71-e03b1505de21.png)](https://cta-redirect.hubspot.com/cta/redirect/575040/26f82c99-55e3-4bb9-8f71-e03b1505de21) Over my 25 years of needing PCA's, I have had several instances of being stuck with a PCA I didn’t like because she either was mean, taking advantage of her job, or not listening to the way I needed my care done, and I never knew what to do. It can be scary. I have routinely been afraid of letting these particular caregivers go, afraid of the retaliation I may face, which is silly I even have to think about it. The hard truth is that there are evil people in the caregiver world, and it is up to you to watch out for them. [![New call-to-action](https://no-cache.hubspot.com/cta/default/575040/89aba5c6-548b-4638-b23b-8c4c299de247.png)](https://cta-redirect.hubspot.com/cta/redirect/575040/89aba5c6-548b-4638-b23b-8c4c299de247) **Topics:** Caregivers, Advice & Tips ### Stay Updated on Advancements On Traumatic Brain & Spinal Cord Injuries About the Author #### Tiffiny Carlson Since 1998, Tiffiny Carlson has been a prolific commentator on all things SCI in a number of prominent magazines, blogs and websites. Hailing from Minnesota, she was the SCI Columnist for New Mobility Magazine for 13 years and she currently works as the Executive Director of SPINALpedia, one of the leading websites for people with SCI to share videos and stories. She has been a C5-6 quadriplegic since a diving accident 24 years ago. Tiffiny has also been a fierce advocate for SCI research. In 2016, the Morton Paralysis Fund honored her for her work. While all SCI topics interest her, dating, love and the business of relationships have always been where her passion lies the most. [Learn More About the Author](https://www.spinalcord.com/meet-our-authors) **Leave a Comment** [![New Call-to-action](https://no-cache.hubspot.com/cta/default/575040/dc8bc979-ba55-463a-9400-f92cbdebcb1a.png)](https://cta-redirect.hubspot.com/cta/redirect/575040/dc8bc979-ba55-463a-9400-f92cbdebcb1a) true ### Spinal Cord Injury - [Types of Spinal Cord Injuries](https://www.spinalcord.com/types-of-spinal-cord-injuries) - [Secondary Complications](https://www.spinalcord.com/secondary-complications-after-sci-spinal-cord-injury) - [Causes](https://www.spinalcord.com/signs-symptoms-of-spinal-cord-injuries) - [Symptoms](https://www.spinalcord.com/types-of-spinal-cord-injuries) - [Prognosis](https://www.spinalcord.com/prognosis-of-spinal-cord-injuries) - [Legal Help](https://www.spinalcord.com/spinal-cord-injury-legal-help-get-a-lawyer) ### Brain Injury - [Types of Brain Injuries](https://www.spinalcord.com/types-of-traumatic-brain-injury) - [Causes](https://www.spinalcord.com/causes-of-traumatic-and-acquired-brain-injuries) - [Symptoms](https://www.spinalcord.com/traumatic-brain-injury-tbi-symptoms) - [Prognosis](https://www.spinalcord.com/brain-injury-prognosis-for-tbi-abi) - [Legal Help](https://www.spinalcord.com/brain-injury-legal-help-get-a-lawyer) ### Finding Treatment - [Physician Directory](https://www.spinalcord.com/brain-and-spinal-cord-injury-physician-directory) - [Rehabilitation Directory](https://www.spinalcord.com/spinal-cord-injury-hospitals-rehabilitation-directory) - [Technology Advancements](https://www.spinalcord.com/sci-technology-advancements) - [Prevention](https://www.spinalcord.com/spinal-cord-injury-prevention) ### Legal Options - [Spinal Cord Injury Lawyer](https://www.spinalcord.com/spinal-cord-injury-lawyer) - [Brain Injury Lawyer](https://www.spinalcord.com/brain-injury-lawyer) - [Types of Personal Injury Claims](https://www.spinalcord.com/types-of-personal-injury-claims) - [Where To Start](https://www.spinalcord.com/brain-spinal-cord-injury-lawyer-where-to-start) - [Local Assistance](https://www.spinalcord.com/florida-personal-injury-claims) #### [About Us](https://www.spinalcord.com/about-us) Spinal cord injuries are traumatic for patients and their families. They cause disruptive changes to every aspect of your life and there is a lot of new information to navigate and understand. Our experts have collected everything in one place to help you learn more about your injury, locate doctors and treatment centers, find financial support, and get assistance navigating your next move. [Learn More About SpinalCord.com →](https://www.spinalcord.com/about-us) ## [Contact Us](https://www.spinalcord.com/contact-us) ![logo-footer-spinal-cord.png](https://www.spinalcord.com/hs-fs/hubfs/img/logo-footer-spinal-cord.png?width=249&name=logo-footer-spinal-cord.png "logo-footer-spinal-cord.png") **  [877-336-7192](tel:8773367192) ** [support@spinalcord.com](mailto:support@spinalcord.com) [**](https://www.facebook.com/spinalcordcom) [**](https://www.linkedin.com/company/spinalcord-com/) [**](https://twitter.com/SpinalCordCom) [**](https://www.youtube.com/channel/UCAbz2AC18acXQkpMNPeDIqg) Copyright 2026 | All Rights Reserved. [Spinal Cord, Inc.](https://www.spinalcord.com) Sponsored by [Tampa personal injury lawyers](https://www.swoperodante.com/tampa-personal-injury-lawyer/) at Swope, Rodante P.A. a Florida law firm located at 1234 E 5th Ave, Tampa, FL 33605. The information provided by SpinalCord.com is not a substitute for professional medical advice, diagnosis, or treatment, see [ Disclaimer Policy.](https://www.spinalcord.com/disclaimer) [**](https://www.spinalcord.com/blog/maintaining-your-safety-independence-with-caregivers#) [**](https://www.spinalcord.com/blog/maintaining-your-safety-independence-with-caregivers#) ```json { "@context" : "https://schema.org", "@type" : "WebSite", "name" : "Spinal Cord, Inc.", "potentialAction" : { "@type" : "SearchAction", "query-input" : "required name=search_query", "target" : "https://www.spinalcord.com/search?q={search_query}" }, "url" : "https://www.spinalcord.com/" } ``` ```json { "@context" : "https://schema.org", "@type" : "Organization", "contactPoint" : [ { "@type" : "ContactPoint", "contactType" : "customer service", "telephone" : "+1-877-336-7192" } ], "legalName" : "Spinal Cord, Inc.", "logo" : "https://www.spinalcord.com/hubfs/Logos/spinal-cord_png.png", "sameAs" : [ "https://www.facebook.com/spinalcordcom", "https://twitter.com/SpinalCordCom", "https://www.youtube.com/channel/UCAbz2AC18acXQkpMNPeDIqg", "http://www.linkedin.com/company/spinalcord-com" ], "url" : "https://www.spinalcord.com/" } ``` ```json { "@context" : "http://schema.org", "@type" : "Article", "articleBody" : "The spinal cord is a vital part of the human body. As the vehicle responsible for carrying messages from the brain to the rest of the body and back again, even the smallest interference can be detrimental. Following a traumatic spinal cord injury, this bundle of nerves can become bruised, also known as a contusion. Because of the nature of the nervous system, any interference can constitute a serious spinal contusion, but these facts will help you dissect all of the information from the medical professionals.

\n\n

What Is a Spinal Contusion?

\n\"Signs-of-a-spinal-contusion-title-image\"\n

Much like any other bruise, a contusion can cause bleeding from local blood vessels and inflammation which, rather unlike bruises on other parts of the body, can have serious negative impacts on the spinal cord itself. Because the “blood must clot to stop the bleeding”a bruise results from contusions also increase cardiovascular risks.

\n

For example, the swelling a contusion can cause will often disrupt nerve impulses that travel from the brain to the body through the spinal cord, and the severity of this will depend upon the level of injury. Unlike a concussion, a contusion would not cause unconsciousness or a ‘blackout’, but instead cause the patient to feel a numbness or tingling in the extremities.

\n

A contusion can cause spinal compression, which happens when there is pressure on the spinal cord. This can go on to cause an array of physical symptoms such as loss of sensation in the feet, inability to use the hands and loss of sexual ability. It must be noted that not all contusions cause spinal compression, and not all spinal compression is caused by a contusion, although they do often connect this way.

\n

Warning Signs of a Serious Spinal Contusion to Watch For

\n

Firstly, doctors will try and establish what area or limb the injury has affected. Spinal contusions most often “affect the upper extremities bilaterally and also sometimes involve the lower extremities,” according to Dr. Wong, an orthopedic physician.

\n

Symptoms include “numbness, tingling, [or] electric shock-like sensations and burning in the extremities,” (American Association of Neurological Surgeons, 2016). Generally falling into the category of “spinal trauma” there are many symptoms which are similar to other forms of spinal trauma and spinal cord injury. Below are some symptoms of spinal trauma:

\n\n

Unfortunately, it is sometimes challenging to identify which symptoms are due to a spinal contusion, and which ones are the result of a spinal cord injury directly. It can sometimes require a few days or weeks for the body to recover from spinal trauma and reveal if any permanent damage is left from the accident that caused the SCI.

\n

Understanding what a contusion is, and how it can come into play following a spinal cord injury is important in order to clearly appreciate your injury, understand your diagnoses, and work toward treatment and a prognosis. Doctors can sometimes use jargon that’s difficult to understand, so the more you can educate yourself about your condition, the more control you can have in your recovery and treatment.

\n

If you still have questions about the details of the spinal cord and how it may be affected from your injury, please contact us or download our guide to understanding a spinal cord injury.", "author" : { "@type" : "Person", "name" : "Spinalcord.com Team" }, "datePublished" : "2020-12-03", "image" : "https://www.spinalcord.com/blog/signs-of-a-serious-spinal-contusion", "name" : "Warning Signs of a Serious Spinal Contusion", "url" : "https://www.spinalcord.com/blog/signs-of-a-serious-spinal-contusion" } ``` ```json { "@context":"https://schema.org", "@graph":[{"@type":"WebSite", "@id":"https://spinalcord.com/#website", "url":"https://www.spinalcord.com/blog/signs-of-a-serious-spinal-contusion", "name":"Spinal Cord Inc", "description":"The spinal cord is a vital part of the human body. As the vehicle responsible for carrying messages from the brain to the rest of the body and back again, even the smallest interference can be detrimental. Following a traumatic spinal cord injury, this bundle of nerves can become bruised, also known as a contusion. Because of the nature of the nervous system, any interference can constitute a serious spinal contusion, but these facts will help you dissect all of the information from the medical professionals.", "inLanguage":"en-US"}, { "@type":"ImageObject", "@id":"Spinalcord Logo", "inLanguage":"en-US", "url":"https://www.spinalcord.com/hubfs/Logos/spinal-cord_png.png", "width":327,"height":300, "caption":"spinal contusion"}, { "@type":"WebPage","@id":"https://www.spinalcord.com/blog/signs-of-a-serious-spinal-contusion/#webpage", "url":"https://www.spinalcord.com/blog/signs-of-a-serious-spinal-contusion", "name":"Warning Signs of a Serious Spinal Contusion", "isPartOf":{"@id":"https://spinalcord.com/#website"}, "primaryImageOfPage":{"@id":"www.spinalcord.com/blog/signs-of-a-serious-spinal-contusion/#primaryimage"}, "datePublished":"2020-12-03T18:30:35+00:00","dateModified":"2020-12-03T18:30:35+00:00", "author":{"@id":"https://www.spinalcord.com/meet-our-authors"}, "description":"The spinal cord is a vital part of the human body. As the vehicle responsible for carrying messages from the brain to the rest of the body and back again, even the smallest interference can be detrimental. Following a traumatic spinal cord injury, this bundle of nerves can become bruised, also known as a contusion. Because of the nature of the nervous system, any interference can constitute a serious spinal contusion, but these facts will help you dissect all of the information from the medical professionals. What Is a Spinal Contusion? Signs-of-a-spinal-contusion-title-image Much like any other bruise, a contusion can cause bleeding from local blood vessels and inflammation which, rather unlike bruises on other parts of the body, can have serious negative impacts on the spinal cord itself. Because the “blood must clot to stop the bleeding”a bruise results from contusions also increase cardiovascular risks. For example, the swelling a contusion can cause will often disrupt nerve impulses that travel from the brain to the body through the spinal cord, and the severity of this will depend upon the level of injury. Unlike a concussion, a contusion would not cause unconsciousness or a ‘blackout’, but instead cause the patient to feel a numbness or tingling in the extremities. A contusion can cause spinal compression, which happens when there is pressure on the spinal cord. This can go on to cause an array of physical symptoms such as loss of sensation in the feet, inability to use the hands and loss of sexual ability. It must be noted that not all contusions cause spinal compression, and not all spinal compression is caused by a contusion, although they do often connect this way. Warning Signs of a Serious Spinal Contusion to Watch For Firstly, doctors will try and establish what area or limb the injury has affected. Spinal contusions most often “affect the upper extremities bilaterally and also sometimes involve the lower extremities,” according to Dr. Wong, an orthopedic physician. Symptoms include “numbness, tingling, [or] electric shock-like sensations and burning in the extremities,” (American Association of Neurological Surgeons, 2016). Generally falling into the category of “spinal trauma” there are many symptoms which are similar to other forms of spinal trauma and spinal cord injury. Below are some symptoms of spinal trauma: Spinal shock — or the loss of feeling or movement below site of injury (Columbia University Medical Centre, 2016) that can last between hours and weeks Loss of bladder or bowel function Difficulty breathing Muscle spasticity Difficulty understanding speech Problems with attention Memory challenges Heart rate and blood pressure problems Unfortunately, it is sometimes challenging to identify which symptoms are due to a spinal contusion, and which ones are the result of a spinal cord injury directly. It can sometimes require a few days or weeks for the body to recover from spinal trauma and reveal if any permanent damage is left from the accident that caused the SCI. Understanding what a contusion is, and how it can come into play following a spinal cord injury is important in order to clearly appreciate your injury, understand your diagnoses, and work toward treatment and a prognosis. Doctors can sometimes use jargon that’s difficult to understand, so the more you can educate yourself about your condition, the more control you can have in your recovery and treatment. If you still have questions about the details of the spinal cord and how it may be affected from your injury, please contact us or download our guide to understanding a spinal cord injury.", "breadcrumb":{"@id":"https://www.spinalcord.com/blog/signs-of-a-serious-spinal-contusion/#breadcrumb"}, "inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https://www.spinalcord.com/blog/signs-of-a-serious-spinal-contusion"]}]}, { "@type":"BreadcrumbList", "@id":"https://www.spinalcord.com/blog/signs-of-a-serious-spinal-contusion/#breadcrumb", "itemListElement":[{"@type":"ListItem", "position":1, "item": { "@type":"WebPage", "@id":"https://spinalcord.com/", "url":"https://spinalcord.com/", "name":"Home"}}, {"@type":"ListItem", "position":2, "item":{"@type":"WebPage", "@id":"https://spinalcord.com/blog/", "url":"https://spinalcord.com/blog/", "name":"Articles"}}, {"@type":"ListItem", "position":3, "item":{"@type":"WebPage", "@id":"https://www.spinalcord.com/blog/signs-of-a-serious-spinal-contusion/", "url":"https://www.spinalcord.com/blog/signs-of-a-serious-spinal-contusion/", "name":"Warning Signs of a Serious Spinal Contusion"}}]}, {"@type":"Person", "@id":"https://www.spinalcord.com/meet-our-authors", "name":"Spinalcord Team", "image":{"@type":"ImageObject", "@id":"https://www.spinalcord.com/hubfs/Logos/spinal-cord_png.png", "inLanguage":"en-US", "url":"https://www.spinalcord.com/hubfs/Logos/spinal-cord_png.png", "caption":"Spinalcord Team"}, "description":"The authors at SpinalCord.com come from diverse backgrounds including doctors, attorneys, medical journalist, and survivors of spinal cord injuries or traumatic brain injuries. Each author brings with them different experiences and expertise which when combined provide clinically accurate information which is useful to all individuals in the spinal cord and traumatic brain injury communities. Within the content you will find citations to medical journals, scientific research, as well as national and local resources to provide immediate support to families in need of assistance. Content is reviewed and updated regularly with changes in the clinical guidelines, new resources, and fresh ways to understand the content such as videos and infographics. ." } ]} ```