Professional Caregiver for Older Adults - Part III: Professional Boundaries

This is a multi-part series to help in-home professional, non-medical caregivers learn some practical, non-clinical skills on how to approach their day to day professional life. In Part III, we will focus on respecting professional boundaries, and your own professional responsibilities.

Respecting Professional Boundaries

A high compliment from a client and their family is that they consider us as ‘part of the family’. This means that our clients feel like they can trust us. Sometimes, this special relationship that we have with clients at a critical moment in their lives means lines can get easily crossed. The challenge for professional caregivers is maintaining professional boundaries with someone who you’re responsible for in a client’s most intimate space: their home or rooms. There are ways to build trust without crossing boundaries. It’s a great feeling to know you can laugh and get along extremely well with a client, however, do not share problems happening in your home with your client. Often our clients may have children or grandchildren our age, they may become overly concerned with our problems, causing them to become agitated or more anxious. We do not want to make clients anxious, but instead to alleviate some of the anxiety they already have. As much as clients become part of our lives, we may want to share information about them. Do not share personal information, pictures like names and medical conditions about your clients – and even worse, pictures – over social media. Not only is it a violation of HIPAA, but it breaks the trust of your clients. That means no pictures or selfies with clients in the background! Do not accept a tip or extra money for the work that you’ve done. Depending on your employer, gifts or bonuses may be appropriate during the holidays. Do not allow clients to purchase gifts or offer you cash, other than what you are already paid to provide care. Borrowing money or getting money from clients can lead to legal problems and questions about your ethical judgement, which is why you should refuse it if you’re ever offered. Generally, there are discussions and conversations that are off the table, unless your client feels comfortable discussing them, because they impact the way you care for them. For instance, it isn’t appropriate to discuss religion or politics. However, if it relates to your ability to provide care, then make sure you know through your agency or the family of your client. If a client eats Kosher, a particular dietary restriction for certain observant Jews, for example, then this is something that makes sense for you to know.

Your Own Personal Responsibilities for Professionalism

It’s hard to know what can go wrong in a single day. We have all had a day where nothing seems to right. Here are some ideas to make the day go better:

Maintaining a positive work attitude and behavior
Being willing to ask for help when you need it. Know that it is better to ask questions than do something that may be unsafe or unprofessional because you lack the skills or information.
Identifying strategies for how to balance work and family responsibilities. Some strategies include arranging childcare and communicating to your supervisor when there are family emergencies.
Coordinating personal transportation, and making alternative plans to maintain work schedule. Also, make sure you figure out how to get to work when your reliable mode of transportation is not running.

If you’re not able to get a ride to your job or to your next client’s appointment, make sure you have a list of family members or friends that you can call in an emergency. We call this a “phone tree.” On days when you are able to help them, you will, and they may be able to help you when you’re not able to get to work. When you’re running late, contact your agency and/or client to let them know that you are having issues with transportation and that you are running late. Remember, as soon as you know you may be late, start making calls, so you can get help as soon as possible. As we’ve said, as a caregiver you demonstrate professionalism by being reliable. Imagine yourself as your own brand, and as a caregiver, you want to build a positive reputation. What to be a Professional Caregiver? Check out Care Academy’s class!

Madhuri Reddy

Dr. Reddy is a specialist in Internal Medicine & Geriatric Medicine. She holds appointments at Harvard Medical School & Hebrew SeniorLife in Boston, MA. She has seen the struggles that families and caregivers go through when caring for adults. Through CareAcademy, she intends to improve people's lives. Dr. Reddy's research is published as journal articles and book chapters. She has also authored a book for family caregivers.