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Setting Good Boundaries as a Professional Caregiver

Often boundaries seem like just one more rule your employer has put in place to control your behavior at work.  They may seem invasive to you as a caregiver because you want to get to know, and take care of your client--at the highest possible level--and therefore you may feel boundaries get in the way.  Having a good understanding of why boundaries are put in place and how they can benefit the professional caregiver more than hinder, can provide relief to people and greatly improve their work/life balance.  

Male nurse and senior woman sitting on the couch

Professional boundaries are guidelines for maintaining a positive and helpful relationship with your clients or residents. Understanding boundaries help caregivers avoid stress and misconduct, recognize boundary crossings, and provide the best possible care.  Caregivers have a powerful role in their relationship with their clients.  They have control over the services provided to their client and at the same time have access to private client information.  Maintaining boundaries helps the Caregiver maintain a helpful “therapeutic” relationship. 

Saying No to Can Protect You

Inherently, Caregivers are pleasers by nature.  This means that saying “no” to someone goes against their nature even more than for most people.  This consistent want to tell people “yes” and do things for them can also cause a lot of other issues.  For instance, by always saying “yes”, caregivers may give away a lot of their personal time or information.  Over a period of time, always being available for everyone else’s needs can be exhausting.  Crossing boundaries just adds to these issues because it opens up personal issues and can take away from the time you should set aside for yourself.  Realizing it is not your job to make everyone else feel good all the time is a good step in gaining a foothold in the work-life balance area for caregivers.  

How can we learn to say “No” and still feel like we can do our job?  One of the secrets is pausing before you answer those difficult questions and consider your alternatives.   Rather than saying, “I can’t do that,” what if instead you said, “Here’s what I can do.”   For instance, a client may ask you if you can give them additional medication for pain and you agree that they are indeed in pain.  Instead of saying you cannot do this, you can respond “I can call the nurse and see what she recommends”.  It’s equally important that you don’t put the nurse on the hook either.  The nurse might recommend something like ice, or massage, which will be within your ability to provide.  

Another issue that comes up might be a gift for you.  If it’s within the guidelines of your company's policies, and you feel comfortable with it personally, you may graciously accept the gift.  If it is outside the policy or it is something unusually large then you need to graciously say you cannot accept the gift.  You should also report any large gifts to your company so they can watch out for the client as a vulnerable adult.  

One good thing to realize is the difference between befriending and friendship. Befriending is good in a professional relationship. It is intended to build trust and assist in understanding and meeting the client’s needs. Friendship signifies a relationship that focuses on the needs of both people, rather than a single-minded focus on meeting the needs of clients.  Stay focused on the client’s needs. 

Another area you might get tripped on is counseling.  As a professional caregiver, you may have a lot of professional experience or you may have personal experience.  Counseling exceeds the scope of what a professional Caregiver is trained to do and if a client requires counseling services, we can help in finding an appropriate provider.  As a Caregiver counseling a client can innocently set up bad situations with family and other professionals.  It’s best to not offer any advice that goes beyond your role and training as a caregiver.  

Typical Boundary Crossings 

Type of Boundary Crossing 

Staying In Bounds 

Sharing Personal Information: It may be tempting to talk to your client about your personal life or problems. Doing so may cause the client to see you as a friend instead of seeing you as a healthcare professional. As a result, the client may take on your worries as well as their own. 

  • Use caution when talking to a client about your personal life. Do not share information because you need to talk, or to help you feel better.  Never share phone numbers or emails. 
  • Remember that your relationship with your client must be therapeutic, not social 

Not Seeing Behavior as Symptomatic: Sometimes caregivers react emotionally to the actions of a client and forget that those actions are caused by a disorder or disease (symptomatic). Personal emotional responses can cause a caregiver to lose sight of her role or miss important information from a client. In a worst-case, it can lead to abuse or neglect of a client. 

  • Be aware that a client’s behavior is the result of a disease or disorder  
  • Know the client’s care plan!  
  • If you are about to respond emotionally or reflexively to the negative behavior of a client, step back and re-approach the client later  
  • Note that the client may think their action is the best way to solve a problem or fill a need  Ask yourself if there is a way to problem solve and help the client communicate or react differently 

Nicknames/Endearments: Calling a client 'sweetie' or 'honey' may be comforting to that client, or it might suggest a more personal interest than you intend. It might also point out that you favor one client over another. Some clients may find the use of nicknames or endearments offensive. 

  • Avoid using terms like honey and sweetie  Ask your client how they would like to be addressed. 
  • Some may allow you to use their first name. Others might prefer a more formal approach: Mr., Mrs., Ms, or Miss  
  • Remember that the way you address a client indicates your level of professionalism 

Touch: Touch is a powerful tool. It can be healing and comforting or it can be confusing, hurtful, or simply unwelcome. Touch should be used sparingly and thoughtfully. 

  • Use touch only when it will serve a good purpose for the client  
  • Ask your client if he/she is comfortable with your touch  
  • Be aware that a client may react differently to touch than you intend  
  • When using touch, be sure it is serving the client’s needs and not your own 

Unprofessional Demeanor: Demeanor includes appearance, tone and volume of voice, speech patterns, body language, etc. Your professional demeanor affects how others perceive you. Personal and professional demeanor may be different. 

  • Clients may be frightened or confused by loud voices or fast talk  
  • Good personal hygiene is a top priority due to close proximity to clients  
  • Professional attire sends the message that you are serious about your job  
  • Off-color jokes, racial slurs, profanity are never appropriate  
  • Body language and facial expressions speak volumes to clients



Getting Back in Bounds

As with any profession, being a Caregiver often has a learning curve with every new client and family.  If you feel like you are having boundary issues be sure to talk to your supervisor and get some advice.  Often you are close to your client and want to continue serving them, but if the boundary issues continue it may be best to ask for a new assignment.  Your company can help smooth things over with your client and find them another caregiver.  

How to Cope When You Care a Lot!

Make time for your family and friends and set expectations around your personal time.  Recognize what people in your life are fulfilling and what people are draining your energy--spend more time with the fulfilling people!  Scheduling regular social interaction with family and friends can go a long way toward maintaining those relationships. Make date nights with your spouse or set up regular get-togethers with friends. Whatever you choose to do, again, make sure to make time for you. We can’t care for others when we aren’t caring for ourselves first!

Interested in what it means to be a Comfort Keeper? Want to learn more about caregiving? Would you like to join us as we provide exceptional care to seniors in the comfort of their own homes? Speak with a member of our team today!

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Acknowledgments

University of Wisconsin OshKosh 

Comfort Keepers Inc.