Being a caregiver can be a very rich work experience. As you care for patients, you also build healthy relationships with them. But sometimes, being human drives us to go beyond boundaries. And that goes for patients, too. While there are clear-cut ethical standards, legal frameworks, and organizational rules to follow to stay within the safe zone, the fine line between what's allowed and what's not can be blurry at times.
Setting boundaries is important because it protects the both patient and the caregiver. It also prioritizes the patient. A patient who needs care is vulnerable because they are dependent on the caregiver for some aspects of their health. It is, therefore, your role, and not the patient's, to establish limits. Those who put their personal needs first at the expense of the patient will be subject to reprimands, or possibly administrative and legal sanctions.
At some point, on the other hand, you may also be put in an awkward situation when it's the patient who crosses the line. Clarifying roles and objectives early on can prevent this from happening.
If you are unsure of where you are in the caregiver-patient relationship, a good question to ask yourself is, "Is this more about my needs and not my patient's?" If your answer is yes, you need to step back and refocus on the patient.
So what are some ways to set boundaries?
1. Lay down some ground rules at the first meeting.
Ask the patient how they want to be addressed and avoid using words of endearment such as "honey "or "sweetie". Tell them how you want to be addressed, too. You may briefly tell the patient how you intend to help them as well as when your duty ends if that's already been determined.
2. Be honest.
If you feel uncomfortable in a situation, say so. If a patient is touching you inappropriately, tell them straight away to stop because you feel uneasy. Discourage suggestive behaviors by your patient.
3. Be consistent when you say 'no'.
Determine which things are non-negotiable. If a family member requests you to run an errand that is not within your role as a caregiver, politely tell them that their request is beyond the scope of your work. Draw a fine line between doing the extra mile and staying beyond your duty hours just because a patient or family member tells you so.
4. Take control of your emotions.
Patient care is never easy and if you find yourself at the end of your wits, you are still expected to hold it together and not to lose control. Reacting inappropriately is a tell-tale sign that you are taking the patient's emotional outbursts personally and not considering it as part or consequence of their illness.
Also, if you notice that you've started to develop romantic or sexual feelings for your patient, remind yourself that you must stop and not act on it.
5. Your personal life is yours alone.
Refrain from dumping your emotional baggage on a patient even if they have the listening ear. Remember that you are the one taking care of them and not the other way around. The patient's needs come first.
6. Keep the patient's information private.
You are clearly crossing boundaries if you share confidential patient information with others, even to family members, without the patient’s consent. Sharing photos of the patient, especially in an embarrassing manner, is clearly out of line and should never happen.
7. Do not make decisions for the patient unless you have the right permissions to do so.
Make no mistake about this. Ensure that you have the consent of the patient or of authorized family members. Such permissions are usually stated in the care plan and do not go beyond simple things, such as choice of clothes or food.
8. Be cautious when accepting gifts.
Patients and their families can become fond of their caregivers and may become very generous as a way of expressing their gratitude. However, accepting valuable gifts is often against agency policies because it may unintentionally lead to favoritism or feelings of indebtedness. It's okay to say 'no' graciously to a patient's gift. Most agencies, however, allow their employees to accept small tokens.
9. No to favoritism.
As a caregiver, you are expected to provide quality care regardless of the patient’s personality or social status. It may be tempting to spend less time with a difficult patient and focus on a celebrity's sick family member, but you are expected to provide both with the same quality care.
Boundaries are set not to limit caregiver-patient interaction but to enhance meaningful connections. Understanding why one should maintain healthy boundaries and ensuring that they do is something every caregiver should do.
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