To Tell or Not to Tell: A Caregiver’s Dilemma

Caregivers spend a significant amount of time with clients, and they can easily earn their trust. Frequently, a client will tell their caregiver personal details about themselves and their families. A caregiver must be mindful about discussing a client’s personal life with others, whether in or outside of the workplace, including secrets they would not want to be shared with others.

Keeping a client’s secrets may make the caregiver uncomfortable and feel obligated to keep all information to themselves but, in some cases, these “secrets” must be reported to the healthcare team or the authorities.

If you are a caregiver, be alert and knowledgeable about the situations in which you must disclose what your client has confided. If you are experiencing a professional dilemma and are unsure of what to do, always remember that in any case where a client’s or another’s life is in grave danger, it is necessary to report this information to the care team or the proper authorities.

Case #1 – “My daughter hits me and locks me in my room when no one is around.”

What to remember: Any case of abuse must be reported. Caregivers who are directly involved in client care are required by law to report both cases and suspicions of abuse. Abuse may take many forms, including physical, sexual, financial, and emotional abuse, as well as neglect.

What to do: You are not in a position to investigate, however you may check for possible signs of abuse such as wounds and bruises. Inform the client that you must tell the supervisor and make a report, and that the proper authorities will be contacted to keep them safe.

Case #2 – “It is over for me. I have plans to take my own life.”

What to remember: “Taking one’s life” refers to suicide, and is the 10th leading cause of death in the U.S. overall. Suicidal thoughts and plans must be taken seriously and never regarded as simply attention-seeking. As a client who requires caregiver assistance tending to their needs, their condition makes them vulnerable and at risk for harming themselves.

What to do: Ask about the details of their plan, such as when they plan to do it and how. This will help the care team prevent the client’s suicide. Tell them that help is available and that you need to inform the supervisor and the team of their plan, to help keep them safe. Encourage them to talk about their feelings and their plan. Be there for them, listen to them, and offer your support.

Case #3 – “I think I have an STI.”

What to remember: Sexually transmitted infections (STIs) are passed from one person to another through sexual contact. STIs can cause pain, sores, fertility problems, and other complications that often only show up years later, if left untreated. The danger is not only to the client but their sexual partners as well. Many STIs are treatable, and early reporting is advisable so that testing and treatment can start immediately.

What to do: Encourage the client to tell their physician immediately, because STIs pose a serious danger to themselves and their sexual partners. Assure them that only the staff directly involved in their testing and treatment needs to know. Do not be judgmental while discussing it with your client, and tell them that there are treatments available if they test positive.

Caregivers are a client's confidante. As such, caregivers are obligated to keep to themselves the personal details that clients share with them, except those that threaten the client's life or the life of another.