11. CAREGIVER BOUNDARIES

 

Boundaries are guidelines, or limits, that a personal care assistant sets with the client regarding acceptable behaviors or tasks. It includes both the personal care assistant and the client understanding the expectations.

 

Clear limits promote safe connections between caregivers and clients; being friendly, not friends.

 

Types of Boundaries

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• Role Boundaries

  • The PCA is in the client’s home as an employee.

• Social Boundaries

  • Talking to and spending time with the client only occur during work hours.

• Time Boundaries

  • PCAs arrive on time for their shift and leave at the scheduled time.

• Gift/Services

  • The caregiver/client relationship should not include giving each other gifts or other services outside of the caregiving role.

• Self-Disclosure

  • PCAs should use caution when sharing personal information with the client. Some information may be upsetting to the client.

• Financial Boundaries

  • The PCA’s duties do not include financial responsibilities.  To avoid misunderstandings, exactly who will pay and how needed items will be paid for should be clear from the beginning.  If family members are involved, they should be buying food and other items the client needs.  The PCA should report it to the supervisor if asked to budget, pay bills, or do similar tasks. 

• Social Media and Confidentiality

  • Do not friend your clients or accept friend requests from your clients on Facebook.   

  • You should never post pictures or videos of your client or their family members.

  • Do not post negative comments or gossip about your clients. 

  • Do not post information about where your client lives, who their friends or relatives are, or where they are. Posting this kind of information is a serious violation of client confidentiality.

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Poor Boundaries and Crossing Boundaries

The following actions and behaviors must not happen between the caregiver and the client:

 

• Relatives or friends should not drive you to the client’s house. The client’s address and phone number should not be given out to anyone. This violates the client’s privacy.

• Relatives and friends should not deliver food to the client’s home or enter the client’s home. This is also a violation of privacy.

• Nicknames: calling a client “sweetie” or “honey”

• Too much touching.  Touching should only occur during caregiving duties such as bathing and dressing. 

• Do not tell jokes that could be offensive, make comments about a client’s race, ethnicity, religion, or politics. Caregivers’ opinions on religion, politics, or sensitive subjects should be kept to themselves regardless of whether they agree or disagree with the client.

• Do not use profane or vulgar language. 

• Do not loan or borrow money.

• Do not encourage the client to give you gifts. Do not accept any expensive gifts.  Do not give gifts to the client.

• Do not use the client’s money, debit cards, credit cards, EBT cards without the client’s permission.  If the client gives permission to use these items, the caregiver must obtain a receipt and give it to the client.

• Romantic Relationships: A caregiver is never permitted to have a

a romantic or sexual relationship with a client.