Crossing Guard

    I have worked as a home health aide since '98. That means I have probably been instructed about boundary issues 98 times.  Fortunately, in this context, it has nothing to do with the Rio Grande, and more to do with real ordinary.  Boundaries in home health care means not blurring the lines between profession and friendship.  It is wonderful to be able to assist people in the comfort of their home, the problem is the comfort of their home.  With no institutional formality, no supervisor looking over your shoulder and, sometimes, years spent with the same client, it is natural to become close. (I refuse to use the current buzzword for client--"consumer". It makes us sound like food.)  In fact, if I were a client, any caregiver who could work for me several hours a day, year after year and never discuss anything personal would give me the creeps. Clients need company as much as competence. Boundaries do not mean there is no friendship between client and caregiver, boundaries mean you function in their home as a professional, not a friend.
     I have worked the same days with the same client for years. In that time I have seen aides for the other days come and go.  Some of them have taken her laundry home to do on their own time, loaned money, borrowed everything but money (she doesn't have any), brought family members--including dogs to her home, eaten her food or taken her out to eat on a daily basis, invited her to holiday dinners, etc. The problem is not so much that it makes us boundary crossing guard caregivers look uncaring, but that eventually those aides wind up sitting on the couch watching movies. They have slipped into friendship mode. Eventually, they have to be replaced. I have many boundary violations of my own. My client has had my cell number for years, but I gave her a "special" ringtone so I can screen her calls. Every light bulb, dish sponge and razor she has used in the past 6 years have come from my house, yet somehow I have managed to keep our relationship professional enough to have had years to enjoy it. When you value your "home work", sometimes the best defense is the fence.