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I’m a caregiver through a local home care agency. I’ve been working with this client and we both have gotten close. She had asked for my number so we can stay in touch. I understand that I should maintain professional boundaries but we both do get along. Is it advised against to keep in contact with the client outside of work?

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It is legal, but I don't think a good idea.  She may call you at all hours.
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While it is wonderful that you get along the bottom line is that this person is a client, an employer, and as wonderful as your bond is you should not forget that fact. As a paid caregiver you will have many clients and they will come and go as their needs or situation change or yours do, that is the nature of the relationship - Keeping a professional distance is better for both of you - you do not want this person calling you for help outside of paid hours.
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Check your company’s personnel manual- usually there are guidelines in the policy that address this.
I’ve been a RN for over 40 years and there are a handful of folks I have stayed in touch with over the years. Less than 5.
As a professional you have to establish boundaries and keep them. While it’s tempting think about why you would want to continue the relationship it may not be therapeutic for the client as they may begin to depend on you too much. You may find yourself in a difficult position.
As far as illegal, no I don’t think it is. But again check your policy at work before proceeding.
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gemswinner12 Jun 2020
It would never be illegal to communicate outside of work hours; nobody would get arrested or put in jail... It just might not be a wise casual relationship. Usually a friendship is give and take from both sides; the new friend may expect free help.
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Yes it is legal, but it is probably not wise. As others have mentioned, the client is probably wanting to extend boundaries for her own benefit, not yours. Does she want to hire you outside of the agency? Be careful about that! Most agencies have strict rules. Even if you are friends and get along nicely, the premise of your relationship is that you are her caregiver . You are able to do things for her that she can’t do for herself.
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My daughter worked in rehab/NHs for 20 yrs. She had her favorites and I only remember one time she "kept in touch" with a patient and his death hit her hard. (She was young at the time and I think learned from the experience) Otherwise, her relationship with the residents stopped when she left work. She kept her work separate from her personal life.

You are this woman's employee and as such some professionalism is needed. You can be friendly and enjoy her company and hrr yours. Like suggested check your handbook from the agency. There is probably something regarding not excepting presents and such. I would tell her a little white lie that the agency does not encourage giving out private info. Like said, this may lead to the woman calling you all the time.
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Is she pressing for your personal phone number? If you don’t feel comfortable with telling her NO outright , you can politely say you’re sorry but you’re forbidden from doing so due to company policy. You could be terminated and you can’t afford to lose your job, as much as you enjoy your time with her. How could she be upset with you over this response? She would likely think even more highly of you for treating your job and employer seriously and with respect.
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I had to find carefiff CD era for my dad on short notice, and they came with good references. After a while one caregiver got pretty chummy and flirty. This made me very uncomfortable, and I kept his wallet and checkbooks with me. She wanted to take him on outings and liked to buy things. I said no to outings- that is my job. And I told her I could not reimburse her for the things she bought unless I asked her to buy them. She became passive aggressive with me and finally quit. She was always kind to my dad and had some nursing skills but her pushy attitude was hard to take.
please consider who hired you and what extent of care they want for their LO. Don’t jeopardize your position nor the referrals you can get. Getting close to clients can be a red flag to the family. There are thieves and dishonest people in your profession, just like in other professions, and while you have only good intentions, the family may not see it your way.
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gemswinner12 Jun 2020
Jcondliffe: Thank you for mentioning the family members’ point of view! My Dad has hired a “cleaning lady” which concerns me from time to time. He has assured me he’s not attracted to her at all, and she has told me her same lack of attraction to my Dad separately....yet it is an ongoing concern to me. One of the very last things I need in my life right now would be a new Step Mom; he has put me through two already!!
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There may be a specific law in your state but I doubt it. The bigger issue is not the legality but opening up a relationship that could eventually negatively impact your employment. Check with your employer.
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TouchMatters Jun 2020
and, being mindful and aware of the emotional and psychological ramifications placed on an elder client. It also is about the legality. A caregiver must read the contract they sign. Caregiver agencies need to protect themselves and abide by laws to be in business.
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Our CNA was very professional, however, 4 years after my husband’s passing we are still friends. I never hired her outside her agency. She was there for us at a very difficult time—always very kind and patient as my husband descended into Alzheimer’s.
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KaleyBug Jun 2020
We have the same situation with my late MIL’s caregiver of 5 years. She is family still all these years later.
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It's an absolute no-no, certainly as long as the professional relationship exists. Your agency has legal responsibilities for what you do. There must be no contact of which the agency is not aware and which it has not authorised.

I sympathise in that this sometimes makes me very sad. There must be a dozen clients I'd love to hear news of, visit in hospital, drop in to see on my way home and check they're okay, or even just say goodbye to when our service hands them over to a permanent provider. But there it is. Except when I am rostered to work with a client, that person's life is officially none of my business and I'm obliged to disregard any information - right down to name, address, phone number, date of birth - that I have been given for work purposes.

You don't have to use much imagination to see how easily such friendships could be exploited, is the why of it. Allowing them would leave the door wide open for abusers.
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EllensOnly Jun 2020
I don't think I could have put that any better.  I work for a state agency that contracts with providers to hire Aides to work in seniors homes.  As soon as we hear that the consumer has been contacting the aide off work hours the aide is pulled from the case.  We cannot allow the appearance that the Aide may be working without pay or authorization.  Any contact should be made through our Case Manager or the Agency assigned.  So in this case the Aide would be risking her employment by sharing her personal contact information with the client.
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Is it "legal".., yes
Is it wise..no
There may be exceptions. But those exceptions might be few and far between.
The CNA that worked for the Hospice my Husband was on I had known her previously, I knew her mother, she was a member of a support group I went to, she also knew my Husband from years ago. We discussed this, she discussed it with her supervisors and we decided that it would not be a problem but rest assured her hours here were looked at closely.

Have you discussed this with your supervisor? (and if you have not and would not that is an indication that this is not "Kosher")
If you were a supervisor in a case like this and you presented your own scenario what would you advise the employee?
Boundaries are established for a reason. Actually for several reasons.
As an employer I would not want you "working on the side" for this or any client.
You need a break, time to separate your work emotions and your personal ones.
There may be the appearance of trying to gain personal gain from the relationship. (as a professional caregiver appearance may be just as important as actual fact)
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My mother talks on the phone for very long periods of time. This makes it difficult for me to contact her, I usually have to drive across town to check on her. So no I would not want another person who is working for her to get more involved. You might think it’s unkind, but people abuse the elderly with there time, emotions, financially and it wears them down.
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Please veify your agency's policy. I think it is unwise to have a personal relationship with your client. Conflict of interest for professional vs personal friend activities. Both types of activities should be done by separate people.
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TouchMatters Jun 2020
Yes, I could not agree more although I am long winded with my response...
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You you could try telling her this:

Because of your professional relationship, your company doesn't allow personal interaction while off the job...

...however, you feel that the two of you do enjoy a very special connection and one day, should it come to pass that you no longer work for her...

...that you would be more than happy, should she want to continue, to share your personal information and remain friends.

That covers "the now" and "the future" and lets her know that you would not abandon her.
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TouchMatters Jun 2020
Many clients do not have the cognitive ability to understand this.

I usually say "I'm busy". If they can comprehend, I will say, "I have a full social life and my job is to support you to (whatever the caregiver wants to say), i.e., develop friendships with others." This can be done in a few ways (if working independently as I do):

(1) support elder to engage in activities offered where they live, if in a residential community;

(2) Give phone number of a local 'friendship' line designed to provide emotional support for lonely elders.

(3) If working for an agency, ask them how to handle the situation.

* * *

You mention 'remain friends.' It is important to clarify the working relationship and what that includes. Paid caregivers are not 'friends' with clients. They support, put client's interests first, and do this work as a person who cares for an elder. This doesn't mean that they are friends. Friends have an EQUAL relationship. A caregiver is 'on' all the time as it is their responsibility to insure the client's needs are met, to the best of their ability and job description.
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Please do NOT give your phone number to ANY client. Here are some reasons why. You have been hired by an agency. YOU are THEIR employee. So... anytime you contact this client, which is YOUR client, not personal friend, you are ON THE JOB and legally your employer and YOU should be paid. This is how you came to know this client in the first place. Also... I have been in this business for 25+ years, home health, and this is what is usually "up" with these clients when they ask for your phone number. They ask for your phone number because they want to hire you out right WITHOUT YOUR AGENCY BEING INVOLVED. They will tell you, "I won't tell your agency that you are here". And this is unethical on their part and if you go along with this, you are being unethical also. Clients try this sort of thing all the time claiming that "I love you" but please do NOT fall for that. Some do really care about their caregivers and do honestly want to become friends but sad to say, a great majority of the time I have found this not to be true. They have tried to get my phone number time and time again by telling me they love me and they would just love to have me come over more and more and when I tell them, 'Well... I can help you call the office and schedule more hours if you like" and they say, "Oh no... no...we don't need to get them involved. You can come and we don't need to call them. I will pay you" and this woman is famous for NOT paying her bills. She is known for lying all the time so please NO... do NOT do this. Sorry to say... many of these patients will say anything to save money. You could get in trouble not only with your agency but the state as well if you are found out and they report you to the state. While you are "visiting" your patient on unscheduled time with your agency, your agency could show up unannounced. And also beware..... they want you to also do work that is NOT ALLOWED by the agency? Many have gotten rid of their house keepers and then expect the caregiver to not only take care of two people... their pets but clean the whole house... some want yard work, mowing and pulling of weeds. Please watch out when a client asks for your phone number.. Usually "up to no good" sorry to say.
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KaleyBug Jun 2020
This goes two ways. We do not ask the caregiver to come when off hours, but many have asked us to hire and pay directly. I politely say no per our contract and theirs we can’t. We have have had BBQ’s and birthday parties the help has been included in. One is usually scheduled to work during this time. The others are guest and treated as guest, and not expected to lift a finger.
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This very issue is how I became divorced. My husband was caring for his childless uncle and the intake nurse at the ALF knew he (uncle)had money. She had all the info on both of them and my husband of course being the contact got calls from her often. I'm sad to say I was so stupid that at the time I did not see all the red flags but many other issues were going on as well. To shorten the story, even though she was (still is) married she took trips with him, accepted money from him and tried to borrow money to start her own nursing agency. They had a full fledged affair behind my back. When I finally found out about it 5 years had passed and he was totally enthralled by her and divorced me. We live in a state of no fault divorce so there was nothing I could do except try to secure my future as much as I could. At the time I was 60, he was 67 and she was 48. At the end of everything I ended up filing bankruptcy, he is paying me alimony and living in his uncles old house. The OW is still working, living with her husband and not a thing has happened to her. BE VERY CAREFUL!
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TouchMatters Jun 2020
What's the OW?
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Donna nailed it. The one thing I didn't consider was the CNA accreditation. In my state, the Nursing board certifies the CNAs. So I guess if you have a complaint, you can report it to the Nursing Board in your state.

And I see where being hired privately you could be asked to do more than you were hired originally to do. At least with an agency, you only do what you are contracted to do.
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One of my clients (my favorite, by far) was so very dear to me. She had my phone number and her daughter (with whom she lived) was VERY respectful of the fact that I had a private life and boundaries were never breached. My agency was not well run and messages sent to them about time changes, etc, never got to me in timely manner, so we decided to just make it be flexible. Zero problems with them.

No abuse of this whatsoever. I also had her home phone number. As she had Parkinson's and often had periods of a lack of speech--I'd make calls for her. ONCE in 2+ years I had to call her home.

It's all about respect and reading the relationship. I also worked (very briefly) for a couple whose kids had moved them out of AL and back into their condo. 2 short days with these people and I had a black eye, a back sprain and more verbal abuse slung at me than I had ever experienced. They wrangled my ph # out of the agency and when I quit (in a huff, I will say, no old man gets to grope at me whenever I'd pass him!) they called and called and wanted me back. They gave me a lousy 'review' but since they couldn't field anyone from the agency to work for them, it was a big club to belong to.

Personally, having had 2 opposite ends of the spectrum to look back on---I would be careful about sharing anything private about my life--but some clients became like surrogate parents to me.
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KaleyBug Jun 2020
Some of my moms caregivers are like family. I have their phone number and they have mine. Like you said not all agencies are efficient. I actually set the schedule before covid, ran it by the girls then sent to the agency my schedule of care needed with who would be doing it on any given day. Dad has given some outdoor furniture and appliances to a few, he always runs it by me to see if I need it. The care is for mom not dad. He is completely sound mind. Mom has dementia.
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My understanding is that home workers are bound by their employee contracts and that ALL agency’s enforce boundaries, which should be clearly stated in your contract and in the elderly persons contract. NO working off the books, NO exchange of personal numbers. You can care about someone WITHOUT violating boundaries. I am an LISW with 40plus years of experience. I have cared about hundreds of clients, without violating boundaries. I was horrified at my moms caring worker who was kindly doing extra work for mom, who insisted on paying her, and who was borrowing $. I eventually reported her. Since learned that most of the agency people coming to the house have offered to buy my moms car. This is not okay!
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Be Careful what you say on this site. Agencies, Long Term Care Facilities, as well as anyone else you might not want gathering information have access to your posts. Of course agencies don't want you hiring their employees. But consider that they are charging anywhere from $18-$25 per hour to their clients. The caregivers are sometimes paid as little as $9.00 by the agency. It's disgraceful. The poor caregivers can't feed their families on that amount, so many will seek out private work when they get the chance. Their contracts sometimes specify that their employees are not allowed to work for a previous client for as long as 5 years! I doubt if that would hold up in court. I have gotten the phone number for each employee and given them mine. If I am out for the day, and there is an urgent question or even an emergency, I want to know immediately. It can take a long time for the message to go through the round about of the caregiver to an agency to the family. The closeness of a client-caregiver relationship will depend on two things; 1. The compassion of the caregiver and dedication of the caregiver to make the well being of the person whose care they have been entrusted with their first priority and 2. The respect and kindness with which they are treated by their client and the client's family.
So, families and caregivers, BE KIND.
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TouchMatters Jun 2020
Be kind and be responsible.
Each person offering caregiver services has different levels of experience, education, emotional maturity, and a sense of professional ethics and responsibility.

If a person wants to exchange phone numbers, they should work directly with an elder and not through an agency.
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The question stated and the issue discussed are different. Yes, of course, care providers want to establish a 'good' relationship. This is a very separate issue with a care provider giving out their personal phone number for personal communications.

INITIALLY, a caregiver needs to immediately contact the supervisor of the agency that employs them when considering these situations and behaviors. A caregiver must abide by their direction. Agencies follow strict laws in providing services to individuals. Agency staff are well trained and experienced to handle these kinds of situations. If you do not want to abide by their legally required working conditions, end your contractual relationship with that agency. You likely would not be able to see your client once you leave the agency for a (long) period of time.

* It is absolutely inappropriate for a caregiver to give out their personal contact information to a client for several reasons:

(1) As stated, you work and are paid by an agency. You must follow their contractual relationship with you, the care provider;

(2) Establishing a 'good' relationship with a client means setting clear boundaries with a client;

(3) Many clients, due to being vulnerable, lonely, and alone, confuse 'caregiver' with 'friend' [in their minds, the relationship changes as their feelings for YOU changes] as when a care provider establishes a supportive one-on-one relationship, it often FEELS like a friendship to the client. They may not have felt 'loved' or cared about in years as a caregiver cares for them now. It is akin to a therapist-client relationship where the client transfers feelings on to their therapist due to their professional support;

(4) It is necessary to consider that elder clients are in various stages of ongoing, changing challenges: cognitively, physically, emotionally and psychologically. They are frightened of the unknown and it is the human condition to want to attach to those who provide care and attention. This is where boundary setting comes in and this is YOUR responsibility.

I work as an independent care provider/manager with clients and their families in a wide range of services. It is critical that I am mindful to create a caring, trusting relationship with a client. This is my job and professional responsibility. At least 50% of my clients attach themselves to me, thinking that we have become 'friends'. They may cognitively be unable to separate their feelings between the care I provide and a social relationship. IT IS imperative that I set boundaries and perform in a professional matter. It feels very sad when a person with dementia doesn't understand my role and talks to me as if we are friends, even though she is paying me to ... (for) watching every second that she is safe, doesn't fall, has hygiene needs taken care of, and be 'on' every moment I am with her. This is the work. It is not a relaxed social event (for me) although it may feel that way to the client.

I have to check myself [you certainly are not alone] as I genuinely care for my clients (and adore some of them). Often, caregiver work creates this quality of closeness and bond.

It is important to remember how the initial relationship happened, i.e., you were hired as a care provider and did not meet this person as a potential 'friend' in a social arena or circumstance. It may feel 'mean' or 'cruel' to set limits although it is the highest respect you can show to an elder you work with to do so.

As mentioned here, a caregiver giving out their personal phone number to a client MAY work out in some circumstances. This doesn't mean it is the right course of action for a professional caregiver to do. Tighest respect you can show is to create and maintain the professional boundaries necessary to be as effective in the work you provide as possible.

Lastly, discuss your concerns and feelings for your client(s) with your friends, or a social worker, or a therapist. We all need
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PatienceSD Jun 2020
Very thoughtful and thorough answer.
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I am for and make it a requirement to get telephone numbers and addresses of caregivers. That is my rule. We are not robots. We are flesh and bones and sometimes we need to talk to the caregiver(s) on an understanding basis.
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Ask your employer if it would be a problem. When the providers call ahead to confirm they are on their way, my caller ID gives me their personal phone number. If I did want to call them, it would be no problem. So, do you use company phone or personal cell for work? Bottom line, I see no harm in talking or catching up - just watch the boundaries like you said.
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PJsDaughter Jun 2020
On the vary rare occasions CG has to call the client-i.e. the client has sent you to buy something urgently needed and requests a specific brand name item (such as for X brand disposable underwear) and the store no longer carries that item you can block your personal number by dialing *67 and call. If the client or client family members request that a CG call in particular instances such as to let them know you are on the way the agency should be made aware of it, even if you use the *67 to block caller ID.
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Your employer will have the answer to this. The waters often get muddied this way and it is often frowned upon. Your employer gets paid out of what funds pay for your care of this person. Often a person will attempt to have you work for them without the employer you have being informed; this isn't good.
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Oh my goodness of course it is. That’s the idea... to become friends. But you need to protect your heart because she may pass.
Love and light
Sabrina
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I used a national home care service for my mom for 5 years until she died in February. The rule is no outside contact. I had phone numbers of almost every caregiver and we texted back and forth as needed. Could not have managed without this approach as trying to get a simple message through to them...do we need anything from the store?...would probably take half a day to convey, if at all. I did this only if the caregiver was OK with that...99% of the time they were...and everything operated much more efficiently.

I did try and draw some boundaries. For example, one caregiver sent me a Facebook friend request. I did not respond.

And good luck with protecting your heart. The truly good caregivers have to give of their heart. When my mom died, the night person, who was in the other room at that moment, burst into tears when I summoned her. The morning person who arrived soon after for her shift reacted similarly. Painful as it was, it meant a lot to me that they grieved as well.
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For all intents and purposes, it may be against company policy, as much as you would like to do.
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I wouldn't recommend it. Professional boundaries need to be maintained. After all, what if the client needs the agency's services again? The company most likely has a policy regarding client/caregiver relationships. The other question to consider is: what if she wants your assistance as a friend if her circumstances change and she needs assistance again? Are you then her caregiver or friend? Better to not cross the line. Sorry.
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I’ll give you a comparison. My DH grew up with several relatives on farms in the country, and the strong message that country people are ‘the salt of the earth’. When 20 years ago we moved to our own farm and agreements came up, DH refused to let me (ex-lawyer) write them down and get them signed – you’ll offend them etc etc. After a couple of very nasty experiences, we now write things down. Usually I don't draw up a formal 'contract', we just send a letter saying 'please let us know if this is not how you remember what we have agreed'.

That’s also the deal with carers. Sometimes a closer relationship will work out fine, sometimes it will go seriously pear shaped. That’s why the services get a lawyer to write down the rules. You work out for yourself the risk of breaking them.
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One thing that I should have mentioned in my earlier response is..
Being "friends" with a client completely changes the dynamics of the relationship.
As a client/caregiver if you do not complete your job, do not do it properly or in some way do not do a "good" job the client can contact the agency and lodge a complaint.
If you are friends it becomes more difficult to be objective about problems if there are any.
As a "professional" caregiver you are trained to observe and report declines that may occur. As a "friend" you might tend to overlook a decline or not notice it as readily as an objective observer.
Both failing to notice or report a decline or a client hesitant to contact the supervisor at the agency is a disservice to you, the client and the agency.
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