Client- Centered Care

DEAR VANESSA,

I will be providing live-in care to an elderly gentleman. How do I stay vigilant and respect my patient’s right to privacy at the same time? Thank you.

-JOSEPH

DEAR JOSEPH,

Vigilance includes these five key components: watchful supervision; protective intervening; anticipating; always on duty; and being there. Regularly check with the patient if there is anything that he needs or if he is comfortable. Show initiative in seeking ways to help him. Listen and have empathy. Look for nonverbal cues. Allow him to feel important. Your goals are to help him improve function and live with greater independence, promote his level of optimal well-being, and assist him to remain at home.

Some clients will like a lot of personal space; others will like a lot of attention and stimulation. Be mindful of the patient’s personal boundaries. Do not hover over him. Explain to him first what you will be helping him with before you do it. Be discreet. Avoid asking inappropriate questions. Be warm and caring but resist the temptation to offer unsolicited advice.

Always remember that you are a guest in someone’s home; treat the patient with the same respect that you would expect visitors in your home to treat you. Respect the patient and his property or belongings. Ask the patient’s approval before opening windows, or changing the temperature of the heater. Do not open drawers, closets, cabinets or any other furniture unless it is necessary; only open as needed and ask the patient’s approval before you touch anything. Do not reveal the patient’s address or telephone number to anyone not involved in the provision of services. Do not call or visit the patient when you are off-duty. Do not remain in the patient’s home when he is not there. Do not use the patient’s address to receive your personal letters and packages. Do not receive personal guests while you are on duty, such as having friends and relatives stay overnight at the patient’s home. Do not use the patient’s personal belongings. Do not pick flowers or fruits from the patient’s garden.

Know the patient’s plan of care which specifies what care he needs and how it will be provided. If there’s anything that concerns you or you don’t understand, ask questions. Offer care that is based on deep respect for the patient as a unique living being, and the obligation to care for him on his own terms (listened to, informed, and involved in his care).

-VANESSA