How do I lovingly keep healthy boundaries?

I agree with many of the above answers. Keep her occupied, take her out to a senior center or other community events where she can meet and converse with others. Reading to her is also a great idea while at home, but you can go to the library, find a nice park bench and read there. How about a bird identification book so when you are out, the two of you can try to identify the many birds you see. Being kind to your client doesn't mean you are investing more than you want to give. I believe as a professional, we need to maintain a professional distance while providing the companionship our clients need. We can be warm & friendly with clients and treat them as we would want to be treated. Every client is different and it can be difficult when clients have quirky personalities but we find a way to work around it. Try to enjoy the time you spend with your client, engage her in activities; I think you'll find you can keep 'yourself' and have a warm relationship with your client. Find a trait you like about your client, find an activity you both enjoy, listening to music and sipping tea while reminiscing is a great way to get to know each other. Sounds like your client needs lots of reassurance, she is feeling insecure and that is a terrible way to feel. Just reassure her, let her know she's doing great. Good luck.

Shakingdust, very respectfully can I suggest that it could be they just find you a bit gung-ho about it? Softly softly...

Heydeb, I found what you said about many of your clients wanting to get too close, too fast really interesting. With my mother, it's the other way about; and I can see what both of you mean. Close bonds of friendship and emotional trust take time, usually: there are occasions when two people just 'click', but I think they're the exception, aren't they?

One of the things that I gave "gold stars" for at the residential care home my mother stayed at recently was that they understood this need for reserve immediately. They were friendly, but they didn't start in with her as though she were a close relative in need of a good old heart-to-heart. They called her by her title and surname until she told them otherwise. They allowed her privacy to help her get her bearings - no one hugged her, or patted her hand, or did any of the things that would have made her curl up and die inside.

I suppose some people thirst for company and conversation, and others are very wary. With this lady who's all over you like a rash, I don't think you ought to fake friendly feelings, even if it were possible; but do sympathise with her. She's clearly lonely, and I agree with many that alleviating loneliness is one of the most important things a professional caregiver can do.

I also take LadeeM's point that you are NOT a surrogate child. I can imagine some families do let that idea creep in - after all, they're paying a caregiver so that they don't have to watch their parent themselves, in a way, aren't they - but that really is unfair. And would they feel the same if the parent suddenly decided you deserved an inheritance, as "surrogate daughter"? - no, didn't think so!

You are there to ensure your client is safe, has her care needs met, and feels comfortable having you around her: be as politely clear about that as you need to be. If you're with her for a significant period of time, and get to know her, that's good and you may find that you begin to develop genuine feelings of affection for her. But they're not part of the care package, and you're not under contract to love her.

I was a full-time caregiver to my MIL who lived to be 98. When I met her at 47, she was a narcissist. When I took care of her, she was a narcissist. We never left her alone with anybody, ever. It got so bad that if my husband left the room to go to the bathroom or put a load of laundry in the washing machine down in the cellar, she would ask where he was. This is part mental illness, part selfishness, enough to drive you crazy. I would reply: He's allowed out of the room. He is not your prisoner. She understood that. She never stopped. You can't dismiss everything as not being a good enough or patient-enough caregiver. They will suck you dry if allowed and even the marrow of your bones will not be enough once consumed. Set boundaries that are kind but firm and pray for death.

Even the closest of good relationships has boundaries. Even a marriage. True love does not mindlessly say yes to everything, like the kind of "love" an overindulgent parent may have for their children, as they fail to help them become independent adults. True love maybe never stops thinking what is best for someone, but that is rarely to indulge every whim or to let itself be used up and worn out. I'm all for crossing boundaries and breaking silos when it really is a good thing...most of my life suffers from too many artificial boundaries and failures of people to pull together for a common good, but real life has some reasonable limits.

This woman is an employee - not family. Everyone who thinks that they are going to get a loving caregiver for $8.00 an hour - who is there to make sure the client is safe, gets her medications and makes sure she has some nutritious food - they still want more?? Caregivers are people also and those type of borderline personalities clients will take and take and NEVER be satisfied. I live with my Mother who is very needy and will swallow my life whole if I let her - and she is my own Mother. I sympathize with the original poster. It is not her job to be a "family member." I really doubt if when the client passes she will be included in the will if she is a family member. Set strong boundaries, do the best you can but do not expect that you are a "cruise director" for your clients. I am sure you do not get paid nearly enough. Good luck, I have been there and know what a tough job it can be.

i was an only child and my private duty nurse/in private homes....my mom was loved by everyone she worked with...the "patient" and the whole family....every case was longterm and every one of them wanted her to stay....when they pass...she would come home and cry and mope for weeks. She watched tv with them...drew pictures, sang songs, read the Bible,they made scrapbooks from their fav fotos... baked cookies and heard their life stories over and over again...she never had one unkind thing to say about them ....she was tired and sometimes her back hurt from some heavy lifting but there were no BOUNDARIES...they just became family.

The minimal, yes. But some people no matter what their age, seem to need someone to vent to, to favor over others, "confide" in, which usually leads to trouble, the I don't like her I don't like him stuff they can tell someone about, almost gossipy type of situation. I wouldn't go there as a caregiver and can understand why you'd feel uncomfortable with that. Change the subject, find distractions for her she can't resist. The health aide I hired for my dad does a good job, we've had 5 and she's the only one who ever actually worked, the downside is the opposite of what you say for us, she's trying to become a part of our family and get stuff, more hours, tips, wants us to let her leave early and pay her anyway, we aren't comfortable with any of that. But I need someone who's kind to my dad when I can't be here, just watch tv with him and talk about the show. So I have a health aide for my dad in my house who brings her own food to my house, cooks it in my stove, spills it all over my stove and leaves it, broke my vacuum, overloaded my washer and burned up the motor, burned my countertop, goes through any paperwork I leave out that she can get to.... and so on, cries to my dad about how little money she makes, and how much she likes the table he's putting in my garage sale. It's pretty bad when the woman's husband calls my house looking for her on weekends because she won't answer her cell and he can't find her, he assumes she's here. She's told me stories of getting POA for patients, moving in with one and living with him for five years, and honestly I think she's married to one of her x patients now. I trust her with my dad physically, don't trust her with anything monetarily speaking. So what do you do when you can't find good and honest help and you're still working?

I am a paid caregiver also.... and the suggestion that this is not a good match for you is right on. I understand exactly what you are saying..... and I am not a good fit for this type of person either.... I love to joke and talk and let the person reminisce.... but constant reassurance takes it's toll, and also on the family if they are honest !!! And for the post about expecting the caregiver to treat the parent as you would.... well, I hope you outline for the caregiver what that is.... I feel I wear many hats in the job I do.... but being a surrogate daughter is not one of them.... I am not trying to be offensive here... but being on this side of caregiving is different from the family side.... it is my experience that way too much is expected and that is why I am so burned out...... I have been doing this for 16 years and it is the families that have burned me out.... not my clients.....

It takes a long time in life to learn to share our hearts with whoever we are with. We are all fragile, insecure beings at some level; as well as, being loving and caring for others; We are learning to give from our light where ever we are. Each moment we live is a gift to us which will not be repeated. Our separating life into work and leisure, friend and foe, family and stranger has done much to put this world on a trajectory of pain and violence. Thank you for asking about these most important things.

Maybe it isn't the field for you if you can't give of yourself and feel good about it. It is a very hard role. You have to compartmentalize your day and feelings. Try to give her what she needs without letting it get to you like that. If you can't, then like I said, it may not be the field for you. I am home with my husband 24/7 and if I had someone coming in, I would want them to treat him like I do and not like a stranger. You don't have to give of yourself, just let her in.

Jeeze, that was long.

Sorry!

GunFite has a very good point.

There is nothing wrong with forming a bond with this lady and it can be done with boundaries. Become her confidant but there's no need for you to share anything with her, in fact you shouldn't. Be her friend but that friendship can only go one way if you want to maintain a professional distance. So many of our elderly folks are very needy so let her need you. You are there for her and there's nothing wrong with allowing her to get close to you. That's what makes a good aide. I am a nurse who works in home healthcare for an agency and we have numerous aides who have had a positive impact on the families they work for. Working in healthcare may not be a good fit if you're uncomfortable with people getting close to you. If you feel like someone is swallowing you whole maybe find something else in healthcare that might be more comfortable for you. When I visit patient's homes I am devoured (continuing your metaphor). Families have lists of items they want to speak to me about, often their loved one (my patient) sits there having no idea what's being said and the aide also has concerns that need to be addressed usually in private. And this is when I'm barely over the threshold! I too do in-home work, usually for well-off patients who can afford my fee and I know how you feel. But going above and beyond is what makes what we do so great. I want our families to call the office and say, "Mary was so great, she did _________ with my mom and mom loved it. We want Mary back!" That's the kind of caregiver I want to employ. Be special! Let this lady get close to you. It's not like she's a part of your life, she's a client. And for the hours that you're there you can make her life so much nicer.

But if you are uncomfortable with this you shouldn't be in the home. Not every client is a good match for every aide and this continues to be a problem for you don't be too hard on yourself and maybe discuss it with your supervisor. We have aides with all kinds of reasons for not working with specific clients and we try to work with them and find them cases that they're comfortable with and I would hope that an aide would come to me and tell me that they're uncomfortable with a patient and tell me why so I can better staff that patient next time.

I don't think you're doing anything wrong but if you have it in you, you can be doing so much more for this lady if you want to be a Super Aide.

I appreciate this post, it is so good that people ask questions and reply.

I also believe that it matters to respond Quickly to client comments or calls - even if the reply is, "no, wait a minute, I'll be there in soon," when you are cleaning or tidying up, or their requests come too often. But every time, the first times, you should go, and check. Any glitch can arise, and it matters to go and ask what's the matter. And be friendly in doing so.

I find it very sad that so much human caring has been delegated to "therapy". There are two sources of fears, I find - one is medication exaggerated requests which can come repeatedly. I find this sad - it is an effect of meds which is so unaddressed by doctors or health professionals - medications are often a quick fix, and few study the effects of long term use, on exaggerating the very symptoms they were given to prevent. I was shocked to learn that meds for diabetes actually cause and exaggerate food cravings - maybe as doses are waning, or whatever.

As a caregiver, I listen, respond, as I said, to the first two requests, instantly. Showing an instant response shows you care and are attuned to their needs. Then if there are repeated requests, I coach the person to wait or manage on their own for longer. "Wean them off the habit. I find that if I do this reliably, the person comes to trust that I am listening, will come, without blaming them.

It is the blame and avoidance , and self focus of the caregiver, that can actually show neglect, even as the caregiver is not aware of actual needs. This brings on more fear, less comfort - and less cooperation in self-care.

What is "too needy?" I understand "too often", but not "too needy". For what you see as an "excessive" need to have someone show they "like" them - may have come from inadequate life training in cooperating, collaborating and working with others. Isolated people need help to learn, not judgment for being needy.

It can help perhaps, for a caregiver to meditate on this more - many people show judgment today, as the media and public world teach young people to focus on pleasant and leave sadness to therapy, while finding instant communication on the internet. Then many judge slower people as "too needy." So the avoidance or judgment adds to the isolation, as people criticize or abandon them.

I had such different results when I really meditated about one man, who was grabby, when I realized his life had been spent with challenges of being different, for he was born with a disability - so he was often "spoiled" - such people may not learn how to collaborate with others and their whole lives are spent in the confusion of not being liked, for no one taught them, gradually, without negative judgment, or eagerness to protect others who can move faster - no one taught the isolated people, the skills of balancing their time - to enjoy being alone time, seek an alone-activity - and then balance that with shared time. Some women, left alone for years after children leave, are lost when they have not worked in any company - never learned the art of asking for companionship, in brief and well timed ways. In elder years, when memory is gone, their needs are expressed more - it's worth empathizing with the confusion and isolation that can be very real, in a society that puts so much focus, in media, on worlds of work and sports and men's ideas of a proper focus - which really applies mostly to the focus of the young and healthy. We often have not found ways of sharing what we can focus on at home - adding structure helps - music, drum, poetry, and just affirm the fun of exploring, AND empathizing that confusion is normal, and part of the process. Simple acceptance and cheerfulness of the caregiver around a person's annoying habits, can allow them to relax and learn, and a valuable relationship can grow. If one finds a client unworkable or really annoying, I think one should ask to work with a different client that they understand and relate to better.

The lady is scared and needs assurance that she is safe & OK. I agree with GunnFite -- "never alone, gets her meds, and is safe" is the MINIMUM. Making her feel not only safe but also loved, liked and appreciated is implied.

That need to be liked is a legitimate human need, and some people get into a vicious cycle of acting needier and needier and being less and less likeable. If you ca do anything pleasant with them and convey interest in them that is strictly non-contingent on them acting needy, it may work. I have someone like this in my life and have had to set boundaries around calls while at work and constant "how r u" texts that usually mean "I want a favor but I've been told to express concern for the other person first" lol. This person does have many strengths as a human being though and getting together for coffee every now and then has been a really good thing.

For me, if I hire a caregiver to make sure my Mom is "never alone, gets her meds, and is safe", that is the MINIMUM I expect. What makes a caregiver special enough to keep is the heartfelt willingness to make sure she feels both liked and loved, even when I'm not there to do that. Playing cards with her instead of texting her own friends, looking through photo albums with her, etc. I would not be willing to pay someone to assume it's always okay to sit and do their homework while Mom watches hours of TV, for example. Don't know if this is what you mean, but the caregivers who have been worth their weight in gold are those who understand that for the hours they are there, they are paid to make her feel not only safe, but also loved, liked and appreciated. After all, she is the reason you have money coming in for service provided.

I live with someone like this. To put it simply she is a narcissist and will absorb everything you have to give and want more. You need to keep strong boundaries. You can be friendly without becoming her friend and confidant.
Try to set up a list of diversions when the conversation turns to this...
Find a task to do with her...sort laundry, read a book out loud, listen to a song, point to a bird, flower or tree outside and ask her questions. Have some games (jenga, chinese checkers) or a puzzle. Turn the TV on to a wildlife/history or travel program. If you can't divert her use the telephone - call someone in her family she can talk to. I rotate family and friends on a daily/weekly basis.

"When you finish for the day and you return home at night, put the burden of work down. Don't carry it home. You can pick it up tomorrow. Whatever burdens you're carrying now, let them down for a moment if you can. Relax; pick them up later after you've rested."