Creating Healthy Boundaries Part 1

Definition   

Personal  boundaries  are guidelines, rules or limits that a person creates to identify for themselves what are reasonable, safe and permissible ways for other people to behave towards him or her and how they will respond when someone steps past those limits.

Why Set Boundaries?

•Setting boundaries protects ourselves and others.

•With established personal boundaries we respect the boundaries of others, staff and patients.

•We are responsible TO others and FOR ourselves

•Boundaries define us:    

o What IS you and what is NOT you.

o Where you END and someone else BEGINS.

o What you OWN and have RESPONSIBILITY for.

In sports boundaries maintain limits, fairness and safety.  Going out of bounds can get you in trouble, disqualified or even end your play.  In hospice, boundaries are lines which separate professional behavior from any behavior which (well-intentioned or not) could reduce the benefit of care to patients and families.

The entire hospice team is held accountable for establishing and maintaining healthy boundaries.

What Motivates Hospice Volunteers?

Healthy

    •  Desire to help or serve others.    

  • Interest in learning.

• Desire to “give back”.

                      • Search for meaning.

              • Respect for human dignity.

Outcome:  Well balanced       

               caregiving   

Unhealthy

• Need for admiration, appreciation, gratification.

• Need to be needed.

• Desire for power, control in the “helper” role.

• Re-live past experience.

• Therapy from personal loss.

• Already know it all – “been there, done that”.

Outcome:  Imbalanced

             caretaking  

  Comparing Relationships

Personal Relationships    

May be forever

Personal choices                    

Spontaneous      

No preparation           

Mutually centered           

Do I like this person?           

                      

Volunteer Relationships

      Time limited

      Structured within role

      Organization commitment

      Requires preparation

      Patient centered

      Can I support this person?   

Hospice Patients are a Vulnerable Population

• This is a time of intense need.

• They are seeking help, direction and services.

• There are many unknowns.

• Many have no idea what to expect.

• They are susceptible to changing emotions.

• Anticipatory Grief.

Volunteers Represent Hospice

As a result volunteers:

• Have intimate access to patients and families' personal time and space.

• Encounter their need to develop sincere connections.

• Bring your own spirituality, beliefs and lifestyle.

• Must remember hospice brings a team approach vs. an individual role.

1. Avoid thinking you can solve patient/family problems. We cannot “fix” their problems or change their family dynamics.

2. Be aware of crossing the line between professional and personal involvement.

3. Be aware of patient/family dependency on you.

4. Do not give advice or instructions. 

5. Good boundaries enable you to actively and confidently engage with the patient/family.

Know Your Role

Patients often get very close to you very quickly.  If you start moving from the outer circle to the inner circle it is not fair to the patient or to their family.

Look at the next Post to find PART 2!