Can Paid Caregivers Also Be Friends?

Don't walk behind me; I may not lead. Don't walk in front of me; I may not follow. Just walk beside me and be my friend.

Albert Camus

Professional caregivers are trained to avoid personal relationships with their clients.  There are lots of good reasons why this policy is standard in health care agencies: emotional investment could skew clinical judgment, agency staff might make private arrangements for employment, thus leaving the agency out of the picture, or the caregiver might give ‘unequal’ quality of care to favored clients who are also friends.

But is it always in the client’s, the caregiver’s and even the agency’s best interest to avoid personal relationships between paid caregiver and client?  In our family, we have enjoyed excellent service from paid care workers who kept a respectful distance from personal conversations.  BUT, most of our paid caregivers over the years have remained close friends – some, I would call lifelong best friends.  There are a number of reasons for this.  My son’s care began when he was a child and pediatrics is naturally less formal than adult care.  Nicholas lived at home, so clinical behaviors were inappropriate in a home setting.  I was always home either looking after our daughter, tending to the pets or cooking in the kitchen.  I am by nature an outgoing person, so we absorbed Nick’s helpers into our family in order to create a sense of normalcy in our day-to-day life.

Of course, we have no interest in becoming best buddies with hospital nurses or specialist rehabilitation professionals.  It’s the homecare workers I am talking about here – the staff who remain in our employ for years at a time.  When Nicholas began secondary school, I needed someone to help him with homework and play computer games with him, allowing me the time to walk the dog, make dinner and help Natalie with her schoolwork.  (Nick has no hand function and has low vision, so helping with his after-school routine isn’t something that I could multi-task.)  I wanted a high school student….someone just a little older than Nick – someone who would be a role model and ‘big brother’.  I telephone the school guidance counselor and was given a short list of recommended candidates.  The first name I called was a young lad called John.  Nick can’t pronounce ‘John’, but he is able to verbalise his father’s name of Jim.  So, John became ‘Jim Jim’.  That was in 1999 and John is still Nick’s best friend and ‘big bro’.  

JimJim taking Nick out for his first ride on a city bus.

JimJim is big brother to Natalie too!

This year, one of Nick’s full-time day caregivers got married and our family joyfully celebrated together with our caregiver/friend and his family.  That particular young man moved to London with us in 2006 and lived with us there for a year before he moved back to Canada and assumed full-time employment at the residential facility where Nick now lives.   What goes around, comes around, and in the case of our caregiver/friends, we are very grateful.

Nick is a young adult and so are his professional caregivers.  Staff are chosen for their medical expertise, but also on the basis of personality and shared interests with Nick.  These young people ARE Nick's friends - they are real friends.  When one young man took a holiday in Greece last summer, he telephoned from Crete to wish Nick a Happy Birthday.  Local time in Greece was 2:30am, but that didn't stop him from picking up the phone to call his best pal. 

Employers, caregivers, clients and families will have to decide if and when it is appropriate to establish and maintain friendly relations that go beyond the usual clinical model of support.  In our case, we absorbed our home-helpers into our family.  I was always home and working with our helpers in a team mode (caring for Nick and his sister was always at least a two-person job), so there was never any possibility of exploitation on the part of anyone.   Our home helpers knew that if Nick was well and pain-free, their responsibility was to be with him, or tag-team with me to do whatever was necessary.  If Nicholas was ill or in distress, our helpers assumed other household responsibilities so that I could be completely present with Nick in his hour of need. 

Today, I would like to pay tribute to our caregiver/friends who, over the last 25 years have given us their expertise, their kindness, their good humor, their tears mixed with my own, and their loyal and abiding friendship.