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Clients and patients who use home health, home care, and hospice want to honor you, and at what better time than the holidays? But where do we draw the line? When do we stop being healthcare professionals, and become friends, or extended family, to our patients and clients?

It’s the most wonderful time of the year! The winter season brings with it the sights, smells and memories associated with the holidays. Whether those senses and memories trigger positive or negative feelings, we are inclined to share those sentiments with the people closest to us.

Clients and patients who use home health, home care, and hospice often include healthcare professionals in that list – and with good reason!

The care you provide as a healthcare professional truly makes a difference. Your attention and expertise may have been the reason a beloved family member lived to see another day, overcame a major health hurdle, or passed peacefully without suffering. In many cases, you will never be forgotten and have cemented a special place in the precious timeline of someone’s life.

They want to honor you, and at what better time than the holidays? They may offer gifts, cards, money, or food – there have even been reports of offers that include vehicles and vacations!

When Do We Stop Being Healthcare Professionals?

Here’s where things get tricky. Where do we draw the line? When do we stop being healthcare professionals, and become friends, or extended family, to our patients and clients?

The answer is a simple and resounding: we don’t.

We are always healthcare professionals.

Sure, we have feelings, and yes, we do have clients and patients that find a special place in our hearts, but the reality is we exist to provide a service that significantly impacts the well-being of those in our skilled care.

Does that mean we become cold? Do we respond rigidly and avoid developing deeper connections with those in our care? Of course, not! What we do is become aware of our professional boundaries and maintain a professional distance while providing excellent care. Sounds simple, but recent survey results show that may not always be the case.

How Many Have Crossed the Line?

At the completion of an HCP course, learners are presented with a post-learning survey. In our course, Maintaining a Professional Distance, learners are asked a series of questions regarding their experience with maintaining professional distance from those in their care.

When we asked the question, Do you struggle to keep a professional distance from your client(s)?, nearly 30% of respondents answered “Yes.”

When asked Have you ever ‘crossed the line’ with a client, nearly 20% had given a client their personal cell phone number, and/or shared personal information or concerns with a client.

One might argue that providing a client with a personal cell phone number or sharing personal information is a great way to build rapport with someone in your care. But, when we look closer at the client / healthcare worker relationship, we find that may not always be true.

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The Client / Healthcare Worker Relationship – a Refresher

A solid understanding of a relationship’s purpose is essential before we can draw boundary lines. Defining the client-healthcare worker relationship is the first step in maintaining a professional distance, so let’s review:

The basic purpose we provide to our clients and patients is to meet their physical and emotional needs. We talk to them about solutions to problems with a goal of identifying their needs, then developing a plan that we can put into action to meet those needs. This leads to a positive outcome where the development of new coping skills and a renewed level of independence are achieved.

That is the basic goal of our professional relationships with our clients. Why then, is it so easy to make it something much, much more?

The goal of a social relationship is to provide companionship, idea sharing, and emotional connection. When you spend a large amount of time with your clients and their families, you learn personal and intimate details of their lives that may entice you to reciprocate and share your similar life experiences. Doing so leads to idea sharing, companionship, and finally, emotional connection.

Fostering a Successful Relationship

There is nothing wrong with developing strong emotions towards your clients and their families. As a human being, it is natural to develop these feelings, but maintaining a professional distance is essential to the success of a professional relationship.

Sometimes, it can be difficult not to cross the line and act on those strong feelings, but doing so can harm your client, causing them to:

  • Have hurt feelings if you take another assignment or leave your job.

  • Become more dependent on you rather than develop important coping skills they need for independence. 

  • Disguise important changes that are difficult for you to observe because you have become too close to the situation.


Here are some warning signs that you may be in danger of compromising your professional distance from a patient or client:

  • Thinking about a client often when you are away from work. 

  • Planning your workday around the needs of one special client. 

  • Spending your free time with a client. 

  • Sharing personal information or concerns about work with a client. 

  • Accepting expensive gifts or money from a client. 

  • Giving a client your personal phone number or home address. 

  • Visiting clients in their homes as a friend, not as a professional.


Do any of those behaviors sound familiar? If you’re ever in doubt about crossing a line, ask yourself: 

  • Is this in my client’s best interest? 

  • Would I feel comfortable telling my peers about what I am doing? 

  • Is what I am doing defined in the client’s care plan?


Professional Relationships and Gifts from Clients

It is common for clients to feel so grateful for all you have done throughout the year that they want to honor you with a holiday gift. For some, your workplaces may allow you to accept certain gifts from clients, like knitted scarves or fresh veggies grown in their home gardens. For others, there is no better time than now to practice your professional boundaries with your patients and clients.

Here are a few guidelines regarding gifts from your clients:

  • Money must never change hands between a healthcare worker and a client. If this is attempted, you must refuse.

  • Accepting money from a patient or client can be seen as financial abuse, and in some cases, could be considered a crime. 

  • Some “favors” can be seen as a type of gift, like borrowing personal items from your clients. 

  • If you are experiencing repeated attempts of a patient offering you money or gifts you cannot accept, always discuss the situation with your supervisor. 

  • When in doubt, follow your workplace policy about accepting gifts.


Let the person down gently, but firmly. The goal is not to hurt the feelings of a patient or client, but to maintain a professional distance. Always thank the person for their thoughtfulness. Express your regret for declining the gift and explain why you mustn’t take it. Return the gift to the person and resume your professional tasks.

The Dos and Don’ts

Maintaining a professional distance during the holidays can be challenging. Our professional goal is to meet the client’s physical and emotional needs by assisting them with developing increased independence and healthy coping mechanisms. Keeping this goal in mind will aid us in creating fulfilling and rewarding relationships with each of our clients.

Here are some final Dos and Don’ts to help create and maintain meaningful professional boundaries:


  • Listen to the concerns of the family and act on those concerns when appropriate. 

  • Encourage your client to participate in their own care within the limits of the care plan. 

  • Help your client understand when requests are outside the limits of a professional relationship.



  • Perform personal services like giving rides to family members or picking up dry cleaning, unless it is outlined in your care plan or contract. 

  • Accept gifts of cash or other expensive items. 

  • Accept gifts unless the refusal could harm the client: for example, if refusing a freshly baked cookie from the client that would cause her to withdraw. 

  • Disclose personal information about your life.


Learn more:

Want to learn more about professional boundaries and your clients? Check out HCP courses: 

online home care training for caregivers, clinicians, and CNAs through Home Care Pulse
HCP Training Courses

HCP Training courses designed to help boost your team’s confidence in care delivery.

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