Dr. Eleanor Barbera

As “Eileen” suggested in the comments section of a recent “Dr. El” blog, disclosing personal information can be a good way to establish a more intimate connection with residents. While self-disclosure can create warmer relationships, there also can be unintended and unwanted consequences to revealing such details.

In contrast to psychologists who study interpersonal interactions for a living, staff members are unlikely to have fully considered the impact of their self-disclosures. Doing so can improve their relationships with residents and avoid unanticipated pitfalls.

Here’s a guide* to the ups and downs of self-disclosure along with a handy flow chart (see below) to help you and your team decide when it’s the right move in any given situation. My inclination toward privacy is reflected in the flow chart, so consider it a starting point for discussion among team members or in a staff training session.

The ups

Part of the pleasure in working with elders is hearing about their lives and learning from their experiences. Sometimes revealing a detail or two from our own lives can help a reticent resident open up.

Self-disclosure allows workers to be more open and relaxed at work and to establish deeper relationships with those in their care.

Being “real” with residents can reduce the somewhat artificial boundaries between people in different phases and roles in their lives and can be part of a healthy organizational culture.

The downs

On the other hand, self-disclosure can sometimes get workers in trouble.

Consider the employee who tells a resident something in confidence that the resident later shares with others in the facility. The employee may still need to provide care to that individual despite the tension caused by the betrayal of a confidence.

Or perhaps a resident learns sensitive information about a worker and uses it in a manipulative fashion. For example, an aide might reveal their involvement in a 12-step program in a well-meaning attempt to encourage a resident to address a drinking problem, but the resident could subsequently threaten to share that private information with the aide’s coworkers unless special treatment is provided.

At other times, boundaries can be crossed in a different way, such as a resident offering unsolicited and overbearing advice to a staff member who has admitted that their child is having trouble in school.

Yet another possibility is that the personal information revealed is disturbing to a resident. This could occur, for instance, when an elder who is feeling particularly upset about his or her physical confinement becomes more distressed after hearing details about the vacation travels of a worker.

Finding a balance

The key to self-disclosure is determining what you’re comfortable revealing and using it in the service of establishing genuine, healing relationships with residents. Some residents respond better to staff revelations than others; some staff members are naturally more open.

It’s often possible to moderate the amount of information shared, depending on the situation. For example, when speaking with a resident with known boundary problems (such as asking overly intrusive questions), a worker might share that she was going on vacation, but not specifics of the trip or her fellow travelers. The same journey could be described in some detail to another resident with better boundaries who might enjoy reminiscing about their own visit to that particular location.

Other factors when revealing personal information include whether the amount of time spent discussing one’s life with the resident is interfering with accomplishing necessary tasks or whether the closeness of the relationship with a particular elder makes a worker noticeably less available for other residents in their care.

Using the decision tree below can help workers think about the factors involved in establishing a friendly, professional persona that succeeds with a variety of residents.

    

                                             

*Reprints are available for multiple copies

 

Eleanor Feldman Barbera, PhD, author of The Savvy Resident’s Guide, is an Award of Excellence winner in the Blog Content category of the APEX Awards for Publication Excellence program. She also is the Gold Medalist in the Blog-How To/Tips/Service category of the American Society of Business Publication Editors Midwest Regional competition. A speaker and consultant with over 20 years of experience as a psychologist in long-term care, she maintains her own award-winning website at MyBetterNursingHome.com.