THE FUNDAMENTALS OF CAREGIVING

Objective: Learn more about the role of a carer and the skills they need to have to
provide effective care.

Learning outcomes

After studying this module, you will be able to do the following:

1. Define the roles and responsibilities of a carer

2. Describe the various legal issues that carers must be familiar with when they work
with clients

3. Develop the skills necessary to communicate effectively with all members of the
service team

4. Develop an understanding of how to communicate with individuals with various

disabilities

5. Discuss the correct etiquette when working with clients

What is a carer? A carer is a person who provides assistance or support with daily
activities can include bathing and grooming, housekeeping; help with meals, and
encouragement of behaviors that enhance community involvement

Other possible titles for a carer include:

• Home care aide

• Personal care aide

• Direct support professional

• Attendant

• Care associate

• Personal Care assistant

• Companion
 • Caregiver

Roles and Responsibilities of Carers

Responsibilities of a Carer

The list of things a carer can and cannot do depends on the setting and the specific job.
It is not possible to write one job description.

JOB PURPOSE

1. To look after the physical, emotional, cultural and social needs of the Clients
using a person centered approach

2. To observe and promote the Client’s choice, independence, dignity, privacy,

fulfillment and other rights

3. To create and maintain good professional relationships with Clients, their family
and friends

4. To actively support other carers

5. To adhere to all regulatory and statutory obligations and the institution’s policies,
procedures and guidelines

Care provision

1. To provide personal care and support to Clients with a wide range of needs,
illnesses and disabilities

2. To know and understand the care and support of the Client

3. To undertake the tasks detailed in the Client’s care and support plan using a
person centered approach and in the least intrusive way

4. To encourage the independence and motivation of the Client and not foster
dependent behavior

5. To assist Clients getting up in the morning and going to bed at night \

6. To assist Clients to wash, bath and shower

7. To assist Clients to dress and undress

 8. To assist Clients to look after their skin, teeth, hair and nails

9. To assist Clients with toileting, continence management and personal hygiene

10. To assist Clients with their medication at the agreed level of support and as
detailed in their Medication Care Needs Assessment

11. To prepare food and drink for the Client, being aware of the Client’s choice,
likes/dislikes, nutritional needs and cultural requirements

12. To provide light general household domestic duties, including housework and
laundry, as detailed in the care plan or instructed by Management

13. To use manual handling equipment safely and correctly

14. To take responsibility for the safe handling of property and equipment belonging
to the Client

15. To maintain good communication and develop effective working relationships

with Clients

16. To provide companionship to the Client, actively talking and listening to them
about their interests

17. To help the Client to maintain contact with their family and friends

18. To accompany the Client on trips into the community

19. To assist the Client to manage their personal affairs

20. To ensure as safe as possible the living environment for the Client, whilst
respecting the Client’s choice and rights

Recording and Reporting

1. To maintain detailed accurate records in respect of care and medication support

given and tasks undertaken

2. To regularly read care and support plans, acknowledging changes

3. To protect the confidentiality of all information relating to the Client and not
divulge information to anyone who is not authorized to receive it
 4. To promptly report to the office or senior staff any issues concerning the care,
support, well being or behavior of the Client and update records accordingly

5. To continue to monitor where concerns have been reported and recorded

6. To recognize the signs of abuse and immediately report abuse or suspected

abuse to the senior staff

7. To report any complaints to the office/ senior staff

8. To contact the office or senior staff if running late

General

1. To dress appropriately, wearing uniform and using personal protective

equipment provided by the institution

2. To seek out best practice and look at innovative ways to improve the quality and
efficiency of service delivery

3. To attend and participate in regular Care Worker team meetings and any other
relevant meetings

4. To attend in house and external training pertinent to the role of Care Worker

5. To ensure completed weekly timesheets are submitted on time

6. To observe all health & safety rules and take reasonable care to promote health
and safety of self and others and raise any concerns to the senior staff

Service team

For any person receiving support, a service team helps to coordinate the service. Each
person on the team has certain functions.

Each situation is different, but often the following are on the team:

1. Nursing staff

2. Doctors

3. Dieticians/Nutritionists
 4. PTs/OTs

5. Orderlies

6. Others

The carer is an important member of the service team. As a carer, you may spend more
time with a client than others. The carer works with the service team to provide care to
the client.

When providing assistance in the person’s home, observe any changes and problems. If
you notice anything unusual-both positive and negative- report it to your supervisor.

Carer Professional Standards

In addition to training, a carer needs high professional standards. The carer and the
client need respect for each other and a professional relationship.

The persons for whom you provide services must be able to rely on you. Your services
help keep people safe and independent.

Below are lists of standards that a carer should aim to meet:

1. Carry out responsibilities of the job the best way you can- take pride in a job well
done.

2. Get the training you need; get continuing education each year.

3. Be dependable and reliable.

4. Maintain a high standard of personal health, hygiene and appearance.

5. Show respect for the client’s privacy when you enter his/her home.

6. Keep your professional life separate from your personal life.

7. Control any negative reactions to chronic disability or living conditions.

8. Maintain safe conditions in the work environment.

9. Do not bring your family or friends to the client’s home.

10. Do not use the client’s things for yourself (phone, food, medications, etc.
 Professional Qualities of a Care Provider

1. Communication Skills Solid communication skills are a basic foundation

for any career. But for carers, it’s one of the most important aspects of the job. A great
care provider has excellent communication skills, especially when it comes to speaking
and listening. They are able to follow directions without a problem and can easily
communicate with patients and families. 

2. Emotional Stability Caregiving is a stressful job where traumatic situations are

common. The ability to accept suffering and death without letting it get personal is
crucial. Some days can seem like non-stop gloom and doom. 

3. Empathy Great carers have empathy for the pain and suffering of patients. They are
able to feel compassion and provide comfort. But be prepared for the occasional bout
of compassion fatigue; it happens to the greatest of carers. Learn how to recognize the
symptoms and deal with it efficiently. 

4. Flexibility Being flexible and rolling with the punches is a staple of any career, but it’s
especially important for carers. A great carer is flexible with regards to working hours
and responsibilities. Carers, like doctors, are often required to work long periods of
overtime, late or overnight shifts, and weekends. 

5. Attention to Detail Every step in the medical field is one that can have far-reaching
consequences. A great carer pays excellent attention to detail and is careful not to skip
steps or make errors. 

6. Interpersonal Skills Carers are the link between doctors and patients. A great care
provider has excellent interpersonal skills and works well in a variety of situations with
different people. They work well with other caregivers, nurses, doctors, and other
members of the staff. 

7. Physical Endurance Frequent physical tasks, standing for long periods of time, lifting
heavy objects (or people), and performing a number of tasking maneuvers on a daily
basis are staples of the carers life. It’s definitely not a desk job. 

8. Problem Solving Skills A great care provider can think quickly and address problems
as - or before - they arise. 
9. Quick Response Carers need to be ready to respond quickly to emergencies and
other situations that arise. Quite often, health care work is simply the response to
sudden incidences, and carers must always be prepared for the unexpected. 

Basic Principles

There are basic principles-beliefs-that all people have rights, abilities, and freedom of
choice. The carer needs to be aware of these principles and ensure that they keep them
in mind when assisting clients.

Such principles include the following:

1. Independence

2. Dignity

3. Person-centered

Working with Older Adults

As people get older, they tend to slow down a little. Unfortunately, younger people
sometimes show disrespect or simply become impatient.

Ageism or age discrimination is all too common in society. If you work with older adults,
it is important to have the right mindset. Keep in mind a few principles.

Below are the lists of principles that you should keep in mind when working with the
elderly:

1. Older adults can do a lot and learn new things. Like all people, they feel better
when they can do things for themselves.

2. Older people have experience and wisdom. They may not know everything you
know, but they know a lot.

3. Always treat an older adult as an adult. Adults are not like children.

4. Older people have interests and likes and dislikes. They want to make their own
choices.
 Legal and Ethical Issues of Providing care

Familiarity with Legal Terms

It is of utmost importance that all carers are familiar with the legal issues that they could
encounter during their work.

Listed below are the most important legal terms in this regard:

1. Abandonment - Patient abandonment is a form of medical malpractice that

occurs when one terminates the carer-patient relationship without reasonable
notice or a reasonable excuse, and fails to provide the patient with an
opportunity to find a qualified replacement care provider.

2. False imprisonment - is the unlawful restraint of a person against his/her will by

someone without legal authority or justification.

3. Assault - an unlawful physical attack or threat of attack, on an individual, with or

without actual injury. It is a crime and therefore, may result in either criminal or
civil liability. 

4. Fraud - is deliberate deception to secure unfair or unlawful gain, or to deprive a

victim of a legal right.

5. Malpractice - It's defined as a violation of professional duty, failure to meet a

standard of care, or failure to use the skills and knowledge of other professionals
in similar circumstances.

6. Battery - is a criminal offense involving the unlawful physical acting upon a

threat, distinct from assault which is the act of creating apprehension of such
contact. In the United States, criminal battery, or simply battery, is the use of
force against another, resulting in harmful, offensive or sexual contact.

7. Invasion of privacy - unlawfully intrusion into a person’s private affairs, discloses

his or her private information, publicizes him or her in a false light, or
appropriates his or her name for personal gain.

8. Negligence - Negligence usually is defined as a failure to exercise the degree of

care that a person of ordinary prudence would exercise under the same
 circumstances. the result of errors in diagnosis, treatment, aftercare or health
management

Distinction Between Laws and Ethics

Carers need to understand the distinction between laws and ethics so that they conduct
their day-to-day tasks safely and in confidence:

Law - is a system of rules that are enforced through social institutions to govern
behavior.  /a rule of conduct or action that a nation or a group of people agrees to
follow. 2: a whole collection of established rules

Ethics - moral principles that govern a person's or group's behavior. /rules of behavior
based on ideas about what is morally good and bad. 

Avoiding Legal Action

As a carer, your primary legal responsibility is to avoid legal action for you and the
company you work for.

In order to avoid legal action- follow the guidelines outline:

1. Know your own strengths … and weaknesses. Don't accept responsibility that
you aren't prepared for.

2. Refuse assignments you can't safely perform.

3. Get clear orders.

4. Be particularly careful with medications.

5. Stay on your patient's good side. Trial attorneys have a saying: “If you don't
want to be sued, don't be rude.” 

6. Don't offer opinions (ever). Avoid offering your opinion when a patient asks
what you think is the matter with him. Reply with “just the facts.”

7. Before you sign … read!

8. Stick to the FACTs. From a legal standpoint, documenting care is as important as

giving the care. If a procedure wasn't documented, the courts assume it wasn't
done.
 9. Do the right thing.

10. Use restraints as a last resort. Follow guidelines from your facility about using
restraints.

11. Prevent patient falls. Patient falls are a very common area of nursing liability.

12. Be familiar with advance directives. Be aware of your state's laws about
advance directives, such as living wills and durable power of attorney

13. Follow facility policies and procedures. Be familiar with the policies and
procedures of the facility where you work. If they're sound and you follow them
carefully, they can protect you against a malpractice claim.

14. Provide a safe environment. When providing care, don't use faulty equipment.
Clearly mark the equipment as defective and unusable. After repairs are made,
doesn’t use the equipment until technicians demonstrate that it's operating
properly. Document the steps you took to handle the problems with faulty
equipment to show that you followed the facility's policy and procedures.

Ethical Principles

Carers need to conduct their roles in an ethical and responsible manner. Follow the
guidelines below in order to do so:

1. Honesty

2. Respect

3. Reliability - the ability to be relied on or depended on, as for accuracy, honesty

Legal and Ethical Issues of Providing care

In 1973, the American Hospital Association (AHA) published A Patient’s Bill of Rights
to promote the rights of hospitalized clients. They were revised in 1992. Since that
time the only real change to these fundamentals has been the packaging. In 2001,
AHA hospitals replaced "A Patient's Bill of Rights" with "The Patient Care Partnership:
Understanding Expectations, Rights and Responsibilities." The messages are still the
same.

Patient’s Bill of Rights

1. The patient has the right to considerate and respectful care.

2. The patient has the right to and is encouraged to obtain from physicians and
other direct caregivers relevant, current, and understandable information
concerning diagnosis, treatment, and prognosis.

3. The patient has the right to make decisions about the plan of care prior to and
during the course of treatment and to refuse a recommended treatment or plan
of care to the extent permitted by law and hospital policy and to be informed of
the medical consequences of this action.

4. The patient has the right to expect that all communications and records
pertaining to his/her care will be treated as confidential by the hospital, except in
cases such as suspected abuse and public health hazards when reporting is
permitted or required by law.

5. The patient has the right to review the records pertaining to his/her medical care
and to have the information explained or interpreted as necessary, except when
restricted by law.

6. The patient has the right to expect that, within its capacity and policies, a hospital
will make reasonable response to the request of a patient for appropriate and
medically indicated care and services. The hospital must provide evaluation,
service, and/or referral as indicated by the urgency of the case. When medically
appropriate and legally permissible, or when a patient has so requested, a patient
may be transferred to another facility. The institution to which the patient is to be
transferred must first have accepted the patient for transfer.

7. The patient has the right to ask and be informed of the existence of business
relationships among the hospital, educational institutions, other health care
providers, or payers that may influence the patient's treatment and care.
8. The patient has the right to consent to or decline to participate in proposed
research studies or human experimentation affecting care and treatment or
requiring direct patient involvement, and to have those studies fully explained
prior to consent.

A patient who declines to participate in research or experimentation is entitled to the

most effective care that the hospital can otherwise provide.

11. The patient has the right to expect reasonable continuity of care when
appropriate and to be informed by physicians and other caregivers of available
and realistic patient care options when hospital care is no longer appropriate.

12. The patient has the right to be informed of hospital policies and practices that
relate to patient care, treatment, and responsibilities. The patient has the right to
be informed of available resources for resolving disputes, grievances, and
conflicts, such as ethics committees, patient representatives, or other mechanisms
available in the institution. The patient has the right to be informed of the
hospital's charges for services and available payment methods.

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a federal
law that required the creation of national standards to protect sensitive patient
health information from being disclosed without the patient's consent or knowledge.

Client Rights

Note

The carer should respect the client’s choices. When a person is not allowed to make
decisions about services that takes away from his/her rights.

As a carer, if you are concerned about a choice, explain why you are concerned,
discuss an alternative, contact your supervisor for instructions, and document what
you did.

These carer rights are based on the rights that all employees should enjoy.

Should an employee not have any of the above rights in their place of work, it would
certainly affect the quality of their work on a day-to-day basis.
Confidentiality

All information about a client of a carer is considered private or confidential.

Whether written on a paper, saved on a computer, or spoken aloud.

This includes:

1. their name

2. Address

3. Age and any other personal information

4. the reason the client is sick

5. the treatments and medications he/she receives,

6. caregiver information,

7. any information about past health conditions,

8. future health plans, and

9. Why the client is open to services.

If you reveal any of this information to someone who does not need to know, you
have violated a client’s confidentiality, and you have broken the law.

Why are Privacy and Confidentiality Important?

Clients need to trust the carer before they will feel comfortable enough to share any
personal information with them. This will take time to achieve.

In order for the carer to provide quality care, we must have sufficient information.

Our clients must know that whatever they tell us will be kept private and limited to
those who need the information for treatment, payment, and health care operations.

What are ways to Protect Confidentiality?

In order to protect the confidentiality of your clients and yourself, consider the
following:
1. Conversation

2. Phone

3. Medical

4. Trash

5. Computers

Adult (elderly) and Child Abuse

Adult and child abuse refers to any form of maltreatment of a person by a caregiver,
family member, spouse, or a friend.

Categories include:

1. Abuse

2. Financial exploitation

3. Neglect

Adult and Child Abuse- Reporting Requirements

All persons responsible for the care of an incapacitated or vulnerable adult or child
have a duty to report suspected abuse and neglect.

Failure to do so can often end in prosecution by the legal system.

This is the case in many countries across the world.

Communication and the Caregiving Process

The Communication Process

Carers need to have exceptional communication skills, and communicating

information with the family and the agency improves the care of the client.

With the above in mind, this unit will present you with the skills necessary to become
an effective, efficient communicator, for the benefit of your clients.
Effective communication happens when the intended meaning of the sender and
the perceived meaning of the receiver are the same.

Verbal Communication

Successful verbal communication occurs when an individual uses a combination of

words or writing in order to pass on information to a specific recipient.

Sign language and braille are also verbal communication.

Braille is the writing system that uses raised dots to express the letters of the
alphabet.

Non-Verbal Communication

Successful non-verbal communication occurs when an individual does not use words
in and still successfully passes on information to a specific recipient.

There are several categories:

1. Facial expression

2. Head movements

3. Hand and arm gestures

4. Eye contact

5. Physical space

6. Touching

7. And physical postures

Even a person’s emotions or how she dresses can influence the communication
process. As much as 90% of communication can be non-verbal.

Communication Styles

1. Aggressive Communication
Aggressive communication may be physical, non-verbal, or verbal. It is used to
humiliate or demean another person, for example, with profanity or blaming.

Why People Communicate Aggressively?

1. They anticipate being attacked and overreact aggressively.

2. They are initially non-assertive. Their anger builds until they explode.

3. They have been reinforced for aggressive behavior.

4. It gets them the attention they desire.

5. They never learned the skills of being assertive.

Consequences of Aggressive communication

1. They get their own way but often alienate others.

2. They are often lonely and feel rejected.

3. They receive little respect from others.

4. They may develop high blood pressure, ulcers and have a heart attack.

2. Passive Communication

The word passive refers to “not resisting”. A verbally passive person keeps quite and
may withhold feedback. This makes communication much more difficult.

Why people communicate passively?

1. They believe they have no rights.

2. They fear negative consequences.

3. They do not know how to communicate their wants.

4. They were socialized to always be compliant and accepting.

Consequences of Passive communication

1. They avoid conflict and often appease others

2. They lose self-esteem
3. They develop a growing sense of anger and hurt
4. They may develop headaches, ulcers, backaches and other
5. symptoms

3. Assertive Communication

Assertive is the ability to say what you want to say, but still respect the rights of
others. When you are assertive, you are honest about your opinions and feelings. At
the same time you try not to criticize or put others down.

As a carer, you should strive to use assertive communication at all times.

Why communicate assertively?

1. It is respectful to yourself and others.

2. It recognizes your needs as well as others. You are not a doormat, and not a
bully.

It is constructive, honest, open direct communication.

Attitudes

The attitudes that we show when communicating with others can have serious
effects how we are communicating.

Attitude toward the receiver or the receiver’s attitude toward the sender also
influences our communication. Our messages are different when communicating the
same content to someone we like than to someone we dislike.

We also structure our message differently when talking to someone in a higher

position than ours, the same position, or in a lower position, regardless whether we
like them or not.

It is important to maintain a positive and professional attitude at all times

when with your clients.

Attitudes

NOTE
Attitudes toward ourselves determine how we conduct ourselves when we transmit
messages to others:

1. If we have an unfavorable self-attitude the receiver may notice the uneasiness.

2. If we have a favorable self-attitude the receiver may notice self-confidence

3. When favorable self-attitude is too strong, receivers sense brashness and

overbearing attitude. Then our communication loses much of its effect.

Barriers to Communication – Poor Listening Skills

Poor listening skills contribute to poor communication. Listening involves not just
hearing the message, but the ability to understand, evaluate and respond.

As a carer, you need to be an active listener.

Steps to Improve Your Listening skills

1. Be quiet. Pay attention to what the other person is saying.

2. Stop all other activities. Focus on the speaker.

3. Look and sound interested. Listen for feelings.

4. Do not interrupt the speaker. Let the speaker finish, even if it takes a long time.

5. Do not try to think of a response while the person is speaking.

6. Do not finish sentences that the speaker begins, clarify what the speaker says.

Barriers to Communication – Other Barriers

There are numerous other barriers to communication. Avoid the following:

1. Giving advice, making judgment, focusing on yourself.

2. Giving false reassurance about your client’s physical or emotional condition.

3. Discussing your own problems or concerns.

4. Discussing topics that are controversial such as religion and politics

 Communicating with Individuals with Disabilities

Therapeutic Communication

Therapeutic communication is a process designed to involve the client in

conversation that is beneficial to her or his physical or mental well being. Good
communication between the carer and the client is important to provide services
that meet the needs of the person.

Some useful techniques, to promote therapeutic communication with the client

include:

1. Use open ended comments to encourage conversation.

2. Learn more about the person to meet the person’s needs.

3. Use paraphrasing or reflective responses to clarify information.

Therapeutic Communication – Strategies

1. Open-ended Questions- is designed to encourage a full, meaningful answer

using the subject's own knowledge and/or feelings. It is the opposite of a closed-
ended question, which encourages a short or single-word answer.

2. I-messages- In interpersonal communication, an I-message or I-statement is an

assertion about the feelings, beliefs, values etc. of the person speaking, generally
expressed as a sentence beginning with the word "I"

3. 3. Reflective responses- is a communication strategy involving two key steps:

seeking to understand a speaker's idea, then offering the idea back to the
speaker, to confirm the idea has been understood correctly. It attempts to
"reconstruct what the client is thinking and feeling and to relay this
understanding back to the client". 

Barriers to Therapeutic Interaction:

1. Language differences
2. Cultural differences
3. Gender
4. Health status
5. Developmental level
6. Knowledge differences
7. Emotional distance
8. Emotions
9. Daydreaming
10. Use of healthcare jargon

Conflict Resolution

Sometimes a client or family member gets upset when you are in the home. It is
important for you as a carer to not get angry. You must be polite and professional,
and you must respond in a way that is not threatening.

Use the following tips to resolve conflict in a professional manner.

Conflict Resolution Strategies:

1. Listen intently. This lets the person know that what he has to say is important.

2. If the person knows that what he has to say has value, he/she will begin to calm.

3. Do not respond with anger or become defensive, try to see from their
perspective.

4. Then, once he sees you as an ally, not an enemy, fill him in on your perspective.

Respectful Communication – Addressing a Client

The most basic forms of communication is using a client’s name. Some people want
you to use their first name; others prefer to be addressed formally. As a carer you
should ask your client how she or he wants to be addressed.

It is also important to treat adults as adults. As a carer, you may work with people
who have a hearing or speaking disorder. Perhaps they take longer to respond.

Sometimes you may have to repeat the message.

It is disrespectful to treat an adult person as a child.

Other ways of ensuring that you show your clients respect include:

1. Do not talk down to a person who has language difficulties.

2. Use adult language; don’t use baby talk.

3. Use adult words. For example, adults use “briefs” (not diapers)

4. Choose adult books and TV programs for your clients.

5. Let each person make choices. Don’t decide for them.

Respectful Communication - Vision Impairment

As a carer – you will work with clients with a range of disabilities. It is of utmost
importance that you can communicate with all clients effectively.

Visually impaired people can often be quite independent; their level of

independence often depends on a range of factors including:

1. The level of their visual impairment

2. How long they have been visually impaired for.

When working with visually impaired people, it is important to keep the following in
mind.

1. Don’t be surprised if the person would rather help themselves.

2. If you are uncertain how to help, ask the one who needs assistance.
3. When addressing the person who is blind, it is helpful to call them by name.
4. Do not touch the person’s guide dog.
5. Let the person hold on to you versus you holding them.
6. When walking into a room, identify yourself.

Respectful Communication - Hearing Impairment

Similarly to individuals with visual impairment, individuals with hearing impairments

often enjoy a strong sense of independence depending on a range of factors
including:

1. The level of their impairment

2. How long they been impaired for.

When working with people with hearing impairment, it is important to keep the
following in mind.
Language Impairment (Aphasia)

Some people can speak but not write. Others can write but not speak. Such language
disorders are called aphasia. It is often the result of a brain injury from an accident or
a stroke, but it does not affect intelligence.

Mental Health Impairment

A person with an emotional or behavioral health issue may have distorted thinking.
He or she may hear voices, see things that aren’t there, be paranoid or have difficulty
communicating. Usually this does not mean the person is aggressive unless he/she
feels threatened. Here are some communication guidelines to use:

When working with people with mental health impairment:

1. If the person has difficulty having a conversation with you, he/she may be able to
enjoy your company in other ways. Consider watching TV, listening to music,
playing cards or being read to. Talk about childhood events

2. Allow the person to have personal space in the room. Don’t stand over him or her
or get too close. This includes touching the person. The person may hit you if you
try a soothing touch.

3. Don’t block the doorway, avoid continuous eye contact.

4. Try to remain calm with a soothing approach. Speak with a slow –paced and low
toned voice.

Cognitive/Memory Impairment

A person with cognitive or memory impairment has difficulty thinking and

remembering. They become very embarrassed if you ask those names or dates.

Since their long term memory is much more intact, they may dwell on events in the
past and not remember such things as a relative’s death or that a child has grown
up.

The two important factors in working with the individual with a cognitive
impairment are:

1. Your actions
2. Your reactions to the individual and his/her behavior

Furthermore as a carer, you will often encounter clients who are confined to or use a
wheelchair. It is important that you are aware of standard wheelchair etiquette, so
you do not offend clients.

Standard wheelchair etiquette can vary from country to country, however some
common rules apply.

When working with people in wheelchairs, keep the following in mind:

1. Ask permission. Always ask the person if he or she would like assistance before
your help. It may be necessary for the person to give you some instructions. An
unexpected push could throw the person off balance.

2. Be respectful. A person’s wheelchair is part of his or her body space and should
be treated with respect. Don’t hang or lean on it unless you have the person’s
permission. When a person transfers out of the wheelchair out of the wheelchair
to a chair, toilet, car or other object, do not move the wheelchair out of reaching
distance.

3. Speak directly. Be careful not to exclude the person from conversations. Speak
directly to the person and if the conversation lasts more than a few minutes, sit
down or kneel to get yourself on the same level as the person in the wheelchair.
Also, don’t pat a person in a wheelchair on the head as it is a degrading gesture.

4. Give clear instructions. When giving instructions to a person in the

wheelchair, be sure to include distance, weather conditions, and physical
obstacles which may hinder travel.

5. Act natural. It is okay to use expressions like “running along” when speaking to a
person in a wheelchair. It is likely the person expresses things the same way.

6. Wheelchair use doesn’t mean confinement. Be aware that persons who use
wheelchairs are not confined to them.

7. Some persons who use a wheelchair for mobility can walk. Be aware of the person’s
capabilities. Some persons can walk with aids, such as braces, walkers, or crutches and
use wheelchairs some of the time to conserve energy and move about more quickly.