When to Say “Yes” and When to Say “No”

Abstract

A total of 79 hospice palliative care volunteers from 2 community-based hospice programs responded to a 27-item Boundary Issues Questionnaire that was specifically developed for this study. Volunteers were asked to indicate whether or not they considered each item (eg, “Lend personal belongings to a patient or family,” “Agree to be a patient’s power of attorney,” “Attend/go into a patient’s medical appointment”) to be something they should not do and to indicate whether or not they have ever done it. On the basis of the volunteers' responses, the authors distinguished between “definite boundary issues” (things volunteers should never do, for example, “Accept money from a patient or family”), “potential boundary issues” (things volunteers should stop and think twice about doing, for example, “Accept a gift from a patient or family”), and “questionable boundary issues” (things volunteers should be aware of doing, for example, “Give your home phone number to a patient or family”). The implications of these findings for training volunteers are discussed and the need for clear and unambiguous organizational policies and procedures to preserve boundaries is stressed. Without clear policies, etc, community-based hospice programs may be putting themselves at legal risk.