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Health. How to work in the privacy of patients’ homes?

Professionals from the medico-social sector regularly intervene in the homes of individuals. Not easy to invite oneself into people’s privacy.

I spent hours in people’s homes, sitting around the living room table listening to their loneliness, coffee in hand, standing in the kitchen trying to resolve marital disputes. I subdued a teenager in crisis in the hallway… Collected myself in front of the photo of a missing mother… So began the diary of Xavier Bouchereau, a specialist educator in a child protection service in Pays de la Loire, published in 2013.

Years spent supporting families, listening to them, finding solutions, often after walking through the doors of their homes. Since then, Xavier Bouchereau has been passionate about this particular work area, in the privacy of homes. As a consultant and trainer, the professional exchanges regularly with his peers, whether they are educators but also home helpers, social and medical workers… According to Fepem, the employers’ federation, nearly 12% of households in France use a job from home.

balance to be found

Home becomes the center of gravity. This can be seen in particular with the desire to keep more and more elderly people in their homes. But working with a person requires a unique posture. Because intervening outside the walls of the institution, while having to embody it, will necessarily have consequences on the involvement of the professional. At home and at our office, we do not behave in the same way. A fair balance to be found between the competence of the mission to be deployed, the framework to be established and what can be given of oneself in this social bond​. The professional repeats it over and over again: We are not sanitized technicians; empathy is essential”.

So, when we enter the other, it is a question of taking care of the codes, rules and different cultures. Behind his desk, the professional invites you to sit down. At home, the professional is invited. The nuance is important. A house carries meaning so it is never neutral to do work there. ​Essential also to leave at the entrance his representations and other clichés”, so as not to blur the commitment. Very quickly, the maintenance of a house, its decoration, its atmosphere, its noises can create a screen. Welcoming a professional into your home remains a breach in privacy, in a protective cocoon. It is up to us to respect this modesty.

Diagnose a family environment

Health personnel working at home are confronted with it every day. When it comes to caring for a patient, it is just as valuable to understand how the patient’s entourage interacts with him. It even has a name, proximology.

So-called “family” doctors and general practitioners who still practice home visits know this well: Some disappointments, misunderstandings come from this complex relationship between a caregiver, the patient and the relatives​, explains Professor Philippe Jaury. On May 9, he spoke on this subject at the Foundation of the Academy of Medicine during a day of reflection on Aging at home. keep someone at home, is it his choice or more that of his relatives; how can it be properly cared for; me, health personnel, what do I put as a personal projection in this situation… These are questions that we must take the time to answer.

Listening, consulting a patient at home often opens the door to better care: See the environment of the person, identify possible conflicts, grasp the points of support… Along with the medical diagnosis, these are all determining elements.

Health. How to work in the privacy of patients’ homes?



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