Client Rights, Confidentiality, and Ethical Practice
What this domain covers
Clients have rights to dignity, privacy, confidentiality, choice, self-determination, and freedom from abuse and neglect. They may refuse care, and a competent refusal must be respected and reported - not overridden. Know advance directives and the rights to visitors, mail, phone calls, and personal belongings.
Confidentiality: share information only with those who need it to provide care (need-to-know). Never discuss a client in public, on social media, or with neighbors. HIPAA governs protected health information, including verbal discussion.
You are a mandated reporter. Suspected physical, emotional, sexual, or financial abuse, neglect, or exploitation must be reported immediately to your supervisor and per agency and state requirements, even if the client asks you not to. Warning signs include unexplained bruises, fear of a family member, withdrawal, poor hygiene, and sudden changes in finances.
Ethical practice includes honesty, keeping promises, avoiding conflicts of interest, and staying within your scope. Do not accept substantial gifts, borrow money, witness legal documents, or act as a client's representative. If you make a mistake, report it honestly.
Traps
Overriding a client's refusal of a bath, sharing details with a relative who calls, keeping a 'small' gift, ignoring abuse signs because the family seems nice, and assuming a confused client has no rights.
Rule of thumb
If the client has the capacity to decide, it is the client's decision - support it, document it, and report concerns.