Confidentiality in care: A valuable foundation for trust and ethics

Sometimes there are built-in structures where habits or rituals maintain a distance between the residents and the staff. When I was at a home, they would offer coffee. I took a cup from the cabinet and started pouring my coffee. A staff member rushed over and said "No, not that cup, it's a patient's cup". Of course, I had to ask if they didn't wash the residents' mugs?

When it comes to caring and supporting people in their most vulnerable moments, confidentiality is a fundamental and important principle. It is more than just a rule, it is an ethical obligation that builds trust and ensures that individuals' rights and privacy are respected.

Protection of personal information

Confidentiality is designed to protect personal information about those receiving care. This means that all information that a caregiver becomes aware of in their work must be treated with the utmost discretion and secrecy. This includes medical information, social and emotional conditions, and other sensitive details.

Trust and open communication

Trust is a cornerstone in the care relationship. When a person in need of care or support trusts that their information will be handled confidentially, they are more likely to be honest and open about their needs and concerns. This allows caregivers to provide better, more personalized care and support.

Respect for individual rights

Every individual, regardless of age, health condition, or situation, has the right to privacy and personal integrity. By respecting confidentiality, it is ensured that these rights are respected and that no information is used in a way that could harm the individual.

Minimize the risk of discriminating or spreading rumors about people

Confidentiality also helps to reduce stigmatization and discrimination. When information about a person's health condition or situation is spread without consent, it can lead to prejudice. This is combated by respecting confidentiality.

Legal responsibility

For caregivers and professionals in the care sector, confidentiality is not only an ethical obligation but also a legal one. Breaching confidentiality can lead to serious consequences such as fines and dismissal.

How we respect confidentiality

Education: Everyone working in the care industry should be educated about the principles of confidentiality and its importance.
Respectful conversation climate: Caregivers should always communicate respectfully with individuals and use their information only for the purpose of providing adequate care and support.
Secure storage of information: All personal data should be stored securely and only be accessible to authorized individuals.
Obtain consent: Before information is shared with others, even within the care team, consent should be obtained from the individual.
Reporting of offenses: If anyone suspects that confidentiality has been breached, this should be reported to a superior.

All healthcare staff are bound by confidentiality. Confidentiality of course also applies to the life story, relationship to relatives and events at the home. Often, the employee has to sign that they are bound by confidentiality when they are hired. But what does it mean and how do you handle it in your unit.

Sometimes you hear healthcare staff tell revealing anecdotes about what has happened at their home. Even if they do not mention names, it is ethically tricky to make fun of aging. It's as bad as making fun of immigrants, women, people with functional variations, or homosexuals. If there is no room to talk and reflect about the difficult things at work, it can become difficult to accommodate everything that happens when the employee comes home. In the worst case, the individual may break confidentiality because the experiences overflow.

We mirror our view of humanity when we talk about others. Making fun of a sick person's behavior is a way to distance oneself from them. It also risks reducing trust in healthcare.

There are also relatives who spend a lot of time at the unit and become like one of the team. Then it can be easy to forget confidentiality. Relatives are not subject to the same confidentiality as employees and employees therefore must not disclose information about the other residents at the unit.

Reflection questions - confidentiality
Care staff:
- Do you have good structures in place to end the work shift and leave thoughts of work when you go home?
- Do your colleagues know what confidentiality means?
- Do you have conversations about how you talk about your work outside the workplace?

Manager, nurse, occupational therapist, and physiotherapist:
- Is there room to document and perhaps discuss what happened during the work shift before going home?
- Do you have an open culture with a high ceiling?
- Are there routines or traditions that contribute to maintaining unwanted distance to the residents?

Residents and relatives:
- Do you feel that the ceiling is high at the home?
- Is it possible to have a good dialogue with the staff where confidentiality is respected at the same time?
- How do you handle what you see and hear in connection with your visits to the unit?

Erland Olsson
Specialist nurse
Sofrosyne - Better care every day