How High-Performing Personal Support Workers Set and Maintain Boundaries When Providing Care: A Case Study in Ontario, Canada.

Personal support workers (PSWs) provide a large proportion of in-home care services for Canadians. PSWs must negotiate with clients and their family on how prescribed care is delivered. How PSWs set and maintain professional and personal boundaries during care is poorly understood, and failure to manage boundaries can expose both PSWs and clients to risk. High-performing PSWs ( = 9) and supervisors ( = 4) within an Ontario, Canada, home care agency were engaged in workshops ( = 3) to identify field-tested strategies and tactics for identifying, managing, and supporting PSW boundaries. A boundary-management framework was generated, including types of boundary challenges; decision-making principles (e.g., consider the purpose of home care); response strategies (e.g., work with the client on an alternative solution); and tactics for action (e.g., use proactive reminders). Supervisory and organizational supports (e.g., enabling "shop-talk") were identified. The framework can inform teaching and practice materials for PSWs in Canada and other countries.