What’s the best way to establish a trusting relationship with a caregiver? - Marguerite David, MSW

Very few people that have spinal cord injury were managers before they broke their neck and needed an in-home attendant. So part of the role of a social worker—if you’re inpatient, and you’re shifting and you know you’re going home with a paid attendant—is to make sure that you go to an attendant management class, you have access to these books, you can even do role playing about how to interview. But once you get the person in your home, you have to be the boss. You establish the rules, you established the hours, you establish the tasks to be done. The other critical thing to do is a performance reviews. Just like we do in our regular jobs in the world, we have to have a performance review. We should do them on a regular basis; make sure that they’re doing the tasks they’re supposed to be doing. And I used to always say the most critical thing in managing an attendant is, “Never ever give them the PIN number to your ATM,” because maybe they have physical difficulty with their hands and can’t get their hands to the ATM. But if you’ve done good preparation, you’ve done the best you can to be the employer. Always be on top of everything they’re doing and don’t ever start becoming such good friends that you develop a sexual relationship, and then it’s all muddied from there, it gets all more confusing. So I think there’s a way to maintain a level of friendship without being best-buddy friends and intimate friends.