The professional secret in the social professions: a brake on the well-being of the home attendants?

Abstract

While the French population is aging, there is a development of home care services,
which responds simultaneously to two reasons: the lack of space in the institution and the desire of the elderly to stay at home. Home attendants or life assistants have the mission of accompanying people who can not perform their daily activities on their own (home, food, shopping, hygiene ...) as well as avoiding isolation. These trades, recognized as physically fatiguing, are also psychologically complex. Not only do they intervene with vulnerable people, they also access the privacy of their accommodation and consequently of their lives. In addition, their work is done in a certain isolation of their peers that can become oppressive. This work wants to give an account -in the first moment- of the problems that these professionals
find, mostly of women, often little or not qualified, through interviews and life stories about their trade and the way in which this is vivid. In a second moment, we
try to elaborate instruments directed to the managers that fit these teams with a view to improving accompaniment in the exercise of their profession. To approach this reality of these professions we have used cross methodology, qualitative in a first time and quantitative in a second moment. The unstructured interviews, which were conducted with about thirty of these professionals, confirmed the complexity of the job, in particular, in connection with the feeling of isolation, the relationship to illness and grief, as well as professional difficulties such as the relationship to time and the scarce financial and social recognition of his trade. We have deepened some of the results obtained in the interviews by means of a questionnaire administered to 90 home attendants and that addressed, in particular the question, "the relationship to the other", both in terms of availability and quality of exchanges and of support. The proposition made in this communication determines in an accurate way an element that agrees with the psychosocial problem, the question of professional secrecy, addressed repeatedly in the two phases of research, qualitative and quantitative. It was envisaged as indispensable by professionals, for many of the people assisted, in particular, it also allows them to gain their trust, facilitating work. However, we highlight a perverse effect of this need for discretion, which can lead home attendants to "say nothing" of their often difficult daily work when they question "doing their job well", or by the stress caused by delicate relationships with the beneficiary of the assistance, while they have little relationship with their peers, after a reflection on the framework and the effects of the "professional secret" on the health and quality of life of the attendees , we question ourselves about the links between the necessary deontology of the professions of the social and the need of social support to face the aversive situations the daily professional. The first results indicate an effect that limits the "sacred" of professional secrecy on access to social support as an adjustment strategy, and possibly "blaming" when professionals have the feeling of "talking or saying" too much. It also results from the first analysis a strong interindividual variability in terms of understanding what is (or should be) the concept of professional secrecy, which comes to parasitize both professional practice, personal well-being and perhaps even the essence of the profession.