For elderly patients and their families, the role of home health aides is a special one.

As part of the job, the aide often assists the patient with the most intimate functions of their day. Depending on the level of support, they may spend the better part of their days with the patient’s family, and they’re frequently on hand for events inside and outside the household over the course of many years.

What if a health aide wants to take pictures or share stories outside the family — especially on social media?

It’s natural — and perhaps even desirable — that the line between employee and member of the household may be blurred.

But what if the health aide wants to take pictures or share stories outside the family — especially in the era of social media?

The emotional line between employee and family friend may become fuzzy, experts told Considerable, but the legal requirements for these medical professionals are clear.

The line in the sand: HIPAA (the Health Insurance Portability and Accountability Act of 1996), which closely controls the privacy of patients’ information.

HIPAA isn’t just for hospitals; without explicit permission from patients or their guardians, any sort of medical care is a private matter, whether the practitioner is working in an operating room or at a birthday party.

But that ambiguity can sometimes affect the judgment even of aides who are certified to offer this type of medical care. “It does happen in the industry,” said Julian Hagmann, vice president of Caring Professionals Inc., a licensed service home-care agency and fiscal intermediary based in Forest Hills, New York. “We have some clients who have the same home health aides for the past eight years and regard them as part of the family.”

HIPAA means that just like any other medical professional, health aides must get formal authorization from the family before sharing pictures or naming names.

Susan Scatchell, business development director with Gentle Home Services of Deerfield, Illinois, told Considerable, “If pictures are to be taken for an event or celebration, a release authorization should be signed only by a competent individual. And a release should be signed by the caregiver as well if you are taking their photograph.

However, Hagmann said, “We’re held by different standards contained in the HIPAA guidelines. It doesn’t matter if the client expressed permission or not.” Indeed, patient privacy is a key part of Caring Professionals’ in-service training for its aides, and violations can result in termination of the aide involved.

“The authorization should state who is requesting the photo and for what purpose. Unauthorized pictures or video-taking is a violation of human dignity and respect. Employees should be educated on how to handle personal health information.

“Inappropriate behavior should warrant termination,” Scatchell said. “Unfortunately, these charges are a misdemeanor, and the workers continue to get employed in the healthcare industry.”

And as for sharing those snapshots on Instagram? “HIPAA Privacy laws prohibits the use of protected health information from being posted on social media networks,” said David Reischer, a New York attorney and CEO of “Even though HIPAA was enacted several years before social media networks were launched, there are HIPAA laws and standards that apply to social media use by healthcare organizations and their employees.”

Reischer continued, “HIPAA violations on social media may result in disciplinary action against the employees concerned, termination of employment for violations of patient privacy, and in some cases, civil charges of elder care abuse or even possibly criminal charges.”

Of course, it’s hard to regulate all aspects of relationships as close as these. “In past experience, I know that families have brought home health aides out for a birthday dinner,” Caring Professionals’ Hagmann said. “What are the chances that the home health aide is taking photos?”