Karen McPhail, RN, MSN
Residents Rights in Care Communities - Know Your Rights
Today I am going step up onto my soap box for a bit as this week has prompted this response! Many of you know I write about what I see, experience, or have been asked about over the course of my week. This week was a very busy week in terms of advocacy across many areas!
Everyone who works in long term care is very familiar with Residents Rights, but in my travels and work I find that these rights are not consistently being respected by many care communities. Communities speak of resident focused care and programs when marketing, but in practice many programs are structured on the terms of the care community and not based on the expressed resident preferences and needs. This is especially seen when it comes to dining, activities, and the choice of service providers!
Among other issues, over the past week I have seen exclusion that is tolerated, ignored or overlooked, resident loneliness where staff are too busy to notice or care to intervene and correct, and sleepy individuals who would have loved to be able to rest more, but have to be at breakfast promptly and during the set time period as mandated.
People come to a care community for "care", not to be mandated to jump through hoops! They are there for a reason, because they require assistance and have often times have experienced loss and have lost control over so many aspects of their life as a result. They need to have some control over their lives and daily functioning, but yet are mandated to come at specific and often unreasonable times for especially dining. In one of the newer care communities dining is set from 7:30 am to 9 am. When I recently expressed concern for one of my clients who prefers to eat breakfast in her apartment, has always slept in, and now truly needs to for health reasons they simply stated in an email back that she needs to come to the dining room as scheduled; the dining director then went on the state- "I prefer that ------- comes to breakfast". They prefer? What about what the resident prefers???? This type of situation in dining and other areas is becoming way too common and must stop. The lack of service focus and compassion is troubling from my standpoint. Where is the problem solving, win- win approach that should be there. Just because we have a large aging population does not mean that it is acceptable to provide substandard, cookie cutter approaches and services! This is also present outside of dining in the choice of care provides and services. Most care communities have contracts with specific clinical groups and skilled providers. Many of the groups provide exceptional service, but residents should always be given choices and not mandated to use one specific provider. I overhead a resident being pressured the other day to use a therapist who did not work well with her in the past and another being pressured to use a new physician who was recently contracted by the care community versus her long term physician who she loved and who knew her care needs and preferences. Residents should not be mandated or pressured to use a service provider and should always have input and be presented with choices!
When searching for a care community know your rights, their responsibilities, and ask questions about how services are resident focused and customized based on care preferences, routines, and expressed needs. Ask for examples of how this is put into practice. Are there set hours for dining or do they accommodate all day dining? How are residents welcomed into the community and supported in forming relationships? Is the care community inclusive and how is this shown, or put into practice? Does the care community have a contract with an outside vendor for services? How is the resident provided with choices in terms of care providers? Take your time when selecting a care community and never feel pressured! Search and see our previous blogs on selecting a care community for a more comprehensive list of questions to consider asking along the way. Exploring these areas is very important as they directly impact quality and overall long term happiness for the resident!
Even with these issues there are some wonderful care communities out there- make sure that you take your time when selecting to ensure that you find the right fit! Seek out guidance through a care manager or other expert. Ensure that their opinion is unbiased and never simply based on compensation from the care community. Eldementals never accepts compensation from a care community or provider so our opinion remains unbiased!
Know your rights! See the link below the VA Residents Rights and also some noted areas below based on todays blog!
The Virginia Resident Rights for Assisted Living:
#8. Is free to select health care services from reasonably available resource
#10 is free from forced isolation, threats or other degrading or demeaning acts against him; and his known needs are not neglected or ignored by personnel of the facility
#12. Is free to voice grievances and recommend changes in policies and services, free of coercion, discrimination, threats or reprisal
#18 Is permitted to meet with and participate in activities of social, religious, and community groups at his discretion unless medically contraindicated as documented by his physician, physician assistant, or nurse practitioner in his medical record.
If you or your loved one is in a care community where they are not supporting and valuing input, reach out to us today as we will advocate and ensure that things are put back on track and that all involved are understanding and providing a supportive, individualized, and service focused care environment!
Care should be on the terms of the individual, we can ensure that your rights are respected and those caring for you understand their responsibilities in providing care.