CONTENTS OF:
IF YOU ARE AFRAIDOur
Mission
Solutions
º You are not alone
º Legal remedies are
available
º You must be strong
The Good Stuff
Residents' Rights
º Your rights as a nursing home
resident
º Admission, Transfer, and
Discharge Rights
º Resident Behavior and
Facility Practices
º Quality of Care
º Quality of Life
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IF YOU ARE AFRAID
FEAR IS
NATURAL
Most of us who have
placed a loved one in a nursing home or who visit nursing homes have been afraid.
Many of the people who call TANHR are typically afraid of:
º Making the wrong decision about placement
º Poor or inadequate care of the resident
º Loss of love or approval of our loved one
º Staff who might retaliate in some manner if we confront them about something with
which we are dissatisfied
º Our loved one's death
Fear is a feeling It is important to recognize and accept
the feeling, or it will haunt us. It is ok to be afraid, but we can decide to act
and make positive decisions in the face of fear. The opposite of fear is love.
And love is a decision.
Guilt and Frustration Other feelings that loved ones and friends
of residents frequently have are guilt and frustration. We are sometimes unwilling
to face two realities: the declining abilities and health of our loved one or friend, and
our own inability to care for the loved one due to reasons such as finances, work or
family responsibilities, lack of resources, or emotional limitations. These are all
valid reasons for placement of a loved one in a nursing home. One result of denial
is guilt. In this case, the guilt is not helpful, because it can immobilize us - not
good for the residents who depends on us to act in their behalf.
We also frequently get frustrated and beat down by problems associated with the resident
or nursing home staff or facilities. This can lead to apathy. Frustration and
its partner apathy are the enemy. Do something, even if it is a
small gesture to make the resident's stay a bit more comfortable or light. Even a
smile and a hello help. It is not necessary to stay long. Brief visits are
often preferred and appreciated by residents.
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SOLUTIONS
Remember three things:
You are not alone
º TANHR is
available for support during difficult times or to help you get the
resources and responses you need. Call us at toll free at
(888)TANHR4U [(888)826-4748] or (972)572-6330. TANHR is working for residents by
accompanying them or their loved ones to nursing home offices, by calling agencies, and by
going to the legislature to try to improve laws regulating nursing homes.
º Reach out to other loved ones or friends for support and encouragement. If
you see regular visitors to other residents, they can be valuable allies and support.
º Look at the other pages on this Web site for additional help: About TANHR, Resources,
What You Can Do, News.
Legal remedies are available for your friend or loved one who is not
getting good care. TRUST YOUR GUT! You know intuitively when someone is being
harmed or neglected. Listen to your feelings. If something happens that really
scares you, ACT! If you have attempted to deal with a situation with staff and
administration of the nursing home and have not gotten results, TANHR has a list of
attorneys who handle these kinds of cases. Feel free to call us even if you are not
sure if there is a legal case or enough evidence, etc. The attorneys can determine
these things.
You must be strong! Residents very often cannot stand up for themselves and they
depend on you to use your eyes and ears in the nursing home. If you
see any resident receiving abuse you should call 911. In
case of inadequate care, first notify the nursing home authorities, and if nothing is
done, call TANHR - (972)572-6330 or toll free at (888)TANHR4U [(888) 826-4748].
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THE GOOD STUFF
One way to deal with fear and
frustration is to do something positive. The opposite of fear is love.
º If you see staff who are doing an excellent job, please let the
administration know. There are many nursing home staff who truly are overworked and
underpaid, but they still care. They need support and encouragement.
º If you know of a lonely resident besides your loved one, stop by and say hello.
º Volunteer or get involved with TANHR. Start a Family Council
at the nursing home where your loved one or friend resides. The State
of Texas requires nursing home facilities to provide space for and listen to
residents and their families and to act on their recommendations.
Family Councils are the perfect forum. Call us toll free (888)TANHR4U
[(888)826-4748] or (972)572-6330 for help in organizing a Family
Council. See our Web page: What you can do
for the regulations and TANHR guidelines for organizing a TANHR unit.
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RESIDENTS' RIGHTS
Under the federal law titled Omnibus
Budget Reconciliation Act of 1987 (OBRA ‘87) you, as a nursing home resident, can
exercise your rights as a citizen or resident of the United States without fear of
discrimination, restraint, interference, coercion, or reprisal.
Your Rights as a Nursing Home Resident
- To be informed of your rights and
all rules and regulations governing resident conduct and responsibilities, both orally and
in writing.
- To inspect and purchase photocopies of your records.
- To be fully informed of your total health status.
- To be informed of facility services and charges.
- To be informed of your physician, and ways of contacting him or her.
- To be consulted and your physician and interested family member notified of any
significant change in your condition or treatment.
- To refuse room changes requested by
the facility.
- To be notified, along with an interested family member, of changes in your rights
as a resident.
- To manage your own financial affairs and not deposit personal funds with the
facility.
- To have any funds you choose to deposit handled with your best interests in mind
and not commingled with facility funds.
- To choose your own personal physician and to be informed of and participate in
your care and treatment.
- To keep private your personal and clinical records.
- To include as privacy rights: 1.
personal care, 2. medical treatments, 3. telephone use, 4. visits, 5. letters, 6. meetings
of family and resident groups.
- To approve or refuse the release of your records except in the event of a transfer
or legal situation.
- To voice grievances concerning your care without fear of discrimination or
reprisal.
- To expect prompt efforts for grievance resolution.
- To examine survey results and the plan of correction.
- To contact client advocate agencies.
- To receive or deny visitors.
- To visit with any relevant agency of the state or any entity providing health,
social, legal, or other services.
- To be treated with dignity and respect in full recognition of your individuality.
- To choose your own activities, schedules and care.
- To organize or participate in groups of choice.
- To have families visit with other families.
- To have group meeting space provided by the facility.
- To invite or deny staff or visitors’ attendance.
- To have a staff person assist and follow up with the group’s requests.
- To have requests and concerns of the group listened to and acted upon by the
facility.
- To be provided activities that meet your needs and interests.
- To be provided social services that will maintain your highest level of
well-being.
- To be provided a safe, clean, comfortable
environment.
- To be provided (1) housekeeping and maintenance services, (2) clean bath and bed
linens in good repair, (3) private closet space as space permits, (4) adequate and
comfortable lighting, sound and temperature levels.
Admission, Transfer, and Discharge Rights
You may be discharged only if your needs
cannot be met, safety is endangered, services are no longer required, or payment has not
been made. Notice of and reason(s) for transfer or discharge must be provided to you in an
understandable manner. Notice of transfer or discharge must be given 30 days prior, except
in cases of health and safety needs. The transfer or discharge notice must include the
name, address and telephone number of the appropriate, responsible protective agency.
Individuals who receive a discharge notice from a facility have 10 days to appeal. You and
a family member must receive written notice of state and facility bed-hold policies before
and at the time of a transfer. The facility must follow a written policy for readmittance
if the bed-hold period is exceeded. The facility must not require a third party guarantee
of payment or accept any gifts as a condition of admission or continued stay. The facility
cannot require you to waive your right to receive or apply for Medicare or Medicaid
benefits.
Resident Behavior and Facility Practices
The facility may not use physical
restraints or psychoactive drugs for discipline or convenience, or when they are not
required to treat medical symptoms. You have the right to be free from verbal, sexual,
physical or mental abuse, neglect or mistreatment, and misappropriation of your property.
In the event of an alleged violation involving your treatment, the facility is required to
report it to the appropriate officials. All alleged violations must be thoroughly
investigated and the results reported.
Quality
Of Care
Each resident must receive necessary care
and services in the following areas:
- Activities of daily living:
cleanliness and grooming, eating and communicating
- Vision and hearing: the facility must, if necessary, provide access to
examinations and treatment
- Prevention and, if necessary,
treatment of pressure sores
- Treatment and services, if necessary, for incontinence and urinary tract
infections
- Prevention of reduction in range of motion
- Mental and psychosocial functioning
- Use of a naso-gastric tube only if unavoidable
- Freedom from accident hazards
- Good nutrition, and a therapeutic diet when
necessary
- Sufficient fluid to maintain proper hydration and health
- Proper treatment and care for special needs such as injections, certain fluids,
-ostomy care, tracheal auctioning, respiratory care, foot care and prostheses
- Resident’s drug regimen must be free of unnecessary drugs, with emphasis on
special care and documentation of antipsychotic drugs
- The facility must be free of medication error rates of 5% or greater; residents
must be free of significant medication errors.
§ 19-901 Quality
of Care. Each resident must receive and the facility must provide the necessary
care and services to attain or maintain the highest practicable physical, mental, and
psychosocial well-being, as defined by and in accordance with the comprehensive assessment
and plan of care. If children are admitted to the facility, care and services must be
provided to meet their unique medical and developmental needs.
Source - Texas Department of Human
Services, NFR/LMC 95-0
Quality
Of Life
A facility must care for its residents in
a manner that promotes maintenance or enhancement of each resident’s quality of life.
Each resident has the right to be treated with
dignity, to choose activities, schedules, and health care consistent with his or her
interests, and to participate in resident council and other group meetings. They must also
receive notice before their room or roommate in the facility is changed.
A resident assessment must be done within 14 days
after the admission of the resident. The assessment will determine the physical and mental
conditions, impairments, functional status, dislikes, and interests of the resident, and
will identify needs for a care plan. Residents are monitored and a new assessment and care
plan must be made if there is a change in their physical or mental condition.
- The facility must examine each resident
and review the data at least once every three months, and more often as appropriate.
- The results of the assessment are to be used to develop, review and revise the
resident’s comprehensive plan of care as necessary.
- The comprehensive care plan must be developed within seven days after completion
of the comprehensive assessment by the physician and the registered nurse that is
responsible for the resident’s care. The resident’s family or legal
representative has a right to participate in reviewing and revising the comprehensive care
plan.
The facility must
provide for an ongoing program of activities designed to conform with the comprehensive
assessment. The assessment must meet the interests and the physical, mental and
psychosocial well-being of each resident.
A facility with more than 120 beds must employ a
qualified social worker on a full-time basis; a facility with less than 120 beds must have
a contract with a certified social worker to provide social services to meet the needs of
the residents as necessary.
The facility must provide a safe, clean,
comfortable and homelike environment for each resident.
Excerpts from Texas Department of
Human Services (NFR/LMC, Sec §19.701, 95-0)
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