Resolving Concerns through the Long-Term Care Ombudsman Program
The Long-term Care Ombudsman Program focuses on educating the community on issues effecting LTC residents. In January 2019, Eric Carlson through Justice in Aging, released the guide 25 Common Nursing Home Problems & How to Resolve Them. This guide compares common misinterpretations or practices with the clear statement of the relevant law. Each month, Region P Long-Term Care Ombudsman Program will review a problem discussed in the guide. This month, we will look at the issue regarding Resident Preferences.
Problem #3: Disregarding Resident Preferences
WHAT YOU HEAR: THE FACTS:
“WE DON’T HAVE A NURSING HOME MUST MAKE
ENOUGH STAFF TO ACCOMMODATE REASONALBE ADJUSTMENTS TO
INDIVIDUAL SCHEDULES. HONOR A RESIDENT’S NEEDS AND
YOU MUST WAKE UP AT 6 A.M. PREFERENCES
EVERY MORNING.”
“OUR GROUP ACTIVIY IS ALWAYS BINGO.”
“IF YOU DON’T LIKE THE DINNER ENTRÉE,
YOU ONLY OPTION IS A PEANUT BUTTER SANDWICH.”
The ability to make choices is vital to a resident’s quality of life. A nursing home should feel like a home rather than a health care assembly line.
A nursing home must make reasonable adjustments to meet residents needs and preferences. For example, a resident has the right to choose activities, schedules (including sleeping and waking times), health care, and providers of health care services consistent with his or her interests, assessments, and plan of care.
The million dollar question is “What is reasonable?,” but this question has no scientific answer. Because the definition of “reasonable” is not precise, residents and family members must be prepared to explain why benefit is worth whatever inconvenience or expense may be involved.
In requesting a change, the resident or resident representative should explain why the change would be good for the resident, and why the law requires such a change. A follow-up letter is helpful, as is a copy the 25 Common Nursing Home Problems & How to Resolve Them guide. Oftentimes, the request for a change can be made in a care planning meeting. The resident or representative may wish to file a grievance if the request is not honored.
A resident council or family council can be a good place in which to organize support for a change in a nursing home’s procedures, and specifically for more person-centered care. Strength is in numbers: if an entire group of residents and family members pushes for a particular change, the nursing home is much more likely to see the light.