Resident s Rights and Dignity INSERVICE TRAINING GUIDE

1. Resident�s Rights and DignityINSERVICE TRAINING GUIDE The Omnibus Budget Reconciliation Act (OBRA) of 1987 gave each long-term care resident specific rights. It is our duty as long term care providers to be familiar with these rights so that we can ensure each resident is treated with respect and dignity. The Omnibus Budget Reconciliation Act (OBRA) of 1987 gave each long-term care resident specific rights. It is our duty as long term care providers to be familiar with these rights so that we can ensure each resident is treated with respect and dignity.

2. Our residents have more than the right to remain silent. They are citizens with all the same rights as you and I, but in addition they are protected by the resident�s bill of rights created by OBRA. The resident�s bill of rights are an ethical code of conduct for healthcare workers. They relate to how a resident must be treated while living in a long term care facility. Our residents have more than the right to remain silent. They are citizens with all the same rights as you and I, but in addition they are protected by the resident�s bill of rights created by OBRA. The resident�s bill of rights are an ethical code of conduct for healthcare workers. They relate to how a resident must be treated while living in a long term care facility.

3. OVERVIEW OF RESIDENT�S RIGHTS Quality of life Providing services and activities Dignity, choice and independence are paramount to quality of life. Our residents deserve consistent care that keeps them as healthy as possible. A resident�s health should not decline as a result of the quality of life, services and activities provided by the facility. Dignity, choice and independence are paramount to quality of life. Our residents deserve consistent care that keeps them as healthy as possible. A resident�s health should not decline as a result of the quality of life, services and activities provided by the facility.

4. Specific Resident�s Rights Right to be fully informed about rights and services Right to complain Right to visits Right to make independent choices Right to security of possessions Right to privacy and confidentiality Right to dignity, respect, and freedom Rights during transfers and discharges Residents have the right to know all charges and all available services, to have a copy of all rules and regulations in a language they can understand, a right to the address/telephone number of the state Ombudsman, the right to see state survey reports, the right to be notified in advance of room and roommate changes, the right to daily communication in their language and a right to assistance with sensory impairment The resident has a right to present grievances to the staff of the facility without fear of reprisal and the right to have the facility act promptly to resolve those grievance. The right to immediate access by a resident�s personal physician and representatives from the health dept and ombudsman programs and the right to immediate access by their relatives and others subject to reasonable restriction with the resident�s permission. Residents have the right to decide how to wear their hair, what clothes to wear and how to spend their free time. The right to reasonable accommodation of their needs and preferences, to choose their own physician and to make choices about their care and treatments The right to participate in community activities both inside and outside the facility and the right to organize and participate in residents� council The right to private and unrestricted communication with any person of their choice, to privacy in treatment and in the care of their personal needs, and to confidentiality regarding their medical, personal or financial affairs. The right to be treated with the fullest measure of consideration respect and dignity. The right to be free from abuse of any kind, including mental and physical, corporal punishment, involuntary seclusion , and physical and chemical restraints, and the right to self determination. Residents have the right to have their personal possessions remain safe at all times and not to have them taken or used by anyone without permission. The right to manage their own financial affairs. The right to file a complaint with the state survey and certification agency for abuse, neglect or misappropriation of their property if the facility is handling their financial affairs. The right to be free from charge for service covered by Medicaid or Medicare During transfer and discharge residents have a right to remain in the facility unless a transfer or discharge is needed to meet the resident�s welfare, is appropriate because the resident�s health has improved and the resident no longer requires nursing home care, is needed to protect the health and safety of other residents or staff or is required because the resident has failed, after reasonable notice, to pay the facility a charge for an item or service provided at the resident�s request. The right to receive at least a 30 day notice of transfer or discharge. The notice must include the reason for transfer/discharge, the effective date, the location to which the resident is transferred or discharged, a statement of the right to appeal, and the name, address, and telephone number of the state long-term care ombudsman. The resident has the right to a safe transfer or discharge through sufficient preparation by the facility. Residents have the right to know all charges and all available services, to have a copy of all rules and regulations in a language they can understand, a right to the address/telephone number of the state Ombudsman, the right to see state survey reports, the right to be notified in advance of room and roommate changes, the right to daily communication in their language and a right to assistance with sensory impairment The resident has a right to present grievances to the staff of the facility without fear of reprisal and the right to have the facility act promptly to resolve those grievance. The right to immediate access by a resident�s personal physician and representatives from the health dept and ombudsman programs and the right to immediate access by their relatives and others subject to reasonable restriction with the resident�s permission. Residents have the right to decide how to wear their hair, what clothes to wear and how to spend their free time. The right to reasonable accommodation of their needs and preferences, to choose their own physician and to make choices about their care and treatments The right to participate in community activities both inside and outside the facility and the right to organize and participate in residents� council The right to private and unrestricted communication with any person of their choice, to privacy in treatment and in the care of their personal needs, and to confidentiality regarding their medical, personal or financial affairs. The right to be treated with the fullest measure of consideration respect and dignity. The right to be free from abuse of any kind, including mental and physical, corporal punishment, involuntary seclusion , and physical and chemical restraints, and the right to self determination. Residents have the right to have their personal possessions remain safe at all times and not to have them taken or used by anyone without permission. The right to manage their own financial affairs. The right to file a complaint with the state survey and certification agency for abuse, neglect or misappropriation of their property if the facility is handling their financial affairs. The right to be free from charge for service covered by Medicaid or Medicare During transfer and discharge residents have a right to remain in the facility unless a transfer or discharge is needed to meet the resident�s welfare, is appropriate because the resident�s health has improved and the resident no longer requires nursing home care, is needed to protect the health and safety of other residents or staff or is required because the resident has failed, after reasonable notice, to pay the facility a charge for an item or service provided at the resident�s request. The right to receive at least a 30 day notice of transfer or discharge. The notice must include the reason for transfer/discharge, the effective date, the location to which the resident is transferred or discharged, a statement of the right to appeal, and the name, address, and telephone number of the state long-term care ombudsman. The resident has the right to a safe transfer or discharge through sufficient preparation by the facility.

5. SPECIFIC RESIDENT�S RIGHTS Right to participate in their own care Residents have a right to receive quality care, to be informed of changes in medical condition, to participate in planning their treatment, care and discharge, to refuse any medication and treatment, to refuse chemical and physical restraints, and to review their medical record. Residents have a right to receive quality care, to be informed of changes in medical condition, to participate in planning their treatment, care and discharge, to refuse any medication and treatment, to refuse chemical and physical restraints, and to review their medical record.

6. Promote Resident�s Rights Choose to give the best care everyday! We promote or violate our resident�s rights during our daily interactions with each resident. Sometimes the smallest actions that we are hardly mindful of, greatly affect a resident�s perception of the care they are receiving. We promote or violate our resident�s rights during our daily interactions with each resident. Sometimes the smallest actions that we are hardly mindful of, greatly affect a resident�s perception of the care they are receiving.

7. Support Resident�s Rights Never abuse or neglect a resident! Report signs of abuse! Involve residents in your planning Follow infection control procedures Follow all safety measures Provide privacy Be sure the resident can call for help Communicate with the resident about the care you are providing Simply swatting a resident on the bottom, Leaving a resident isolated in a room, giving a resident treatment in the hallway, insisting a resident take medication the doctor prescribed despite the resident�s protests, not replacing missing dentures that are lost after admission are all examples of violating resident�s rights. To support resident�s rights we should respect our residents� right to independent choice. Ask each person what name they prefer to use. For example the name on her chart my read Maryann but she has been called Marti since high school. Also some elderly consider it disrespectful for younger people to address them by their first name. An example introduction would be �Hello, my name is Mary Ann, please call me Ann. What would you like me to call you?� Ask your residents when they would prefer to eat or bath. Examples of safety measures would be to use gait belts during transfers and locking the wheels of a bed or a chair before transfers. Simply swatting a resident on the bottom, Leaving a resident isolated in a room, giving a resident treatment in the hallway, insisting a resident take medication the doctor prescribed despite the resident�s protests, not replacing missing dentures that are lost after admission are all examples of violating resident�s rights. To support resident�s rights we should respect our residents� right to independent choice. Ask each person what name they prefer to use. For example the name on her chart my read Maryann but she has been called Marti since high school. Also some elderly consider it disrespectful for younger people to address them by their first name. An example introduction would be �Hello, my name is Mary Ann, please call me Ann. What would you like me to call you?� Ask your residents when they would prefer to eat or bath. Examples of safety measures would be to use gait belts during transfers and locking the wheels of a bed or a chair before transfers.

8. It�s the LAW! Remember OBRA 1987 is federal law. The purpose of residents� rights is to safeguard and promote dignity, choice and self determination of long term care facilities and to protect civil, personal and privacy rights of residents. last sentence directly from Arkansas Advocates for Nursing Home residents website article titled Resident�s Rights by Alice Ahart) Remember OBRA 1987 is federal law. The purpose of residents� rights is to safeguard and promote dignity, choice and self determination of long term care facilities and to protect civil, personal and privacy rights of residents. last sentence directly from Arkansas Advocates for Nursing Home residents website article titled Resident�s Rights by Alice Ahart)

9. Ombudsman An official, usually appointed by the government, who is charged with representing the interest of the public by investigating and addressing complaints reported by individual citizens. Wikipedia.org The Arkansas Ombudsman program website describes an ombudsman as someone who intercedes with governments and institutions on behalf of ordinary citizens. The ombudsman can be a valuable tool to ensure resident�s rights are honored. Each resident should have contact information for the ombudsman and it should be clearly posted in the facility. The Arkansas Ombudsman program website describes an ombudsman as someone who intercedes with governments and institutions on behalf of ordinary citizens. The ombudsman can be a valuable tool to ensure resident�s rights are honored. Each resident should have contact information for the ombudsman and it should be clearly posted in the facility.

10. Dignity The quality or state of being worthy of respect, esteem, nobility, and honor

11. Ways to Promote Dignity and Respect Call people by the name they prefer Always acknowledge a person The tone of your voice is important Choose your words carefully It�s not always what you say, but how you say it One of the complaints people frequently voice is someone didn�t even speak to me. Just smiling, nodding your head or saying hello when you pass in the hall can help someone feel important. Use the same tone of voice with your resident as you use when talking to other adults, there is no need to talk to residents as if they are children. Do not sound rushed or rough. Even people who cant understand words anymore can feel the emotion behind your tone. Never curse or swear around residents, of course. But consider the least offensive words when asking about bowel functions or voiding also, these are very private matters and people may be embarrassed to discuss them. One of the complaints people frequently voice is someone didn�t even speak to me. Just smiling, nodding your head or saying hello when you pass in the hall can help someone feel important. Use the same tone of voice with your resident as you use when talking to other adults, there is no need to talk to residents as if they are children. Do not sound rushed or rough. Even people who cant understand words anymore can feel the emotion behind your tone. Never curse or swear around residents, of course. But consider the least offensive words when asking about bowel functions or voiding also, these are very private matters and people may be embarrassed to discuss them.

12. Assisting with Personal Care Assure physical privacy for all people, even those who do not seem to know the difference Make sure each person is properly draped and pull privacy curtains and close doors Knock, announce yourself and wait for a response

13. Use Your Good Manners Respect private conversations and telephone calls. Leave the room when the resident has a call Do not talk �over� people, or ignore their presence Do not interrupt people while in the bathroom

14. Use Your Good Manners Respect private time and personal property Do not interrupt them if they are dressing themselves Allow residents to choose their own clothes and be patient if it takes awhile

15. How do Your Residents Feel? Worthless or a nuisance Neglected or ignored Like they are an object and not a person Disrespected Like part of a family Supported and cared about Like a valuable person Respected Examples of interactions that could lead to the feelings in column A are: not responding to residents� requests, talking to coworkers while caring for a resident, not providing privacy during peri care, being rushed and not listening, giving residents bibs like babies instead of offering napkins, calling people sweetie or honey instead of the name they prefer. You have the power to inspire the feeling in column B by talking to your resident during care, asking them how they want their hair, what clothes they�d like to wear and listening. BE Patient! Honor your resident�s preferences if your patient has farmed for 65 years and had his coffee at 4am, help him to continue that. If your resident has always bathed at night before bed, help her continue that. Examples of interactions that could lead to the feelings in column A are: not responding to residents� requests, talking to coworkers while caring for a resident, not providing privacy during peri care, being rushed and not listening, giving residents bibs like babies instead of offering napkins, calling people sweetie or honey instead of the name they prefer. You have the power to inspire the feeling in column B by talking to your resident during care, asking them how they want their hair, what clothes they�d like to wear and listening. BE Patient! Honor your resident�s preferences if your patient has farmed for 65 years and had his coffee at 4am, help him to continue that. If your resident has always bathed at night before bed, help her continue that.

16. Questions? Questions? QUESTIONS?

17. Arkansas Innovative Performance Program401 West Capitol AvenueSuite 400Little Rock, AR 722011-877-375-5700www.afmc.org/aippemail: aipp@afmc.org