Knowing Residents' Rights

• Dignity and Respect
• Restraint
• Managing Money
• Privacy, Property and Living Arrangements
• Guardianship and Advance Directives
• Visitors
• Medical Care
• Social Services
• Moving Out
• Discharge and Transfer
• Rights for Families and Friends

New nursing home residents will almost always go through a difficult adjustment period, even if the nursing home is providing good care. The adjustment can be made easier with the support of family and friends. After the resident has settled in and has begun to adjust to the nursing home routine, they may be interested in knowing about resident rights and some special protections under the law. By law, the nursing home must provide a written copy of these rights upon admission.

Dignity and Respect

Nursing home residents have the right to be treated with dignity and respect. And as long as it fits their Plan of Care, they have the right to make their own schedule, including when they go to bed, rise in the morning, and eat their meals. They also have the right to select the activities they would like to attend. They also may have the right to leave the facility with relatives or friends after notifying the staff.

Restraint

It is against the law for a nursing home to use physical and chemical restraints, except when necessary to treat medical or psychiatric symptoms, and prescribed by a physician. Restraints may not be used for discipline or for the convenience of the nursing home staff.

Restrained residents may have decreased functional ability, lower self-esteem, and feel depressed or angry. Restraints do not necessarily provide security or safety. Residents also are likely to be seriously injured if they fall with a restraint on. A physician must provide medical orders for any use of restraints and give the reason why they are needed except in certain emergency circumstances.

Managing Money

Residents have the right to manage their own money or to pick someone they trust to do so. If a resident requests the nursing home to manage their personal funds, the resident must sign a written statement that authorizes the nursing home to do this. However, the nursing home must allow the resident access to their bank accounts, cash, and other financial records. The nursing home must protect their funds from any loss by purchasing a bond or providing other similar assurances.

Privacy, Property, and Living Arrangements

Residents have the right to privacy. In addition, they have the right to keep and use their personal property, as long as it does not interfere with the rights, health, or safety of others. Their mail should never be opened by the home unless the home is given permission by the resident. The nursing home must have a system in place to keep residents safe from neglect and abuse, and to protect their property from theft. See if there is a safe in the facility or cupboards with locked doors in resident rooms. If a husband and wife live in the same home, they are entitled to share a room (if they both agree to do so).

Guardianship and Advance Directives

Nursing home residents are responsible for making their own decisions (unless they are mentally unable or have made legal arrangements for help). They may also draw up a document called an Advance Directive or "living will", which is required in some states. It is a legal document that says what type of medical treatment they want or don 't want in case they cannot speak for themselves.

They may designate someone else to make health care decisions for them. This is called a Durable Power of Attorney for health care. The person named will become the legal guardian if the resident should ever become incapable of making decisions. Depending upon State laws, a lawyer may be needed to draw up a Durable Power of Attorney order or a living will. Although the nursing home should be able to help with this, other help is also available. Check with the State Health Insurance Assistance Program (SHIP) or with the local Office on Aging to find out if your State has any legal assistance services that help with preparing these documents. The phone number for the local Office on Aging can be found in the government pages of the phone directory.

Visitors

Residents have the right to spend private time with visitors at any reasonable hour and have the right to make and receive telephone calls in privacy. The nursing home must permit family to visit residents at any time, as long as their presence is wanted. Residents do not have to see any visitor they do not wish to see. Any person who provides health or legal services may see residents at any reasonable time.

Medical Care

Residents have the right to be informed about their medical condition, medications, and to participate in developing their Plan of Care. They have the right to examine their medical records and reports upon request. They have the right to refuse medications or treatments, and to see their own doctor.

Social Services

The nursing home must provide each resident with any needed social services, including counseling, mediation of disputes with other residents, assistance in contacting legal and financial professionals, and discharge planning.

Moving Out

Living in a nursing home is voluntary. Residents are free to move to another place. However, nursing home admission policies usually require that residents give proper notice that they are leaving. If they do not give proper notice, they may owe the nursing home money based on the home's proper notice rules. When going to another nursing home, make sure the home has a bed.

Discharge and Transfer

Whether leaving a room or the nursing home, change can be very traumatic for residents. Nursing homes cannot discharge residents unless:

• It is necessary for the welfare, health, or safety of the individual or other residents;
• Their health has declined to the point that the nursing home cannot meet their care needs;
• Their health has improved to the point that nursing home care is no longer necessary;
• The nursing home has not been paid for services received; or
• The nursing home closed.

Rights for Families and Friends Relatives and friends have rights too. Family members and legal guardians have the right to privacy when visiting the nursing home when the resident asks. They also have the right to meet with the families of other residents and to join or address family councils.

By law, nursing homes must develop a Plan of Care for every resident. Family members are allowed to participate in the development of the care plan with the resident's permission. Relatives who have legal guardianship of nursing home residents have the right to examine all medical records concerning their loved one and the right to make important decisions on his or her behalf.

Family and friends can make sure the resident receives good care. They should visit as often as possible, know the nursing home's staff and procedures, express concerns to the right staff member, and participate in the nursing home's family council if there is one. If there isn't a family council, consider starting one.

If you have problems or concerns about the care provided by the facility, there are people in the nursing home who may be able to help, such as the Director of Nursing or the facility's administrator. If the home does not address your concerns or complaints to your satisfaction, call the State's inspection agency or the Long-Term Care Ombudsman. The telephone numbers for these agencies should be posted in the facility in a prominent place.