Have you ever thought about the rights of nursing home residents, and how they apply to you or your loved ones?
Many of our elders have a fear of being shipped off to a nursing home and forgotten. Dying alone is a prospect that no one wants to face. Most families, if not affectionate or devoted, are at least dutiful enough to visit relatives in nursing homes regularly, giving their seniors at least the feeling of being cared for during their twilight years. And, in most cases, family members of the younger generations will make it a point to find out how their elder is being treated, and right any wrongs in that department, whether they have to meet with higher-ups on the nursing home staff or enact litigation to bring justice to their beloved grandfather or grandmother.
Everybody knows what “feels right” in terms of living conditions and other factors in the life of a nursing home resident. In terms of residents’ complaints about nursing homes, rights violations are some of the most disturbing.
But what exactly are nursing home residents’ federally protected rights? What rules are explicitly laid out to make sure no one falls through the cracks and to guarantee civil and personal privileges for all? In other words, what is Uncle Sam doing to protect our relatives who live in these care facilities?
Government Statutes On Rights of Nursing Home Residents
Please note that institutions that do not receive Medicare or Medicaid funding are exempt, in part, from federal policing of resident rights. But for those that do, there are two main sets of laws put in place to look out for the treatment of nursing home residents. The first of these, the Civil Rights of Institutionalized Persons Act, was passed in 1980. The second, the Nursing Home Reform Act, became law in 1987. Together, they represent a shield for elders in care facilities against any kind of abuse or neglect. To take a closer look at this framework of protections, we will here specify some of the specific rights in question. Read on.
1 – Right to Dignity
No one likes to be humiliated. And when you’re in the care of staff members at a facility, there’s always the danger of having your dignity compromised. Say you or your loved one has “an accident,” and soils their clothes or bedclothes. The manner in which the dilemma is solved, under federal law, must not compromise the dignity of the person in question. And that’s just one example.
A nursing home resident has a right to dignity no matter what the circumstances of the situation, from their interactions with nursing home personnel to the daily maintenance of their health and well-being. No one is to be belittled, mocked, put down, or otherwise have their personal self-esteem stepped on in any way.
Need help getting dressed? You will not be made to feel inferior as a result. Hands too shaky to use your fork and knife? You have a right to be fed in such a manner as to retain your self-respect. Taking abuse from a fellow resident? It is the law that the abuse must be stopped in a manner befitting your dignity as an individual, without cause for embarrassment or loss of personal agency.
Part of being human is having the right to hold your head high, and that right doesn’t stop just because you’re a resident in a nursing home.
2 – Right to Privacy
This one is simple, though it can be hard to define succinctly. No one can go through your dresser drawers or other personal effects. No one can listen in on any conversations you have with your family or your doctor. No one can watch you while you change clothes, bathe, or use the toilet, unless you need assistance with those things, and then it’s understood that it won’t be shared with others. The right to keep things that are personal to yourself is sacrosanct. Your right to privacy does not end when you take up residence in a nursing home. Period.
3- Right to Freedom from Discrimination
We’ve all seen it on employment paperwork. You will face no discrimination based on your race, age, religion, national origin, disability, gender, or sexual identification. The laws of the United States are very clear on this.
A Muslim has just as much right to exist in a nursing care facility as a Christian. A gay resident has just as much agency as a straight resident. Part of the American dream is that it includes members of all groups, no matter who they are. Under the eyes of the law, all people are equal and will be treated as such. That’s the definition of freedom in our great land, and it applies to nursing home residents just as much as to anyone else.
4 – Right to Freedom from Restraint
In the words of the Nursing Home Reform Act, restraints of residents in the facility milieu are only to be made “by appropriately qualified professionals in keeping with accepted professional standards, and are not [to be] used as punishment, in lieu of treatment, or for the convenience of staff.” In other words, no one is allowed to tie you to your bed, with very limited exceptions. Also, an examination of the Reform Act reveals that part of its intention was and is to reduce the widespread use of physical restraints.
If you, as the resident, or your elder who lives in a nursing home becomes a danger to themselves or others, restraints may be employed. But, as the law says, restraints are not to be used lightly or arbitrarily, in any event. You’re not living in Arkham Asylum. Everybody who works at your nursing home is, by law, required to learn the appropriate use of restraint as a protection tool, and they also learn the specific situations in which it is to be used.
Outside of that, a nursing home resident has the right to free bodily movement, at all times.
5- Right to Be Informed of Medical Treatment
Most nursing home residents take at least one prescription. One example of the right to be informed about and participate in your medical treatment is the ability to discuss any changes in medication or dosage with your medical provider — before they happen.
This is often a part of a broader “treatment plan,” a document that you have the right to be involved in creating that outlines the different medical and personal goals involved in your receipt of services. If there’s something you want changed, you can change it through discussion with your doctor or nurse practitioner, and if there’s a part of your care that you want discontinued, you can do that as well.
Part of this group of medical rights is called informed consent, defined as a patient’s right to ask questions and receive detailed information about any upcoming medical treatment or procedure. It’s an important part of the rights of nursing home residents, just as with the population at large.
To ensure that informed consent takes place, physicians are instructed to take certain actions. The first is to assess the patient’s ability to understand the information well enough to make a decision about the treatment in question. The second is to present information — including the diagnosis, the specific purpose of the proposed medical intervention, and the risks and benefits of it — all in an accurate manner and in a way that is sensitive to the patient’s comfort and privacy.
6 – Pecuniary Rights
“Pecuniary” is just a fancy term for anything that has directly to do with money. One of the rights of nursing home residents is to be free to handle their own finances. Everyone can have and spend their money as they see fit.
You may be thinking, “What’s there to spend money on in a nursing home?” There’s more than you might expect, everything from magazine subscriptions to gifts given to relatives and friends during visitation, even the eventuality of having to seek damages for injustice, whether it be substandard care in the facility or an outside case in which the resident has a direct interest.
The long and short of it is, your money is your money. You can’t be forced to have a payee handle your funds or to enter into any similar arrangement without your knowledge and written consent.
7 – The Right to Visitation
Simply put, you have a right not to be isolated from your friends and family. When you want to see them and they can come during visiting hours, they won’t be turned away. This goes for immediate and extended relatives, pastors and priests, personal lawyers and advocates, friends old and new, and the list goes on. As a nursing home resident, you can keep the company you want.
This is one of the most important rights of nursing home residents, because loneliness is a common and serious issue for many. You may have a roommate or a group of fellow residents you eat, watch TV, or play cards with, but it’s still difficult to be away from the place and people you call home on a permanent or extended basis. Spending time with those you know and love is absolutely essential for good mental health, and that’s why it’s a federally protected civil right.
8 – Right to Complain
No matter how nice the nursing home or how well things have gone up to a given point, there will eventually be something a resident isn’t happy about and wants to see changed. So not only do you have the right to complain, but you also are guaranteed access to someone who can do something about your complaint — whether it’s verbal or written.
If you’re like me, you’ve noticed in recent years that when you’re on a tech support or customer service call, where you used to be able to demand that the representative you’re talking to put their supervisor on the line, these days when you make that request, they’re likely to refuse, saying “My supervisor will only tell you what I’ve just told you.”
But despite that disturbing business trend, to the contrary, any nursing home resident who isn’t satisfied with the attention their complaint has received has a right to go over the head of the unhelpful staff member. Even if all escalations fail, the resident can call or write an advocacy agency like LeadingAge (formerly American Association of Homes and Services for the Aging) or even the DHHS Office of the Inspector General, which has personnel devoted to seeking reparations.
9 – Protection from Unfair Transfer and Discharge
Speaking of unhelpful staff members — in the unfortunate event that a nursing home resident has an ongoing conflict with anyone who has power in the home, not to worry. Even if that individual comes to have the opinion that you’re a “problem resident,” they are legally barred from transferring or discharging you for solely that reason.
Feuds can happen. It’s just a fact of life. But in terms of “shape up or ship out,” it’s the organization that has to shape up when you as a resident are unhappy, and they can’t make you ship out with no legitimate reason. Rest easy. The federal government has your back.
So, without going into the various state laws in place depending on your location within the U.S., this article has covered the basics of the rights of nursing home residents. And it’s not because residents are necessarily considered weak or underserved, thus in need of special protections. To the contrary it’s that a nursing home is a place where things can happen behind closed doors — or in the hearts of the unkind — that make it important to actively extend and protect the usual rights of an American citizen. We, our parents, and our grandparents can take solace in that. The forces of good are at work.
Finally, if you have any related experience and you have a second, leave a comment below to let us know about it. Elder Guru represents a conversation, not just a one-way flow of information. Thanks!