Key Terms

Definitions and Concepts Related to Elder Care and Resident Rights

Types of Mistreatment in Care Settings

• Abuse

  • The willful infliction of injury, unreasonable confinement, intimidation, or punishment with the resulting consequences:

  • Physical harm

  • Pain

  • Mental anguish

  • Examples of abuse include:

  • Not serving lunch at the same time every day.

  • Not addressing a resident by name upon entering the room.

  • Acting hurriedly during patient care.

• Misappropriation of Resident Property

  • The deliberate misplacement, exploitation, or wrongful use of a resident’s belongings or money without the resident’s consent, which can be temporary or permanent.

  • Examples of misappropriation include:

  • Placing a resident's hairbrush in a bedside table drawer instead of its usual place on top of the dresser.

  • Putting a resident's blanket in the facility laundry hamper rather than keeping it in the room for family pickup.

  • Accidentally leaving a resident’s remote control out of their reach.

• Neglect

  • The failure to provide goods and services necessary to avoid physical harm, mental anguish, or mental illness.

  • Examples of neglect include:

  • Forgetting to remind residents about scheduled activities, such as bingo.

  • Waiting outside the restroom door while a resident needs assistance.

  • Not offering snacks during communal activities.

Legal Framework for Nursing Facilities

• Omnibus Budget Reconciliation Act (OBRA)

  • A federal law passed in 1987 that establishes regulations for nursing facilities and nurse aide training programs.

  • Important aspects of OBRA include:

  • Enabling individuals to become Certified Nursing Assistants (CNA) without completing the Nurse Aide Training and Competency Evaluation Program (NATCEP).

  • Mandating the protection of employees by enforcing workplace safety standards.

  • Regulating the nurse aide registry and its training programs.

Care Philosophy

• Person-Centered Care

  • Care that focuses on promoting independence and autonomy, providing choice, and controlling the resident's experience based on a collaborative team philosophy.

  • Distinctions of person-centered care include:

  • Care is not limited to one individual at a time; it encompasses multiple residents while still emphasizing activities of daily living.

  • It contrasts with outdated care models that lack individual focus.

Advanced Directives and Healthcare Decisions

• Advanced Directive

  • A legal document that allows an individual to dictate the care they wish to receive if they become unable to make decisions themselves.

• Living Will

  • Unlike an Advanced Directive, a Living Will is not a legal document and does not affect healthcare decisions for individuals who cannot advocate for themselves (True/False clarification).

• Durable Power of Attorney for Health Care

  • A legal document that grants an individual the authority to make medical decisions on behalf of another person if they are incapacitated (True).

• DNR Order (Do Not Resuscitate)

  • An order that instructs medical staff not to perform CPR in cases of cardiac or respiratory arrest (True).

• POLST (Physician's Order for Life-Sustaining Treatment)

  • A medical order used for patients who are very ill, detailing the treatments they wish to receive (True).