Residents RIGHTS!!

TheCommuter, BSN, RN · Apr 6, 2011

Yes, LTC feels like a jailhouse at times. Elderly residents have rights. Prisoners have rights, too.

Unfortunately, routine is king in the nursing home setting. If staff deviates too far from the routine, the sheer volume of residents would receive no care at all. Routine is also king in the prison setting. I'd hate to be brutally honest, but my personal opinion is that nursing homes and prisons are institutions with quite a few similarities.

The elderly are neatly packaged and warehoused in nursing homes. Inmates are neatly packaged and warehoused in prisons.

orthonurse55 · Apr 7, 2011

I completely understand what you're saying. They DO have rights, and they have to be respected. But on the other hand, we have schedules to keep and our own priorities to meet. I am very guilty of breaking certain "rules" if they are not going to hurt anyone and they are ridiculous. Some residents are allowed outside to smoke on their own. They are very self-sufficient. I just don't see why they are on an every three hour schedule and only allowed one at a time. WHY? What the he*# else do these people have to look forward to? there's another guy, older man, who is extremely heavy. Like 350-400 pounds or so. They put that man on a weight reduction diet. He has NOTHING in his life anymore except three meals a day! And if he asks for more food he is told no, or the dietary staff will ask the nurse. If I am the nurse, he is allowed to have it. But I have seen some people be very rude to him and tell him he's on a diet and he knows that!

And another thing - in my entire adult life, since grade school actually - I have not eaten breakfast. But if I am in a LTCF they will force me to get up at the butt crack of dawn and practically force me to eat that stuff! :eek: That really would not be within my rights! I would rather sleep in and get up in time for lunch!

Dorali, BSN, LPN, RN · Apr 7, 2011

I agree 100%!!!

I can understand why they have to have a routine, the whole facility would be crazy if we didn't, but some of the things these people have to do is ridiculous.

I have a woman on my hall who celebrated her 100th birthday last month. 100! She is healthy, not a diabetic, takes hardly any meds (I think a daily multivitamin!!), and in her right frame of mind. Sometimes, she doesn't want to get up for breakfast. She says, "but I'm sleeping so good." Can she stay in bed? No. Why not? I don't know.

Diet restrictions are useless here though. Another resident is obese and stays in bed. 1800 calorie restriction. She has two grilled cheese sandwiches and two bowls of Cheerios for breakfast every morning. Lunch, she has asked for thirds. Why? "Because if they ask for something you have to give it to them." The way I see it, a diet restriction is a doctor's order. You are supposed to follow it. If they ask for 12 Lortabs, do we have to give them that too? Of course not, that isn't ordered. So why is their diet any different?

I know it can't be like this at every facility. How do you handle diet restrictions where you are??

orthonurse55 · Apr 7, 2011

The charge nurse is allowed to authorize some changes in the diet order. Like my example before. My man might ask for an extra egg or one more slice of bacon. If this were a hospital and the patient's life depended on him losing weight, I would never allow anything additional. But really, the poor old guy is never getting out of there. He's going to die in the nursing home - no more family, no more freedom. Just his wheelchair and his television and an occasional extra egg or piece of bacon. I don't see how it can hurt.

fuzzywuzzy, CNA · Apr 7, 2011

I can't imagine getting through the day without the routine (that would be a total disaster), but I agree that some of the rules are stupid. I have residents who don't want to get up and eat breakfast in the morning and I have to tell them "Sorry but I have to put it in front of you." I used to work with a nurse who would harass us until we forced residents to do things that really didn't matter that much, like eating an entire meal. So what if they start skipping meals and lose a few pounds when they're 98 years old? Or they don't want to go for a walk one day?

asfreeaswelleverb · Apr 7, 2011

I'm gonna have to disagree with the inmate comment.. The people that r actually in prison obviously did something bad and residents in a nursing home live there because they dont have a choice. They should not be told when to go to bed or when to get up out of bed, or when to eat or they cant eat this or that. I see this on a daily basis and it really gets under my skin.

On the whole routine thing, I agree that everybody has a routine down and they like to follow that routine. But its not up to us to do certain things.. its what the residents want or need at any point and time. So we, as cnas, should make it all about what the residents want or need.. we are in their home and we work for them. They pay us to give them the care they need and deserve from us. I honestly treat them as if they were my parents or grandparents. :heartbeat: )

CrunchRN, ADN, RN · Apr 7, 2011

Diet restrictions in the nursing home are ludicrious.

If the resident is competent they should have the right to have whatever they want and deal with the consequences if they choose.

My God - what else do they have? Any little pleasure they can get should be allowed.

hope1234 · Apr 7, 2011

I totally agree. I understand that a rountine has to be or else STUFF would hit the fan. I think that the reason is understaffing. When u r short handed, you have a certain amount of things to do, and a certain amount of time to do it in. And LTC's r always shorthanded. They just simply wont hire enough. The whole jurking the residents up with the chickens really irratates me. I worked at this one place where one of the residents got up when she was good and ready. And if u tried to convince her otherwise, she would take your head off. Literally, she would try her best to remove you from the club of the living. We were told to let her get up when she wanted to. Which was fine, but why did all the others have to get up anyway. Why did she have to become combative in her own home( and it is there home) just to be able to get up when she wanted. And totally different situation but related to the deit thing. My dad was terminally ill w/ stage 4 lung cancer, put on Lortab for pain. 1 month into his treatment( he lived 5 monts after diagnosis), his Dr. changed him to a Pain patch,which didnt relieve the pain. Dr said he would become addicted to the Lortab. SO WHAT!!!!! He is dying, no hope of recovery. What sense did that make?

asfreeaswelleverb · Apr 7, 2011

Thats a horrible story.. i think some people get into the medical field just because it pays good. If ur not gonna do whats best for the patient/resident then u have no business being a nurse or a doctor.. or a cna. And at a nursing home theyre basically there until they die.. so in my opinion i think they should get to do whatever they want, however they want, and whenever they want. As long as they r well taken care of.. as they should b if ur doin ur job, then it shouldnt b a big deal if they wanna stay in bed for breakfast, or if they dont wanna go to bed until midnight.. i guess im just very opinionated about this subject because i see it all the time and i do not think its fair.

yousoldtheworld · Apr 8, 2011

I agree, I also hate getting them up so early if they aren't going anywhere. At the same time, I realize that WITHOUT that routine, nothing would ever get done and the nursing homes would be even more of a mess than they are. Unfortunately, that's just the reality of caring for 12-15 total care residents.

I don't like making anyone do things they don't want to do.

But at the same time, letting them do whatever they want whenever they want, however they want would make it impossible to take good care of them, let's be honest. You'd never get anything done, people that didn't feel like being changed would have open sores from lying in urine, some people would never be washed, etc. There needs to be a balance.

They should be given as much freedom as possible WITHOUT jeopardizing their well being - and yes, that well being sometimes has to be maintained by having them do things they dont' really want to do.