When coding for resisting care. If a resident refuses to take a whirlpool or shower, but does take a sponge bath. Does that resident still need to be coded for resisting care? Also if a resident refuses to get out of bed. The resident does have a bed bath and gets ready for the day. She just refuses to get out of bed. She would rather stay in bed and watch TV. Does she need to be coded for resisting care? Another question about Podiatrist visits, do we need a care plan for that or adding it to the ADL care plan is sufficient. Thanks in advance.

I need a little help please. What if they refuse to follow or cannot do the restorative plan? Please someone shed some light.

Hi--

RE: RESISTING--please be sure that she is RESISTING (meaning that she is NOT CAPABLE of making decisions, and that a surrogate has made decisions regarding her care plan) not MAKING THE DECISION TO DECLINE/REFUSE/CHANGE "prescribed" or "proscribed" care. Then make the decision--perhaps the CP should include acceptable alternatives under either circumstance.

Podiatry visits should already be on the Physician's order sheet, which is also considered part of the CP.

RE: Restorative plan--Again, figure out if she is RESISTING or DECLINING. If she is CANNOT DO, the plan must be re-evaluated/revised. If DECLINING, try to figure out WHY and go from there. If RESISTING, perhaps revise plan and turn into more of a game, or an activity she likes.

Good luck!