Ethics question....

Nurses General Nursing

Published

  • Specializes in ICU, Cardiac Cath Lab.

I'm a Nurse at a geriatric long term care facility. A few days ago I entered the room of one of my residents and saw his wife attempting to make him write his name. My resident has advanced dementia and was just doodling on the paper. I asked his wife what she was doing and she said she was letting him practice writing his name so he could sign some papers in front of a notary. I told her that he would not be able to comprehend what he was signing and she just said that her lawyer told her it would be alright. She said the paperwork has something to do with some property. Evidently the two of them were fairly wealthy. Shortly after I left his room she wheeled him outside and met a notary in front of the building where my resident made his mark on whatever papers she had. I brought it to the attention of my DON and she said that she spoke with our CEO but it seems they either have no answers or do not care. I feel sure that what transpired was not legal but I'm not sure where to go with this. Any advice would be appreciated.

ORNurseCOS

127 Posts

Sounds fishy, it would be easy to have a judge rule him medical incompetent and render his signature unneeded depending on what it is actual for. On the other hand if there is foul play a foot the other party involved could very easily challenge the validity of the signature so its a wash.

You've done all you can by reporting it and that is the end of it for you IMO.

tyvin, BSN, RN

1,620 Posts

Specializes in Hospice / Psych / RNAC.

Oh my...you are just starting to see what happens in nursing. As your superiors have said they aren't quite sure they can legally do anything. We are nurses and will come into contact with many ethical situations. You can take comfort that it was his wife and not some other relative taking advantage.

She's done with him or else he wouldn't be in LTC but, it his wife. My own mother took care of an Alzheimer's husband but didn't put him in LTC. I suggested she make her his POA so she could independently make all the decisions and sign whatever documents that came up. It made things much easier.

Doesn't his wife have POA over him? Did he sign himself in? If she is POA, she wouldn't need his signature. Perhaps someone needs to educate her as to relieve her mind and stop trying all this forcing the husband to sign documents. Maybe that's something you can do is check to see who has POA...I'm sure if she isn't POA, the one who is would be very interested in what happened. Or perhaps that's a step she needs to take.

So sad the things I've seen and experienced in relation to what you witnessed. It's the first ethical situation for you, but understand; it won't be the last.

rholster

4 Posts

Specializes in ICU, Cardiac Cath Lab.

Thanks tyvin, I've been a Nurse for 12 years and seen my fair share of ethical problems. This is just the first time I've asked myself if I'm obligated to involve the law. I just have a strange feeling about this and I know, at a minimum, the Notary was wrong to witness and notarize the signature of someone who is obviously not competent enough to know what he is signing.

JWG223

210 Posts

It sounds fishy, but you don't know the whole story. Sometimes legal doesn't mean "right" and sometime illegal doesn't mean "wrong". I remember years ago, my grandparents signing things over to my father. They had put it off and put it off, and finally did so. Not out of reluctance to sign over, but out of simple procrastination and refusal to accept that their time may be short. What if this man had done similar? What if maybe something had changed...say...an investment gone bad/good and something needed revising? What if in his normal frame of mind, he would have wanted done what he signed, and she was honoring his wishes to the best of her knowledge?

Maybe she was being a snake, and maybe she was just doing right by the man he used to be.

What you saw was not legal. What you saw may not have been "wrong".

My position that unless you know whether it was right or wrong, you keep doing your job and leave the affairs of others where you've observed no harm, to themselves.

Just my .02 based on things I've seen and similar questions as yours that I've asked of my own conscience and morality.

Editorial Team / Admin

Rose_Queen, BSN, MSN, RN

6 Articles; 11,658 Posts

Specializes in OR, Nursing Professional Development.

Would it be possible to take this to the ombudsman of the facility? He or she is in a patient advocate role and could get the ball rolling if there are issues. Maybe also elder abuse in a financial form?

rholster

4 Posts

Specializes in ICU, Cardiac Cath Lab.

Rose, I'm not familiar with the term "ombudsman"? JWG223, thank you. Part of me just wants to turn my back and walk away from the situation and the other part knows that it was wrong and I feel obligated to do something. I'm just not sure where to turn. :(

JWG223

210 Posts

Rose, I'm not familiar with the term "ombudsman"? JWG223, thank you. Part of me just wants to turn my back and walk away from the situation and the other part knows that it was wrong and I feel obligated to do something. I'm just not sure where to turn. :(

If you feel like it is wrong to turn and leave others to their affairs, I think in this case that you should do something. There exists reason enough to act on good faith that something may well be wrong. Do what YOU think is right, because at the end of the day, noone shares your thoughts as you lay down to sleep. Make sure you sleep well. It's important.

Editorial Team / Admin

Rose_Queen, BSN, MSN, RN

6 Articles; 11,658 Posts

Specializes in OR, Nursing Professional Development.
Rose, I'm not familiar with the term "ombudsman"? ]

Here's some resources: NORC - National Long-Term Care Ombudsman Resource Center.

These are the ones specific to Texas: National Consumer Voice

Specializes in SICU, trauma, neuro.

You could google long-term care ombudsman and/or vulnerable adult reporting for Texas; that should get you pointed in the right direction. Hopefully it turns out to be nothing, but remember we're mandated reporters. If we suspect financial abuse or any other kind of abuse, we're not obligated to do an investigation--we ARE obligated to report it to those who are able to investigate.

Esme12, ASN, BSN, RN

1 Article; 20,908 Posts

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Rose, I'm not familiar with the term "ombudsman"? JWG223, thank you. Part of me just wants to turn my back and walk away from the situation and the other part knows that it was wrong and I feel obligated to do something. I'm just not sure where to turn. :(

It says on your profile that you are from Texas....Long-term Care Ombudsman annual reports (DADS)

Congress amended the Older Americans Act in 1978 to establish the Long-Term Care Ombudsman program to serve residents in long-term care facilities. Ombudsman services are available in every state and territory of the United States. In Texas, the Office of the Long-term Care Ombudsman operates in the Texas Department of Aging and Disability Services.

The Texas Ombudsman Program advocates for quality of life and care for residents in nursing homes and assisted living facilities. Federal and state authority mandates ombudsmen to identify, investigate and resolve complaints made by, or on behalf of, residents and to provide services to help in protecting health, safety, welfare and rights. Information and assistance in choosing the most appropriate living residence is also a valuable service.

VANurse2010

1,526 Posts

Oh my...you are just starting to see what happens in nursing. As your superiors have said they aren't quite sure they can legally do anything. We are nurses and will come into contact with many ethical situations. You can take comfort that it was his wife and not some other relative taking advantage.

She's done with him or else he wouldn't be in LTC but, it his wife. My own mother took care of an Alzheimer's husband but didn't put him in LTC. I suggested she make her his POA so she could independently make all the decisions and sign whatever documents that came up. It made things much easier.

Doesn't his wife have POA over him? Did he sign himself in? If she is POA, she wouldn't need his signature. Perhaps someone needs to educate her as to relieve her mind and stop trying all this forcing the husband to sign documents. Maybe that's something you can do is check to see who has POA...I'm sure if she isn't POA, the one who is would be very interested in what happened. Or perhaps that's a step she needs to take.

So sad the things I've seen and experienced in relation to what you witnessed. It's the first ethical situation for you, but understand; it won't be the last.

Saying she's "done with him" just for putting him in LTC is way harsh. I suspect she's no spring chicken herself and perhaps she's not physically capable of rendering care. That doesn't mean "done."

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