Published Jun 12, 2009
Here'e the situation: The assisted living center where my friend's dad and mom live (in another state) called today to tell her that her father was found in bed with another resident (unmarried woman). They explained that were calling becuase it was their ethical obligation etc etc. and that sexual activity between residents is common and they were considering changing her fathers meds and were going to discuss it with his doc.
My question: Please explain why the assisted living center felt obligated to share this information with her? Would'nt that be considered a HIPAA violation? My friend is the medical POA, so maybe they needed to tell her about the med change?
morte, LPN, LVN
if the dad is not competent....the family or other "responsible" party needs to be notified in these cases....now that would be a spouse first....if the mom isnt competent either, than it goes down the tree from there......IF the dad is competent yes it would be a confidentiality breach
What is the reason for the notification of the wife or competent party? Is he at risk for putting other resident's in harms way? Is the assisted living facility informing the family because they have some liability? Would the facility also inform the single lady's family?
What I am not clear on is the cognitive/competency status of the individuals involved. If they are all competent it is no ones business but theirs, in my opinion. If one party is not competent, then the issue should be addressed with the competent individual and the family/RP of the incompetent party. Why your friend was called could be that he is not competent? If he is and they wanted to relay medical information, then that was all that should have been relayed. His sexual promiscuity is not something that should be discussed with others without his consent if he is competent. I'd be mad as the devil if it were me and I snuck out one night to the hot senior down the hall and someone called my son about it!
Ruby Vee, BSN
hiv is on the rise among senior citizens, probably since the advent of viagra. if dad was engaging in unprotected sex with another lady, one or both of them may be at risk. also, if dad is promiscuous and is still engaging in intercourse with mom upon occasion, mom is also at risk. i would think that if either dad or mom is incompetent, that's something the poa should be aware of.
of course not knowing the situation, it could have simply been the case of a conservative nurse being horrified by dad's behavior and wanting to "tell on him."
VivaLasViejas, ASN, RN
We had a similar situation at the ALF where I was the DON for 2 1/2 years. The gentleman involved was married, but because they didn't get along, his wife lived in another facility; the lady was unmarried but had some dementia. (Actually he did too, but he wasn't as far down that road as she was.) The staff was scandalized and wanted to tell his daughter, but since he was still driving and managing his own finances, I came down on the side of privacy. His lady friend, on the other hand, had a daughter who was her POA and managed everything for her, so we did inform her of the relationship.
Fortunately for all concerned, the daughter was OK with all of this, mainly because her mom was so happy! But I discovered that education about these matters is sorely lacking among long-term caregivers; the myth that older adults aren't interested in sex is stubbornly persistent, and when they defy the stereotypes, facility staff are often unwittingly punitive.........either by forbidding them to be alone with the object of their affection, or by telling their families of the affair, sometimes causing them to be moved to another facility and thus separating the couple.
Then when you throw dementia into the mix, it gets even more complicated. What happens when one party is still relatively 'with it', and the other is not? The State regulations say that one of our duties as a facility is to prevent abuse of all kinds, presumably including resident-to-resident abuse........and clearly, having sex with someone who is not competent to make the decision to do so IS abuse. That vulnerable resident must be protected. But what if SHE doesn't feel she's being abused? What if she wants to be with a man who finds her attractive and provides her with sexual gratification? What about her rights as a human being who, even though she has dementia, is still an adult?
The hard and fast rule is, there IS no hard and fast rule..........each case has to be dealt with on an individual basis.
That said, in the OP some mention was made of changing the male resident's meds........The ALF needs to be extremely cautious about that, as it is also considered abuse to manipulate a resident's medications to encourage/force them into compliance with acceptable behaviors as determined by the facility. It's called a chemical restraint, and is against the regulations of most if not all states.
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