Ethics question....

[rholster]

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.

[GHGoonette, BSN, RN]

1: If the wife is his guardian and has power of attorney then he does not need to sign, she is legally entitled to do so. 2: If he is mentally incompetent to make his own decisions it is a simple matter to bring this before the court. If the medical records show that he does indeed suffer from advanced dementia this is a straightforward process, and any legal person, including the notary, would know that. 3: Under such circumstances, persuading the patient by any means to sign for any transaction constitutes coercion, which remains illegal and may be classified as a form of assault. 4: Documents acquired in such a manner are therefore invalid and any attempt to transact using them may be regarded as fraud.

I agree, as a nurse it might not be your responsibility, but you definitely need to get what you saw down on paper and bring it to the attention of the authorities. If you know anyone in the legal profession ask them "off the record" what the implications are and what you should do.