Exceptions to the Right to Refuse

[Purple_Clover]

Can someone provide me a reputable and authoritative source to exceptions to the Right to refuse treatment or care? 

Am I understanding correctly that for use to force care (especially basic hygiene) would mean the resident would have to be declared incompetent in a court of law? 

[TheMoonisMyLantern, ADN, LPN, RN]

So, the answer to this is complicated and is going to be primarily driven by what state you live in because each one has a different process, requirements, etc. but no matter where you are, overriding a person's rights to force care is a big deal. It typically requires the assessment of multiple physicians that are in agreement that the treatment is necessary, not to mention a psychiatrist or psychologist to evaluate the person's capacity to make decisions and understand information, the patient's next of kin would be involved and eventually it gets passed on to a judge and they can order what care the patient is to receive. These orders are typically time sensitive and are meant only to stabilize the patient and get them either medically stable or psychiatrically stable enough to make their own decisions. 

In the case of hygiene alone I've see social services get involved and get the patient involved in counseling in an attempt to improve hygiene. Unfortunately in my state hygiene is "lifestyle choice" and is not an infection control issue in the eyes of the law. 

Hope this helps.

[Purple_Clover]

On 1/5/2021 at 9:20 AM, TheMoonisMyLantern said:

So, the answer to this is complicated and is going to be primarily driven by what state you live in because each one has a different process, requirements, etc. but no matter where you are, overriding a person's rights to force care is a big deal. It typically requires the assessment of multiple physicians that are in agreement that the treatment is necessary, not to mention a psychiatrist or psychologist to evaluate the person's capacity to make decisions and understand information, the patient's next of kin would be involved and eventually it gets passed on to a judge and they can order what care the patient is to receive. These orders are typically time sensitive and are meant only to stabilize the patient and get them either medically stable or psychiatrically stable enough to make their own decisions. 

In the case of hygiene alone I've see social services get involved and get the patient involved in counseling in an attempt to improve hygiene. Unfortunately in my state hygiene is "lifestyle choice" and is not an infection control issue in the eyes of the law. 

Hope this helps.

That helps a lot! I've emailed my BON as well to see what specifics they can give me too. 

I have CNAs who are cleaning a resident who is clearly refusing and combative and I will have nothing to do with it. I'm not going to court over some silly shet like this.