Julie: Agree 100% with Nurse Ratched and cheerfuldoer.
I served as Ombudsman in my area.
Need to determine:
1. Who signed consent forms for admission to facility? If not patient, Signer establishes themself person as to speak on pt's
behalf ONLY IF patient is incompetent. Otherwise PATIENT can make her own desisions...would worry about undue influence from her spouse here.
2. Dtr as POA-- 100 agree with Nurse Ratched. Ombudsman will help make determination of who can speak for patient. What is patients take on all this suctioning??? If husband attempts to move her before investigation done, Call Protective immediately and police.
Adult Protective Services Units were established to investigate reports of abuse, neglect, or exploitation, and to assist in obtaining protective services for endangered adults. An "endangered adult" is usually defined as any individual over 65 years of age (some ststes ages vary, may start at age 18) who is incapable by reason of mental infirmity or other incapacity of either caring for themselves or managing their property, and is harmed or threatened with harm as a result of neglect, battery, or exploitation. As part of the Older Americans Act amendments of 1987, Congress provided for the Long-Term Care Ombudsman Program whose primary purpose is to "establish a regular presence in long-term care facilities to become well-acquainted with residents, employees, and the workings of each facility to educate and be observent for signs abuse".
Mandatory reporting by health professionals is required in US under the Older Americans Act and is part of most states nursing practice acts. These "red-flag incidents" should have alerted your staff/management/doctor to contacting your ombudsman immediately. Hopefully this will be done in this casue in order to avoid spouse removing patient from facility. In PA "When there is clear and convincing evidence that, if protective services are not provided, the person to be protected is at imminent risk of death or serious physical harm, the agency may petition the court for an emergency order to provide the necessary services "
PA's law...similar most states on based on federal law
What is Mandatory Reporting?
Employees and administrators of nursing homes, personal care homes, domiciliary care homes, adult day care centers and home health care. If the abuse involves serious injury, sexual abuse or suspicious death, reporters must also call police and the PennsylvaniaDepartment of Aging at (717) 783-6207 or the Pennsylvania Department of Health Nursing Home Complaint Line at 1-800-254-5164.
Failure to report as required by Act 13-1997 can result in administrative or criminal penalties (especially to nursing staff).
Every report of abuse received by the Area Agency on Aging must be investigated to determine if the reported victim needs help to protect him/herself from abuse, neglect, exploitation or abandonment. Each report must be classified as emergency, priority or non-priority. Emergency reports are investigated immediately, non-priority reports are investigated within 72 hours.
Once the incident has been identified as protective and it has been determined that service provision is necessary the Area Agency on Aging in most cases must have the older adult's consent to provide protective services. Permission is not required if the services have been ordered by a court, requested by the older adult's court appointed guardian, or provided as part of an involuntary, emergency intervention court order because of imminent risk of death or serious physical injury.
All services offered to victims of abuse, neglect, exploitation or abandonment must be based on a comprehensive assessment of the victim's needs and described in a written service plan presented to the victim for his/her approval.
Finally, in the provision of protective services certain rights must be guaranteed. Those rights are as follows:
Victims have the right to be told that someone has reported that they might be the victim of abuse and need protective services.
Victims can refuse to accept services.
Victims have the right to legal counsel when the Area Agency on Aging attempts to obtain an emergency, involuntary intervention court order.
Victims have the right to a guarantee that all information concerning their case will be maintained confidential.
Alleged abusers have the right to be notified after substantiation of a report and given an opportunity to challenge the findings of the investigation.
PA Protective Services for Older Adults
Understanding what Elder Abuse is:
The Older Americans Act-Using Your State's Long Term Care Ombudsman
Council for Older Adults, Delaware County, Ohio
National Center for Elder Abuse (NCEA) - www.elderabusecenter.org
Adult Protective Services: Ethical Principles and Best Practice Guidelines http://www.elderabusecenter.org/publication/ethics.pdf
ELDER JUSTICE: Medical Forensic Issues Concerning Abuse and Neglect http://www.ojp.usdoj.gov/nij/elderjust/elder_05.html
[I] You were a true patient advocate in helping to get this reported. Make sure incidents regarding husbands behavior are documented in chart, even if late entries needed.
Keep us updated. Patients spouse has a problem that needs to be addressed. Not an easy situation. Karen [I]
Edited for spelling