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Not disclosing patient death to family member

Posted
ddib3 ddib3 (New) New

Hello!

I'm a Illinois-state CNA at a private nursing facility directly outside of Chicago. I have a patient about 87 years in age who, along with him, had a wife who was receiving care from the facility as well. We welcomed his wife around a year after we'd welcomed him; yet, there is some sketchy behavior going on in the home. His wife passed away about 5 months ago, and since then he's been asking for her and wanting to see her continuously. I wasn't his nurse for a while due to a great influx of residents, but I've ultimately been placed back with him today. When I asked my supervisor why he is not aware of the recent passing of his wife, she told me to never tell him and I did not need a reason.

I'm very baffled because I believe this is breaking some kind of HIPAA violation, because I'm concerned as to why a husband is not made aware of his wife's death. Please let me know if there is something I can do. They have no kids, no really close family.

Hoosier_RN, MSN

Specializes in dialysis. Has 27 years experience.

are you a CNA or nurse? only asking because you call yourself both in your post. #1, does patient have dementia? If he does, telling him his wife is dead can be detrimental, as he doesn't remember her passing. #2 there may be family dynamics that you are not aware of, and if a family member with legal authority doesn't want hubby to know, then that could be it.

Never tell a demented person their loved ones have died. Can you imagine getting that news every day for the rest of your life?

Sour Lemon

Has 9 years experience.

I'm very baffled because I believe this is breaking some kind of HIPAA violation, because I'm concerned as to why a husband is not made aware of his wife's death. Please let me know if there is something I can do. They have no kids, no really close family.

HIPAA has nothing to do with withholding information from a patient, although withholding information can certainly be an ethical issue. I believe your supervisor should keep you "in the loop" and let you know the specific reason you are "never to tell" ...but ultimately, it's not your call to make.

KelRN215, BSN, RN

Specializes in Pedi. Has 10 years experience.

What kind of HIPAA violation do you think this could possibly be? Do you know what HIPAA is?

psu_213, BSN, RN

Specializes in Emergency, Telemetry, Transplant. Has 6 years experience.

are you a CNA or nurse? only asking because you call yourself both in your post.

I too am curious. I think the OP's positions plays a role in whether the OP needs to know why the resident was not told of the passing.

brownbook

Has 35 years experience.

I appreciate you caring and asking your supervisor. You seem to be a very caring CNA .

Your supervisor's response was unhelpful.

Hopefully, as others here have alluded to, it is simply that the husband is confused and believes his wife is alive. It is okay to lie to a confused patient who won't remember from one day, or hour, to the next that a loved one has been dead for many years.

Hello!

I'm a Illinois-state CNA at a private nursing facility directly outside of Chicago. I have a patient about 87 years in age who, along with him, had a wife who was receiving care from the facility as well. We welcomed his wife around a year after we'd welcomed him; yet, there is some sketchy behavior going on in the home. His wife passed away about 5 months ago, and since then he's been asking for her and wanting to see her continuously. I wasn't his nurse for a while due to a great influx of residents, but I've ultimately been placed back with him today. When I asked my supervisor why he is not aware of the recent passing of his wife, she told me to never tell him and I did not need a reason.

I'm very baffled because I believe this is breaking some kind of HIPAA violation, because I'm concerned as to why a husband is not made aware of his wife's death. Please let me know if there is something I can do. They have no kids, no really close family.

If you are a CNA as you state, it is important to point out that while you are key player on the team, you are not a nurse. That title is reserved only for people who have passed the NCLEX and are LPNs or RNs.

And no, not telling the resident about his wife's passing is in no way a HIPAA violation. HIPAA violations have to do with people who have no role in the patient's care accessing his records or people on his health care team giving out his protected health information to people who have no role in his care without his permission. Depending on the circumstances, it could be a violation of ethics, but that is not necessarily the case here. Maybe they've told him a hundred times already, and for him it was devastating news each and every time. There could be a myriad of valid reasons why it has been determined that giving him this news is imprudent.

psu_213, BSN, RN

Specializes in Emergency, Telemetry, Transplant. Has 6 years experience.

When my Grandfather died (he was still living at home), my Grandmother lived in a facility--she had pretty significant dementia. The decision was made by her children (my aunt/uncles and my mother) not to tell her that my Grandfather had died. It was a family decision. Not trying to be rude about it, but I don't think the aides in the facility were owed any explanation as to 'why'--they just had to know that she was not being told of the passing.

I will just say that I routinely give appropriate information to the UAPs with whom I work. I find the answer given to the OP to be condescending and unprofessional. If/when a UAP sees what is happening with care of certain situations and is (or may be) troubled by it, most of the time I think it is wrong to not respectfully address their concern. They want to do the best for patients just as I do.

"You don't need a reason" is an inappropriate answer. If the information can't be disclosed then it is still more respectful to answer in a way that conveys appreciation for the staff member's concern.

Ruby Vee, BSN

Specializes in CCU, SICU, CVSICU, Precepting & Teaching. Has 40 years experience.

I will just say that I routinely give appropriate information to the UAPs with whom I work. I find the answer given to the OP to be condescending and unprofessional. If/when a UAP sees what is happening with care of certain situations and is (or may be) troubled by it, most of the time I think it is wrong to not respectfully address their concern. They want to do the best for patients just as I do.

"You don't need a reason" is an inappropriate answer. If the information can't be disclosed then it is still more respectful to answer in a way that conveys appreciation for the staff member's concern.

I agree -- it would have been far more helpful (and appropriate) to say "We've disclosed his wife's death, but he has dementia and cannot remember. And then, if needed, explain the rationale.

When my father died, my mother was constantly looking for him and then getting angry that he "left me for some floozy." The only thing that calmed her was telling her that he was dead -- he hadn't left her willingly, he died. My sister put my cellphone number into the speed dial of Mom's phone, and it made for some pretty interesting conversations, especially at work.