WHAT ARE YOUR RIGHTS IF YOU ARE IN A NURSING HOME?
You have many rights under the law if you are a patient in a California nursing home. They include these five important rights:
• The right to choose your personal doctor.
• The right to refuse to take any drugs that affect your mind. Any use of drugs that affect your mind must be used to treat medical symptoms and not be used for the purpose of discipline or staff convenience.
• The right to refuse any plan of care, treatment, or procedure.
• The right to be treated with respect and dignity in recognition of your individuality and preferences.
• The right for a relative or legal representative to act on your behalf to exercise these rights when you are unable to do so.
This information is a summary of the California Department of Health Services’ information page on Patient Rights. For complete text see http://www.cdph.ca.gov/healthinfo/pages/nursinghomepatient.aspx
RIGHT OF CHOICE – HEALTH CARE DECISIONS
If you are in a nursing home federal and state regulations give you the right to be treated with respect and dignity and to make choices about how you want to live your everyday life and receive care. The nursing home must provide you with the necessary care and services to attain or maintain your highest practicable level of physical, mental, and social well-being. You have the right to take part in the process that decides what those services will be.
YOU HAVE THE RIGHT TO:
• Choose a personal attending physician.
• Be fully informed of your total health status. This includes your medical condition, opportunities for restoring you to your former level of fitness, your ability to carry out daily living tasks, and all other aspects of care you are receiving. This information must be presented in a language you can understand.
• Receive all information you need to know in order to make a decision about your care and treatment.
• Participate in developing your care and treatment plans. You also have the right to have a family member or representative participate on your behalf or with you during these meetings.
• Be fully informed of the benefits and risks of a proposed treatment or any recommended changes in your care and treatment. If your doctor recommends the use of a drug that will affect your mind your doctor must first obtain “informed consent” from you or your representative, if you are unable to give consent. Informed consent means that you are given all the information necessary to allow you or your representative to decide when to accept or refuse treatment. Information includes such things as the duration of the treatment, the benefits and risks of the treatment, possible side effects, and other alternatives.
• Be free from physical and chemical restraints and drugs that affect your mind except for limited periods of time in an emergency situation when you or someone else would be in danger.
• Refuse treatment. If you are able to make health care decisions, you may refuse any plan of care, treatment, or procedure. You cannot be treated against your wishes. If you have given “informed consent,” you can revoke it at any time. You can also choose someone to make health care decisions for you should you no longer be able to make decisions for yourself.
• Prepare an Advance Health Care Directive that allows you to say who you want to speak for you and what kind of treatments you want. These documents are called “advance” because you prepare one before healthcare decisions need to be made. They are called “directives” because they state who will speak on your behalf and what should be done.
This information is a summary of the California Department of Health Services’ information page on Right of Choice – Health Care Decisions. For complete text see: http://www.cdph.ca.gov/HealthInfo/Documents/RightofChoiceHealthCareDecision.pdf
WHAT IS AN ADVANCE HEALTH CARE DIRECTIVE?
An Advance Health Care Directive (AHCD) is a written power of attorney for health care naming someone to make health care decisions for you that may be oral or written. The AHCD communicates your wishes about the care and treatment you want, and who you want to speak for you if you reach a point where you can no longer make your own health care decisions.
The law does not require that you must have or make an AHCD.
If you already have a Durable Power of Attorney for Health Care, it is still valid and does not have to be replaced by the new AHCD unless your health care instructions, or the person you choose to make decisions for you have changed.
You should select a person who knows you well, and whom you trust to carry out your directions.
You do not need an attorney to complete the AHCD.
You are NOT required to complete an AHCD when you enter a nursing home.
You make your wishes known, orally and/or in writing by declaring your desire to receive or not receive life- sustaining treatment under certain conditions and outline your instructions pertaining to health care.
If you are capable of making your own decisions, you can revoke or change an AHCD at any time by informing your surrogate or agent orally or in writing. The revocation must be clearly documented by health care providers. Completion of a properly completed new AHCD form revokes the old form.
A written AHCD is valid forever unless you revoke it or state on the form a specific date on which you want it to end. An oral AHCD naming a surrogate is valid only during a specific course of treatment, illness, or stay in the facility. An oral designation of surrogate supercedes a previous written one. An oral individual health care instruction is valid until you revoke it.
Other documents that help determine your health care desires if and when you are unable to make such decisions for yourself:
Do Not Resuscitate
You may include your directions regarding CPR, also called Cardio Pulmonary Resuscitation. Directions to your family and physician for “no resuscitation” ensures that if your heart or respiration stops, no CPR will be started. Your wishes should be clear to your family, legal representative, or decision-maker, and you may sign a form along with your physician designating your wishes. No one can make you sign such a form—it is your choice. Your agent or surrogate may sign this form if you are unable to and this is consistent with your wishes.
Preferred Intensity of Treatment Form
This is a document that your physician may use after a discussion with you and/or your surrogate or agent about your preferences for care. You may decide to receive an antibiotic, or an intravenous or other treatment, specific to a medical problem. Your physician would document your decision in your medical record.
This information is a summary of the California Department of Health Services’ information page on Advance Health Care Directives. For complete text see http://www.cdph.ca.gov/HealthInfo/Documents/AdvanceHealthCareDirectives.pdf
DO NOT AGREE TO ARBITRATION IF YOU ENTER A NURSING HOME OR OTHER CARE FACILITY
Nursing home and residential care facilities often attempt to evade accountability by asking a patient or their representatives to arbitrate any disputes that might arise between them. To best protect your rights, you should NOT agree to arbitration.
Often these requests for arbitration are hidden in the fine print of lengthy admission contracts or other papers given to you by the care facility.
These arbitration agreements force families to take their case to an arbitrator even when a loved one is seriously injured or dies. Arbitration is the process of settling disputes outside the court of law, in a private setting, and with a private (and expensive) arbitrator. By signing an arbitration clause, parties agree to give up their constitutional right to have their dispute decided in a court of law in front of a jury. It is important to know the decision of the arbitrator is final and not subject to appeal.
Care facilities ask you to sign arbitration agreements because it is to their advantage, not to the advantage of the resident and their families. It is an effort to prevent residents from being able to sue them for negligent caregiving and other residential rights violations. Forced arbitration also allows care facilities to keep the facts of cases secret. Even if a case raises important public health and safety issues, irresponsible actions by the care facility may never be exposed to the public and the negligence could continue.
For further information on this subject, please see: