Proper care for nursing home residents should include respect for their last wishes. Unfortunately, sometimes facilities and their staff fail to provide end-of-life respect, which can lead to nursing home abuse or neglect. Advance directives (ADs) are an important consideration to take when transitioning to a nursing home, and can help prevent nursing home abuse.
What Are They?
Advance directives are legal documents that detail exactly how end-of-life care should be administered. Some examples of advance directives are DNRs (Do Not Resuscitate orders), living wills, and establishment of a health care proxy (someone authorized to make medical decisions). Especially important in nursing homes, ADs can detail what care a nursing home resident wants to accept or refuse during a medical crisis. For example, a nursing home resident may not want to receive CPR or they may want to donate tissue and organs after death. These kinds of decisions can be spelled out in an AD. In Illinois, the Department of Public Health is required to make available certain types of advance directive forms, including DRNs, living will forms, and health care proxy forms to meet these goals.
The importance of advance directives in nursing homes cannot be overstated. Making end-of-life wishes clear to nursing home staff is so important in fact, that The Centers for Medicare and Medicaid Services (CMS), a federal government agency that helps administer Medicare, recently issued a notice that nursing home policies must allow for a full implementation of residents’ ADs. Specifically, this notice now requires all nursing home facilities to administer CPR in accordance with a resident’s advance directive. This means that if a resident’s advance directive calls for CPR when medically necessary, the facility staff must perform CPR until paramedics arrive (or must not perform CPR if the resident has a Do Not Resuscitate order).
Traditional nursing home abuse often takes the form of physical harm. Some examples of nursing home abuse include allowing a resident to develop bedsores or pressure ulcers, failing to provide a resident with proper nutrition, failing to provide adequate medication, or inappropriately confining or restraining a resident. Though failing to follow a resident’s advance directive may not sound as dangerous as other forms of abuse, it can be just as degrading and harmful. According to The National Center on Elder Abuse (NCEA), creating an AD can be a powerful tool to prevent nursing home abuse. The NCEA identifies advance directives as a way to guard yourself or your loved one from future neglect or abuse because these directives establish health care wishes instead of leaving potentially life or death decision up to a nursing home staff.
Unfortunately, even with an AD in place, you or your loved one may still experience nursing home abuse. Staff may refuse to administer CPR or treatment dictated by the advance directive, and this can seriously or possibly fatally harm a resident. If you or your loved one has been a victim of nursing home abuse or neglect, contact our experienced nursing home abuse attorneys immediately to discuss your legal options.