RESIDENT STATEMENT OF RIGHTS AND RESPONSIBILITIES

In keeping with the Mennonite Nursing Homes Inc. Mission and Vision statements:

FOUNDATIONAL PRINCIPLES:

Communication

Privacy

Respect

Autonomy

Choice

Independence

Security

Flexibility

RESIDENT RIGHTS

1. You have the right to be treated with consideration, respect and dignity.

2. You have the right to participate, to the degree you choose or are able, in the planning and carrying out of your care and activities wherein your values, needs, and preferences are central;

This means:

• You will be supported to maintain your cultural and spiritual values and beliefs and to have them respected and incorporated into the planning of your care.
• You will be supported to maintain ongoing communication with care team members to ensure important information is shared.
• Your care team is responsible to be familiar with your care needs.
• You will be informed of the options and expected outcomes of any medical decisions you make.
• Your care team will explain your medical conditions, care, and treatments and you will be supported in your right to make decisions.
• Your care team will do its best to help you understand discussions about your care and well-being (e.g., through translation if required, communication boards, or other types of assistance).
• You will be supported to maintain your independence to the greatest extent possible.
• You will be involved in setting goals and developing strategies to achieve them (e.g., maintaining continence or walking).
• You will be provided with opportunities for physical and meaningful activity.
• You will be asked to designate someone (such as a family member or friend) to make decisions and to speak on your behalf, in the event that you are unable to do so (e.g., health-care decisions).
• You will know the names and roles of the people providing your care (care team members will wear nametags and identify themselves).

3. You have the right to express thoughts, feelings and suggestions and to have them acknowledged and responded to without fear or negative consequences.

This means:

• You have the option to participate in resident councils/associations in homes where they exist.
• Your care team will assist you, if needed, to express your thoughts, feelings and suggestions (e.g., through translation or other types of assistance).

4. You have the right to have your privacy respected;

This means:

• You will be offered options for privacy during your personal care;
• You will be offered options for privacy during toileting;
• You will have the option to communicate in private and to receive visitors;
• Your private and personal information will not be shared with people not involved in your care.
• Your care team will knock before entering your room.

5. You will have the right to have personal belongings and furnishings in the home as long as space limitations and safety needs are recognized.

This means:

• Your independence and autonomy will be promoted by ensuring personal items are placed where you may easily access them (e.g., combs, remote controls, telephones).

6. You have a right to a safe environment.

7. You have the right to be informed in advance of additional charges for specialized services or items not covered by your monthly resident charge.

RESIDENT RESPONSIBILITIES

1. Be considerate and respectful of the rights of others.
2. Contribute as much as possible to the growth of the community for all residents within the home.
3. Give correct and complete information to your care team and participate in the planning of your care.
4. Ask questions when you do not understand information.
5. Be patient and understand that care is provided to those whose needs are most pressing. This may result in delays in your care.
6. Meet the terms of policies and practices of the home.
7. Maintain independence and participate in your care and decision making to the greatest extent possible.
8. Be informed about how your choices affect your health.
9. Designate someone, such as a family member or friend, to make decisions on your behalf in the event that you cannot make decisions for yourself in the future.
10. Take responsibility for your personal belongings to the extent that you are able.

FREQUENTLY ASKED QUESTIONS

Why have these guidelines been developed?

As part of a commitment to promote resident directed care, Saskatoon Health Region developed a welcome package for individuals moving into a long term care (LTC) home for the first time. During this process, it was identified that guidelines for resident rights and responsibilities did not exist in the Region. In keeping with Accreditation Canada’s Long Term Care Service standards, the Region’s commitment to Client and Family Centred Care and the recommendations identified in the Patient First Review, the Region embarked on a collaborative process with residents and families to develop these guidelines.

What are resident directed care, and client and family centred care?

Resident directed care places residents at the centre of their care by giving them choices. Care team members support residents to participate in planning their care by encouraging independence and involving them to participate in decisions affecting their environment—their home.

Client and family centred care is an evolutionary approach whereby the planning, delivery and evaluation of health care is based on mutually beneficial partnerships among clients, families and care providers.

How were these guidelines developed and who was involved?

Saskatoon Health Region conducted focus groups with resident councils and associations throughout the Region. Residents identified the foundational principles in creation of the guidelines. Consultation also included the Client and Family Centred Care Specialist, Client Representatives, long term care administrators, managers and directors of care, and Saskatoon Health Region’s legal counsel.

Who are care team members?

A care team is a group of people that works with you. The team ensures you are cared for as a whole person—your social, spiritual, mental and physical needs are all important.

You and your family are central to your care. You will work in partnership with members of the care team. Care team members include all of the individuals who work in the home and who have involvement in resident care. Care teams include physicians, nurses and continuing care/special care aides. They may also include nurse practitioners, recreation therapists or activity directors, spiritual care providers, dietitians, physiotherapists, occupational therapists, speech language pathologists, psychologists, behavioural consultants and psychiatrists. There are also important members of the care team that may not be directly involved in the care of residents but contribute to their well being. They are maintenance and environment service workers, food services staff and finance and administrative staff.

What is meant by the phrase “ongoing communication will be supported?”

Ongoing communication refers to how communication is supported and when communication is supported.

With respect to how: there is a formal process of communication that continues throughout an individual’s stay in LTC. This involves regular care conferences when the care team, resident and family gather to review the resident’s overall health and well-being. Care conferences are usually held once a year.

There is also informal communication. This usually involves the resident or family identifying concerns or questions they have or the care team providing information that has a direct impact on the individual’s care. It is expected that this informal communication happens on a daily basis as care team members, residents and families interact with one another. Some residents require special assistance to communicate (they may have difficulty with speech, or use assistive devices, or they may be unable to understand or make their needs known). In these instances, it is expected that care team members and families have a heightened role in communicating with each other for the benefit of the resident, and include the resident to the extent that she or he can be or wants.

With respect to when: formal and informal communication occurs from the day the individual is welcomed into the home and continues for the length of his/her stay. In other words, communication must be ongoing among residents, families and the care team. When there are changes in a resident’s needs or health status, it may be decided that a care conference would be the most beneficial means of communicating these changes and the resulting changes to care.

How do these guidelines apply to residents who are unable to understand their rights or take responsibility for the items outlined in the guidelines?

Some residents are unable to understand their rights or take responsibility for their behaviour. This is often due to medical and/or psychiatric conditions that prevent them from being held accountable for their actions.

With respect to understanding their rights, this group of residents rely on their families and their care team to demonstrate increased vigilance in ensuring that their rights are respected.

With respect to residents who are unable to take responsibility for following guidelines, policies and procedures, again, families and the care team have an increased responsibility to act on behalf of the resident. For example, to ensure safety, rooms should be free of excessive clutter. A resident unable to follow this policy on his or her own would rely on families and the care team to work together to remove unnecessary items and keep the room tidy and free of hazards.

One of residents’ responsibilities is to contribute to the growth of the community—what does this mean?

For long term care communities to meet their greatest potential and for members to optimize meaning in their lives, all persons, including residents should use their gifts, talents and experiences. All people have inherent worth and have gifts, talents and experiences that can contribute to the well-being of others. The late Jack Funk, in the foreword he contributed to the Welcome Guide shared this concept through his words:

Figure out what contribution you can make to this community. For example, one resident has taken it upon herself to greet everybody with a smile and a handshake. Another one is a very good listener. A third resident offers praise to the people she meets. My contribution is doing what I love to do—collect and write stories for others to read. Hopefully help them remember. I have computer skills which I am willing to share.

Most important, do not dwell on the reality of the moment. It can overwhelm you. Instead, let the possibilities of this moment encourage you to believe there can be gold in the time ahead.

Always remember, that because you are a person you have a right to be. It is not shameful to ask for help.

~~Jack Funk

He shared his belief that residents should aspire to contribute their gifts rather than be passive recipients of care.

What are resident councils?

Some homes have active Resident/Family Councils that add to the operation of the home through different activities such as fundraising and advocacy. These activities are aimed at improving life for the residents.

Councils encourage residents and members of the care team to work together toward improving the experience of all residents. Councils may take resident concerns, wishes and resolutions to the management of their home. Councils assist by sharing important information and play a part in making decisions about things that could affect the day to day lives of all residents, their families and the care team.

Interested individuals are encouraged to ask whether their care home has a Resident/Family Council and how to become a part of this group.

What is meant by “residents are responsible for meeting the terms of policies and practices of the home?”

Policies have been established to ensure individual safety and the safety of others. To that end, residents are expected to comply with the policies and practices of the home. Regional policies are available for review on the Health Region website under the heading “About Us.” Residents may request to review policies specific to the home by speaking with management at the home.

An example may be helpful: During an influenza outbreak, infection control policy indicates that residents who have been infected must remain in their rooms. Family visits may also be restricted during this time.

Residents have a right to a safe environment. What does this mean?

Safety is a priority in the strategic plans of long term care homes. Homes are required to have safety plans and are required by law to conduct monthly fire drills. Homes are also required to have infection control plans and practices in place and must meet policies and procedures for cleanliness and safety.

Safety is seen as a responsibility of all members of the LTC community including the care team, residents, family members, visitors and volunteers.

Residents and families are vital in the role of promoting safety and are included to the degree that they are able to prevent and report adverse events.

The care team is trained to identify, reduce and manage risk. Everyone is encouraged to identify potential safety risks and report them to the appropriate person. Saskatoon Health Region and the management of long term care homes follow up on reports and work to prevent the problems from recurring.