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Providing Care with Dignity and Respect
Diane Peters, RN, MS, Director of Leadership & Quality Initiatives
April 23, 2008
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Over the past few weeks, Perspectives has focused on how the new survey process is going to affect you as professionals. This week, we would like to change gears and talk about topics that should be in the forefront of our minds as providers of quality care - dignity and respect. What does providing care with dignity and respect mean to you? What does it mean to your support staff? Is your whole care center on the same page when it comes to providing quality care to your seniors?
Legislators, regulators and senior advocates have increased their attention to the quality and value of care and services provided to seniors. This attention is evident in the increased focus on abuse prevention and investigation of abuse allegations. Survey processes are also changing, the voice of the seniors and families using care services are the foundation for the survey and in identification of areas of noncompliance and potential abuse and neglect.
Regulations have tightened regarding the reporting and investigation of potential abuse and neglect for "vulnerable adults", our clients/residents. Abuse is defined as the willful infliction of injury, unreasonable confinement, intimidation, or punishment with resulting physical harm, pain, or mental anguish. Abuse may be verbal (threatening or frightening), physical (holding down, pinching, slapping, etc), mental (humiliation, intimidation, harassment, etc) or sexual (inappropriate touching, assault, etc).
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These regulations define neglect as unintended failure to provide goods and services necessary to avoid physical harm, pain, or mental anguish. Some examples of neglect may include; not using a gait belt as required to transfer, failure to perform range of motion exercises as ordered, leaving a client wet or soiled and skipping work in a client's home without notifying your employer.
Misappropriation of property is defined as the deliberate misplacement, exploitation, or wrongful temporary or permanent use of a resident's belongings or money without the resident's consent.
Recognition, investigation and reporting of potential abuse and neglect are mandated for all providers of care and services to seniors. The definitions of abuse and neglect relate to care provided to vulnerable adults in senior care settings. The specifics of the federal and state requirements may vary for nursing homes, assisted living, and home health including the time frames and reporting procedures for reporting and investigation of incidents.
Understanding the regulations and identifying and reporting potential abuse and neglect are important and necessary. As leaders and managers of care and services for seniors we must direct our focus to fostering a culture in our organizations that values the dignity of each individual we care for. We also need to ensure that we provide an environment that allows for and promotes care and services that is based on the needs and desires of each individual. This requires a change in the systems and process of our management, workplace and care practices to improve relationships among staff and between staff and clients/residents, improve retention and satisfaction.
 Diane Peters is training via Video Conference on April 29 from the Aging and Services Division, Minnesota Department of Human Services in partnership with the MN Department of Health. Her topic is "Educate to Protect: The Assessment, Investigation and Prevention of Adult Abuse and Neglect in Nursing Facilities." For more information please visit http://agingtraining.dhs.state.mn.us.
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