Page 74 - The Deep Seated Issue of Choice

THE DEEP SEATED ISSUE OF CHOICE
APPENDIX C
APPENDIX C
OBRA ‘87 Surveyor Training on Resident Rights. 1987. Selected excerpts.
A New Perspective on Resident Rights
Dignity means more than door-knocking.
OBRA 87 gives us the opportunity and obligation to reexamine our attitudes, our routines, and personal assumptions regarding resident rights. We have the chance to re-focus our efforts and, in the process, social awareness and ethical practices that emphasize individuality will evolve.
When we reaffirm the dignity of each resident, we will also enrich the lives and values of our staff members. And, as we seek new ways of enhancing independence and offering new choices and opportunities to our residents, staff members will feel rewarded by those they empower.
Enriched lives means more productive lives for our staff. Pride and personal determination will improve the quality of life for our elders.
Busy care-givers are routinely required to make “on the spot” decisions. In the past, these decisions may have been made with the primary focus on efficiency and not on thoughtful consideration to individuality. To place appropriate emphasis on resident rights, we may need to sacrifice some efficiency for the sake of human pride.
Goals must be set that hold individual dignity in higher esteem than overall facility efficiency. It will not be easy. Years of caring practices and habits based on experience will need to be challenged. Ideas once believed to provide quality will need to be reexamined.
New ways to promote self-determination in a dignified fashion need to be identified. Communication and access both within and outside of each nursing facility needs to be fostered. Facilities can begin by creating and/or revising written policies and procedures that outline conflict resolution for staff and residents, as well as families, in areas pertaining to resident dignity and rights.
The following examples address areas in which quality care and resident rights should be examined.
Quality and the Dignity of Risk
The frail, elderly nursing home resident often must balance the dignity of risk,
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