The right to refuse

A resident has the right to be informed about the medications he or she is taking and also to refuse to take a medication. The resident has the right to know what medication is being given and why. The facility may have a policy about what information the medication aide may give to the resident. The medication aide does not force residents to take medication. Appropriate measures to encourage taking of medications when directed for recipients who are not competent should be used. The person responsible for direction and monitoring should be able to answer any questions that may arise. When in doubt, ask the supervisor or person providing direction and monitoring.

If the resident refuses to take a medication, report the refusal to the supervisor or person responsible for direction and monitoring. Record the refusal on the medication record, and include the reason the resident did not take the medication in the resident’s file.

Confidentiality

All information about the resident is confidential. This means that all staff must keep personal information about the resident to themselves unless it affects the health and well-being of the resident. This includes information about medications. If a staff person feels the need to share information, it should be shared with the supervisor or person responsible for monitoring.

Do not talk about the resident with other workers, other residents, friends or family. Be sure not to discuss resident issues in a public place where other people could overhear the conversation. Never discuss a resident’s behavior, condition, medications or other information where others could hear the conversation.

Neglect and Abuse

All citizens of the United States are guaranteed certain rights under the Constitution. These same rights apply to residents who live in or use services from the types of facilities in which medication aides work. Federal and state laws are in place to assure resident rights are protected. Resident rights include the right to be free from abuse and neglect.

Each staff person has a legal and moral responsibility as a caregiver to protect the rights of vulnerable people for which he or she provides services. Vulnerable people include children, frail elderly and adults with disabilities. Personnel are expected to act as advocates for residents and report any situation believed to prevent a resident from enjoying his or her rights as a citizen of the United States. Recognizing a resident’s physical boundaries and property rights is important for the medication aide. It is not appropriate to accept gifts from residents, or to borrow money or items from residents. It is not appropriate to have any sexual contact with residents. Respect for belongings and physical space is important.

Neglect

Neglect occurs when goods or services needed by the vulnerable person to prevent injury, emotional pain, mental distress or physical illness are not provided. Making promises and not keeping them, not feeding a resident incapable of feeding himself or herself, removing the call light, or not providing incontinence care as needed are all examples of neglect.

Neglect means failing to provide care that you should have provided. The consequence of neglect is harm to the vulnerable person, or to his or her property. Examples of being negligent is when a resident is caused harm by: 

• Not following a supervisor’s directions 
• Not following the accepted procedure for a task
• Performing a task without training
• Failing to give to a resident a medication that has been ordered by a physician 
• Giving medication by the wrong route or in the wrong dose, or violating any of the five rights 
• Telling a resident you will return in five minutes and then forgetting to return

Abuse

Abuse means to harm a person intentionally. Abuse may occur in any of the following ways: 

• Physical abuse is contact with a resident’s body that harms or is likely to harm the resident. Hitting, punching, slapping, pinching, rough handling, and use of restraints for punishment or staff convenience are all forms of physical abuse. Forcing someone to take medications against his or her will is also a form of abuse. 
• Mental/emotional abuse occurs when an action causes unnecessary fear or emotional pain. Examples include intimidation, ridicule, namecalling, verbal threats, yelling, screaming and humiliation. 
• Sexual abuse is any type of inappropriate sexual intimacy or inappropriate comments between two people. Touching breasts or private parts, sexual activity without consent and threatening sexual contact are all forms of sexual abuse. Sexual abuse includes sexual harassment, sexual coercion, sexual assault and incest. 
• Involuntary seclusion is a form of emotional abuse. It occurs when the resident is separated from others or confined to a room without consent. A resident confined for a brief period to reduce agitation, or to protect the resident or others, is an exception. 
• Misappropriation of resident property is the deliberate exploitation of belongings or money without the resident’s consent. Misappropriation is also the misuse of resident property. Examples include not asking permission before using resident property, damaging or destroying property, and theft.  
• Verbal abuse occurs when words are used to humiliate or degrade the resident. Examples include name calling, teasing and threatening. Nebraska defines verbal abuse as the use of oral, written or gestured language that includes disparaging or derogatory terms directly to residents, or doing these things within their hearing or sight.

Everyone’s Abuse and  Neglect Responsibility

• Know about abuse
• Watch for abuse
• Prevent abuse
• Report Abuse

Each facility has a dedicated program to prevent abuse. This program includes employee screening, training, and the policies and procedures used for prevention and investigation of abuse.

Signs of Potential abuse in residents 

• Unexplained bruises or skin tears 
• Anxiety and nervousness 
• Fear and avoidance of touch 
• Withdrawal or depression 
• Frequent crying 
• Changes in personality 
• Acting fearful around a specific person
• Appearing upset yet denying anything is wrong

Reporting Abuse and Neglect

If anyone suspects a resident has been abused or neglected, it is his or her legal responsibility to report the situation according to the employer’s policies. This usually means reporting the facts to the supervisor or person responsible for direction and monitoring. The facility will conduct its own investigation and will report the situation to the correct authorities. The employer cannot punish a staff person for reporting suspected abuse or neglect if it is done in good faith.

If a staff person believes the situation was not investigated or reported correctly, the employee should then report the situation to the authorities. To report suspected abuse or neglect of a vulnerable person, call:

National abuse/Neglect hotline 1-800-652-1999