Failure to Provide Dignified Toileting Assistance
Penalty
Summary
A resident with diagnoses of Parkinson's disease, non-Alzheimer's dementia, and anxiety, and a severely impaired cognitive status (BIMS score of 5), was identified as dependent on staff for toileting and hygiene. The resident's care plan directed staff to assist with toileting before and after meals, at bedtime, and as needed, and the care card in the resident's room indicated the need for toileting assistance. On the evening in question, after being put to bed by a CNA, the resident requested to use the restroom. Instead of assisting, the CNA instructed the resident to be incontinent in bed and stated she would return later to provide incontinence care. This action was reported by the resident's family, who expressed distress over the incident. Interviews with other staff, including CNAs and the restorative nurse, confirmed that the standard practice and expectation was to assist residents to the bathroom or provide alternatives such as a bedpan or urinal if needed. Facility policy also emphasized the right of residents to dignity and individualized care. The incident demonstrated a failure to honor the resident's right to a dignified existence and appropriate toileting assistance as outlined in their care plan and facility policy.