Failure to Support Resident Self-Determination in Daily Mobility
Penalty
Summary
The facility failed to promote and facilitate a resident's right to self-determination by not providing the necessary support for the resident to get out of bed daily. The resident, an elderly female with a history of cerebral infarction, muscle weakness, abnormal posture, anemia, muscle wasting, hyperlipidemia, depression, anxiety, and hemiparesis, was assessed as having moderately impaired cognition and required substantial to maximal assistance for self-care, including the use of a mechanical lift with two staff for all transfers. Despite her care plan indicating these needs, the resident reported not being assisted out of bed for seven consecutive days, despite making daily requests to staff. Observations over two days confirmed the resident remained in bed, wearing the same pajamas and in the same position, and staff interviews corroborated that staffing shortages and equipment limitations contributed to delays or failures in meeting resident requests for assistance with mobility. The resident expressed dissatisfaction with the care received, specifically noting that her requests to get out of bed were acknowledged but not acted upon in a timely manner, often only being addressed late in the day when it was nearly time to return to bed for dinner and nightly care. Staff interviews further revealed an awareness of resident rights and the importance of self-determination, but also acknowledged that staffing and equipment constraints impeded their ability to honor resident choices consistently. The facility's policy on resident rights emphasized the importance of dignity, respect, and participation in care, including the right to receive necessary care to achieve the highest possible level of health. However, the failure to provide timely assistance for the resident to get out of bed as requested demonstrated a lack of support for resident choice and self-determination, as required by both facility policy and regulatory standards.