From securing appropriate power-of-attorney documents to working with an ombudsman, providers have several strategies in place for helping residents with important decisions regarding their care. Three senior living executives weigh in on their best courses of action when a vulnerable resident with little family support needs their help.
Resident Care: How do you solve problems for vulnerable residents without engaged family members or guardians?
“It’s important to get as much information as
possible during the discovery phase prior to move-in. This includes
finding out whether there are any advance directives, and with whom the
resident wishes to share information. We encourage residents to make
their own decisions for as long as possible, and that includes
encouraging them to plan ahead for how their care will be managed in
the event they become incapacitated.
It’s also important to begin communicating with any family,
guardian, and/or power-of-attorney designee from the time of move-in.
Share information on an ongoing basis, even if it involves simply
sending a letter or picture. If you develop that relationship early on,
then you will have a more established footing if difficult care
decisions must be made. Of course, in the event that absolutely no one
is responsible for that resident, we may seek the assistance and
guidance of the local ombudsman.”
— Brenda Kennedy
Vice President of Clinical Services, Bell Senior Living, Greensboro, NC
“Whenever a new resident moves in, we always discuss whether they
have established an advance directive and a power-of-attorney. Too
often, people will download power of attorney paperwork from the
Internet, get it notarized, and think that that will suffice. In fact,
most durable health-care power-of-attorney agreements will not become
active until a physician says so, in writing. Is the power of attorney
financial or durable? If durable, is it activated, or simply drawn up?
We also invite the local ombudsman or other expert to discuss these
matters during family night, and open the event to the public. If one
of our residents still does not have an active guardian, we seek one
out from their extended family, church, or community affiliations.
Failing that, we involve the local ombudsman, Area Agency on Aging, or
adult protective services for positive assistance.”
— Robert Enloe Vice President of Quality and Clinical Services, Signature Senior Living, Lewisville, TX
“Residents have the right to make their own choices, even a choice
that the provider believes is not the best one. In states where
regulations strongly favor resident autonomy, the resident’s decision
is the one that counts. However, too often a resident is inclined to
make a bad choice simply because they lack sufficient information to
make a better one. Our responsibility is to ensure residents get the
best information in order to make the best decision possible.
Our communities are mostly small enough that staff can truly get to
know each resident. We also offer companion care, such as for doctors’
appointments. We conduct frequent resident evaluations—at least once
every 90 days—and hold weekly conference calls with the director and RN
coordinator for selected residences to discuss every resident’s status.
That helps keep staff engaged and identify potential risks. Lastly, we
always try to keep up communications with guardians, even disengaged
ones.”
— Judy Swartzell, Senior Vice President of Resident Services, Bickford Senior Living, Olathe, KS
