Daily Life
Bob’s scheduled shower time is 6:00PM. Bob attempts to go in the shower at 4:00PM. Staff tell him he’s only allowed to shower at his scheduled time.
What is the right to make choices about daily life?
Residents are allowed access to the bathroom, including showers, whenever it is not in use by another resident.
Taylor refuses a newly prescribed medication because it makes them feel tired. Staff tell Taylor they have no choice and must take it.
What is the right to refuse medications or treatment?
Unless there is a court order or emergency, residents may refuse treatment. Staff should document the refusal and notify the nurse or provider.
After repeated food-seeking behaviors, staff suggest Dorothy waits in her room while the rest of the residents eat, so Dorothy could eat in isolation after the others.
What is the right to freedom from extreme treatments?
This is not an appropriate action for ongoing behavior management. Alternatives must be used, such as additional staff during meal times or utilizing the hierarchy of dining support.
Emma asks Scott to assist her in filing a grievance about him. Scott tells her, “You need to talk to the manager, not file a grievance.”
What is the right to exercise their rights?
Staff must assist, explain options, and help residents access advocacy or grievance processes.
Maria reports ongoing stomach pain and increased anxiety. Staff notice changes in her eating and sleep patterns but delay notifying health services or leadership because the schedule is busy.
What is the right to prompt and adequate care/treatment?
Staff must respond promptly to health concerns and follow reporting procedures to ensure timely medical evaluation.
During a stressful shift, a staff member yells at Nina for asking repeatedly about the outing this weekend.
What is the right to humane psychological and physical environment?
Residents must be treated with respect and dignity, even during challenging moments. Tone, language, and patience matter. Per DHS regs, the activity calendar must be posted with all activities and costs.
Jordan has a history of self-injurious behavior in the bathroom. A staff member suggests locking all of the bathrooms to prevent potential self-injury.
What is the right to the least restrictive setting necessary for safety?
Staff should explore less restrictive options first, such as increasing bathroom supervision or adding approved environmental supports – alarms, DORs.
Two staff members discuss Lily’s medical appointment in the dining room while other residents are present.
What is the right to maintain confidentiality and privacy?
Resident information must be shared only with appropriate staff and in private settings.
Molly, a new resident, explains she has to complete the chores on her chore list or she will not be able to watch tv until they are completed.
What is the right to refuse work that financially benefits PWH?
Residents cannot be required to do work that financially benefits the provider. Participation must be voluntary and therapeutic, not labor. Chores have to be tied to ISP goals or personal skill development.
Chris frequently calls his sister to talk about another resident. Staff yell out, “That’s not true!” in the middle of Chris's phone call.
What is the right to personal communication?
Residents have the right to personal communication; staff should not be listening in. Staff concerns should be addressed through the Core team for follow-up.
A team meeting is held to update Alex’s behavior support plan. The behavior plan is implemented without Alex’s knowledge or consent.
What is the right to participate in treatment and care decisions?
Alex has the right to participate, ask questions, and express preferences, even if support is needed to understand the information.
Ben is out of his toothpaste and does not have sufficient funds until his next paycheck arrives. Staff say he has to wait and he shouldn’t have bought that DVD last week.
What is the right to manage finances or assign a second party?
PWH is responsible for managing residents’ finances. If residents do not have appropriate funds to provide basic personal care supplies, PWH is responsible for providing them.