Communication, Resident Rights, and Psychosocial Care
Resident rights
Federal law and New York regulations guarantee dignity, privacy, self-determination, choice, freedom from abuse and neglect, and freedom from restraints used for discipline or convenience. Residents may refuse treatment, keep and use personal possessions, send and receive mail unopened, use the telephone privately, receive visitors, take part in care planning, and complain without retaliation. An ombudsman and a resident council exist to protect those rights. Do not accept money, tips, or gifts of value, and never sign as a witness on a resident's legal documents.
Communication
Knock, identify yourself, and get to eye level. Explain what you are going to do before you do it, and use the resident's preferred name. For hearing loss, face the person, cut background noise, speak clearly and slowly, and never shout. For aphasia or stuttering, allow time and do not finish sentences unless asked. Use a qualified interpreter - not a family member - for important information. Behavior is communication: a resident with dementia who resists care may be in pain, hungry, tired, or overstimulated. Try later, simplify, and redirect.
Confidentiality and abuse
Discuss care only with the care team and only in private - never in the hallway, elevator, or dining room, and never with another resident's family. Abuse includes physical, sexual, verbal, emotional, and financial abuse, neglect, and involuntary seclusion. As a mandated reporter you report immediately to the charge nurse and administrator; New York also requires reporting to the Justice Center hotline. You do not investigate.
Trap: "I would report it at the end of my shift" is always wrong. Reporting is immediate.
Rule of thumb: if you would not want it said about you in a public hallway, do not say it here.