Resident Rights and Independence Promotion
Core concepts
Resident rights come from federal OBRA requirements and state law, and questions in this domain usually have one correct answer that preserves choice. Residents have the right to dignity, privacy, confidentiality, and freedom from abuse, neglect, exploitation, and restraint. They may refuse care or treatment, make their own choices even when the CNA disagrees, keep and use personal possessions, manage their own money, send and receive unopened mail, use the telephone privately, receive visitors, practice their religion, take part in activities, and voice grievances without fear of retaliation.
Abuse includes physical, sexual, verbal, emotional, and financial mistreatment and involuntary seclusion; neglect is failure to provide needed care. A CNA who observes or suspects abuse must report it immediately to the nurse and, in Tennessee, to the appropriate state agency. The CNA does not investigate.
Choice is the theme. Offer options within the care plan: which shirt, when to bathe, what to eat. A resident who refuses a bath is not being difficult; the CNA respects the refusal, informs the nurse, documents it, and offers again later. Never open a resident's mail, share information with a caller, or accept gifts or money.
Traps
Look for answers that sound helpful but overstep, such as doing a task for a resident who can do it themselves or talking the resident out of a refusal. Contacting the ombudsman is a resident's right, not a threat.
Rule of thumb
Ask whether the action protects both the resident's right to choose and their safety. If it does not, do not do it.