I work for a local retirement home, or more correctly a Residential Care Facility for the Elderly. I have worked for this community for over ten years and I have become very involved and invested with the community, the staff, management, and, more importantly, the residents, past, current, and future. The industry my community belongs to is essentially healthcare. Albeit a more specific, niche part of healthcare. The building I work for is not a nursing home, and the residents, although some may move in as technically “independent” residents, each is still receiving assistance with a variety of activities of daily living. Such activities include but are certainly not limited to meal preparation, transportation, housekeeping, and laundry. If a resident moves in as one who requires more assistance our community will provide more hands-on assistance with other activities of daily living not listed previously such as medication management, varying level of assistance with bathing, dressing, and, if needed, time and placement orientation. Because of the amount of assistance we are able to provide we are often confused for a nursing home, as mentioned above, and we are also mistaken simply as apartments for senior citizens.
Because of these social pressures inadvertently incorrectly defining us, we a are forced to simultaneously market our building to encourage families to have a discussion with their loved one and consider moving into an Assisted Living Community, and to educate those who we are marketing to exactly what it is we are. We provide more care than a senior citizen apartment complex, and we provide a more comfortable and welcoming environment than a Skilled Nursing Facility can provide, especially when the potential resident does not need medical attention, but still requires some assistance. What I have noticed, as part of the marketing team in my building, is that we need to provide said education more so to the medical professionals than we do to our potential residents and their families. Specifically when placing a resident who has memory issues. We have to make the decision and be certain that we are providing the most appropriate placement for all residents who come though our doors. More times than not, when we send off paperwork to doctors’ offices prior to a potential resident moving in, the doctor will state, in the paperwork, that the patient, because of his or her memory issues, has a form of dementia. After we meet the potential resident we notice said resident does not have dementia, and only has, what is medically considered MCI, or “Mild Cognitive Impairment” generally due to old age.
When we have cases such as these we feel we have a duty to not only appropriately place the potential resident with what we feel is the correct level of care, the level of care the families feel comfortable with, and we must also adhere to rules and regulations set by our licensing and by the state. Regardless if another, often a competitor, can provide the same level of care as our community, we must make the families aware of all their options.
Other that what was mentioned above I don’t feel that I have had to deal with too many ethical issues because I deal with families and residents solely before they move in. After residents move in they bring their concerns either with the Assisted Living Director or the Director of the building. I am aware there have been issues where residents weren’t necessarily happy living anywhere other than their own home, however we have been told by the family that they had already sold the residents home, and we were left with the decision of either telling the resident the truth about the beloved home, or if we redirect their concerns. Times like these, when families ask us to, more or less, “control” the actions of their parents living in our community we must find common ground between what we are being asked by the families and what we are obligated to do by law. For example we are not allowed to medically control a residents behavior unless prescribed by a doctor, even if a family member with full medial power of attorney asks us to. All residents have their own residents’ rights, which we must abide by.
I am biased; I have been with my Residential Care Facility for the Elderly for such a long time it is impossible not to be. With that being stated, I genuinely feel that the team I work with is constantly ethically and morally sound. There are rare occasions that members of the team may falter, but the team as a whole will always make the appropriate corrections to any unethical or immoral action.