Dilemma
Suggested Response
A family member complains about a resident’s care, but the resident says everything is fine and asks you not to proceed.
Your primary responsibility is to the resident. If pursuing the investigation would identify the resident, you must discontinue it unless the resident grants permission to proceed. As an alternative, if you feel there is a problem with the care in the facility, you might be able to pursue a more general investigation, taking care not to do anything that would reveal the resident's identity.
The resident complains, but a family member urges you “not to rock the boat.”
This case is more clear-cut: the resident has requested assistance, and you should honor that request. Explain to the family that you are obligated to assist residents in resolving problems.
Relatives want you to investigate their complaint, but do not want the resident to know what you are doing. (For example: two relatives are involved in a dispute over who is to provide for the resident’s expenses; or, relatives may fear that the resident will be upset or alarmed by a problem.)
This is a particularly sensitive situation. It may be advisable to have a general conversation with the resident to ascertain whether he/she is concerned about the problem mentioned by the complainant. You will have to judge whether there is a problem concerning the resident. If the resident is being victimized, you are responsible for addressing the problem. You should not become involved, however, in family disputes, which are not affecting the resident’s well being.
A resident who is unable to make decisions for him/herself, but has not been legally declared incapacitated, makes a complaint.
Even though the resident may be confused or unable to express a decision, you should check into his/her complaint. It cannot be dismissed as invalid just because it comes from someone who is confused. However the resident’s condition should be considered as one factor in determining whether the complaint is valid. Consider what you know about the resident and about the facility. Try to understand what the resident is expressing, determine if there is an underlying message or unmet need.
A case arises involving a resident for whom a guardian has been appointed.
In most cases, you work through the guardian. Exceptions to this rule would be:
The complaint is about the guardian or some action of the guardian. The complaint is about the issue of whether the guardian is needed. The guardianship is a limited one (the resident retains the right to make some decisions). With these types of cases, talk with your LTCO supervisor. It may be advisable to seek advice from the LTCOP legal counsel or from an appropriate legal agency.