LTC facilities struggle with safety versus autonomy

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Nursing homes often must strike a balance between respecting residents' safety and their rights, particularly in areas such as smoking and sexuality, researchers report.

Cornell University investigators presented results from their study and offered recommendations at the annual conference of the American Society on Aging. One major issue: smoking. While the Omnibus Budget Reconciliation Act of 1987 says nursing home residents have the right to smoke, other research indicates up to 72% of fire-related deaths in nursing homes result from smoking. Researcher Melissa L. Martin, M.D., says one way to navigate the issue is to test whether a resident is capable of extinguishing a cigarette or hot ashes.

Resident sexuality is another hotly debated topic in nursing homes. Researcher Paula E. Lester, M.D., citing a National Association Directors of Nursing Administration/Long-Term Care survey, said directors of nursing frequently struggle with whether to allow residents with moderate-to-severe dementia to have sexual relationships. Among surveyed facilities, 37% had a policy regarding sexual activity, while 35% had designated areas set aside for resident intimacy. The researchers recommended addressing hot topics like this frequently to find a balance between a patient's rights and safety.