The Oregon Caregiver SPRING/SUMMER 2022 www.ohca.com 18 LEGAL & REGULATORY Equality and Inclusion in Senior Living By Eugenia Liu, Oregon Health Care Association In long term care settings, it’s not uncommon to hear statements that are borne out of concern for resident health and safety, such as: “Excuse me, you can’t bring the dog into the dining room for health reasons.” “Sorry, but we do not allow motorized wheelchairs on our community van because it’s not safe.” “Due to COVID-19 protocols, we cannot allow visitors or anyone other than the resident in the treatment area.” While well-meaning, contained within each of those statements is an element of bias. There is no doubt that promoting resident health and safety is a top priority for senior living providers, and it is also engrained in everything staff do for residents. However, it is critical to find a balance between that focus and other, equally important goals: eliminating bias and ensuring equality and inclusion in the care and services delivered. Oregon and federal law provide strong protections for residents’ individual rights, including the fundamental values of independence, choice, and dignity. In residential care and assisted living facilities, OAR 411-054-0027 outlines the resident’s bill of rights. For nursing facilities, resident rights are found under state rule OAR 411-085-300 and OAR 411-085-310 as well as federal rule 42 C.F.R. 483.10. Beyond the rules that are specific to assisted living and nursing facilities, there are broader rules such as Oregon’s public accommodation law, ORS 659A.403, as well as the Americans with Disabilities Act (ADA) and the Fair Housing Act, which are designed to prohibit discrimination and ensure equal access to care, services, and housing opportunities. Furthermore, facilities are prohibited from retaliating against a resident who exercises these rights and protections. Collectively, these rights and protections work together to enhance a resident’s quality of life, recognize each resident’s individuality, and ensure person-centered care. These rights and protections apply to all residents, regardless of race, color, sexual orientation, gender identity, or physical impairment. Under this framework, a resident’s service animal may be allowed to accompany the resident into the dining room. This framework could allow a resident to board a community van using the resident’s motorized wheelchair, or to have a visitor, such as a spouse or other person, accompany the resident into treatment areas to provide support with communications despite COVID-19 restrictions. These rights and protections also allow residents to choose roommates when sharing a bedroom, associate and communicate privately with any individual of their choice, and have equal access to services offered by a facility. At the same time, these rights and protections are not limitless nor absolute and they do not require a facility to undertake actions that would place resident or third-party health and safety at risk or create an undue hardship for the facility. Understanding the framework is key to cultivating an environment that values both concepts equally. As with every other aspect of care and services in a facility, the facility’s frontline staff play a critical role in executing on these core values. Staff already receive regular in-service training on protecting and respecting residents’ rights, as required by the statutes that govern these facilities. In-service training can include detailed examples of resident rights and reinforcement of existing communication channels, such as the grievance process or an ethics/compliance hotline. This training provides staff with the foundational awareness to not only treat residents with dignity and respect, but to identify and report violations of resident’s rights as well. Staff also need to be empowered to integrate resident rights and protections into resident care. This can be trickier as Staff need to be empowered to integrate resident rights and protections into resident care. This can be trickier as staff may avoid asking questions out of fear of doing or saying something wrong.
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