Right to Personal Freedom and Autonomy

Nursing home residents don’t forfeit their independence when they enter a facility. They retain the right to make choices about their daily lives, including what to wear, when to sleep, what activities to participate in, and whom to associate with.

Residents have the right to receive visitors of their choosing at reasonable times, maintain personal possessions (within space limitations), and participate in social, religious, and community activities. Facilities should accommodate these rights to the greatest extent possible while maintaining a safe environment.

The use of physical restraints (such as bed rails, wheelchair belts, or wrist restraints) is strictly regulated and should only be employed when necessary to ensure the resident’s safety or the safety of others, and only with proper medical authorization. Chemical restraints—medications used primarily to control behavior rather than to treat medical conditions—should never be used for staff convenience.

Right to Privacy and Confidentiality

Privacy is a fundamental human need that doesn’t diminish with age. Nursing home residents have the right to privacy in their personal care, medical treatment, personal communications, and visits with family and friends.

This includes the right to send and receive mail without interference, make telephone calls in private, and meet with visitors in private spaces when possible. Medical information should be kept confidential in accordance with HIPAA regulations, and financial matters should be handled discreetly.

Right to Report Violations Without Retaliation

Fear of retaliation can silence victims of nursing home abuse or neglect. Federal and Arizona state laws explicitly prohibit nursing homes from retaliating against residents who file complaints or participate in investigations. This protection extends to family members who advocate on a resident’s behalf.

Arizona residents or their representatives can file complaints with:

• The nursing home administration (following the facility’s grievance procedure)
• The Arizona Long-Term Care Ombudsman Program
• Arizona Department of Health Services
• Arizona Adult Protective Services

Common Violations of Residents’ Rights

Understaffing and Poor Quality Care

Inadequate staffing is at the root of many nursing home violations. When facilities operate with too few caregivers or inadequately trained staff, residents suffer. Basic needs go unmet, medical conditions go unmonitored, and the risk of accidents increases significantly.

For example, a resident who needs assistance with toileting may be left waiting for extended periods, potentially leading to incontinence, skin breakdown, urinary tract infections, and loss of dignity. Similarly, residents who need help eating may receive meals that go cold while waiting for assistance, contributing to malnutrition and dehydration.

Bedsores (pressure ulcers) often develop when immobile residents aren’t repositioned regularly—a common consequence of understaffing. These painful wounds can progress rapidly, leading to infection, sepsis, and even death if not properly treated. The presence of advanced bedsores is almost always indicative of neglect.

Arizona regulations specify minimum staffing ratios, but many experts believe these minimums fall short of what’s needed to provide quality care. Families should inquire about staffing levels, particularly during evenings, nights, and weekends, when facilities often operate with reduced staff.

Financial Exploitation

Nursing home residents are particularly vulnerable to financial exploitation due to potential cognitive impairments, isolation from family members, and dependence on caregivers. This exploitation can range from petty theft of personal items to sophisticated schemes involving coerced changes to wills or power of attorney documents.

Common forms of financial abuse in nursing homes include:

• Unauthorized charges for services that weren’t provided or weren’t necessary
• Staff “borrowing” money with no intention of repayment
• Stealing cash, jewelry, or other valuables from residents’ rooms
• Forging signatures on financial documents
• Manipulating residents into making gifts or financial decisions that benefit the abuser

Families can help prevent financial exploitation by maintaining oversight of their loved one’s finances, regularly reviewing bank statements and facility bills, securing valuable items, and being wary of sudden changes in financial arrangements or new “best friends” among the staff.

Overmedication and Chemical Restraints

Some nursing homes resort to inappropriate use of psychotropic medications to manage residents with dementia or behavioral issues. These “chemical restraints” are often administered for staff convenience rather than medical necessity, effectively sedating residents to make them easier to manage.

Antipsychotics are particularly concerning, as they carry a black box warning from the FDA when used in elderly patients with dementia, citing increased risk of death. Despite this, inappropriate use of these medications persists in some facilities.

Signs of chemical restraint may include:

• Sudden onset of lethargy, confusion, or sedation
• Slurred speech or difficulty staying awake
• Decreased interest in activities previously enjoyed
• New medication regimens without clear medical justification
• Behavior that appears overmedicated (drooping head, inability to stay awake during the day)

Families should request complete information about all medications prescribed to their loved ones, including dosages, reasons for use, and potential side effects. Any sudden changes in medication, particularly the addition of psychotropic drugs, should be questioned.

What to Do If a Loved One’s Rights Are Violated

Document the Issues

If you suspect your loved one’s rights are being violated, thorough documentation is crucial. Keep a journal of observations, including dates, times, and descriptions of concerning incidents. Note the names of staff members involved and any witnesses present.

Photographic evidence can be particularly compelling, especially for physical injuries, unhygienic conditions, or evidence of neglect. Take photos that clearly show the problem, with timestamps if possible.

Request and review your loved one’s medical records regularly. These records may reveal inconsistencies in care, unexplained injuries, weight loss, or other signs of neglect that might not be immediately apparent during visits.

Speak with other visitors or residents (if appropriate) who might have witnessed concerning incidents. Their observations can corroborate your concerns and strengthen your case.

Report to Authorities

If you believe your loved one is in immediate danger, call 911. For less urgent concerns, follow these reporting steps:

1. Report to facility management: Start by addressing concerns with the nursing director or administrator. Follow the facility’s formal grievance procedure, which should be provided to you upon admission.
2. Contact the Long-Term Care Ombudsman: Arizona’s ombudsman program advocates for residents’ rights and can investigate complaints. They can often resolve issues informally and maintain confidentiality if requested.
3. File a complaint with Arizona Department of Health Services: ADHS is responsible for licensing and regulating nursing homes and can investigate allegations of abuse, neglect, or rights violations.
4. Report to Adult Protective Services: APS investigates allegations of abuse, neglect, or exploitation of vulnerable adults and can intervene when necessary.
5. Contact law enforcement: Some forms of abuse (physical, sexual, financial) are crimes and should be reported to local police.

The National Center on Elder Abuse (NCEA) also provides valuable resources and guidance for those dealing with suspected nursing home abuse.

Keep records of all reports filed, including copies of written complaints, names of officials you spoke with, dates of contact, and any response received.

Bottom Line

Understanding and protecting nursing home residents’ rights is not just a legal matter—it’s a moral imperative. Our elderly loved ones deserve to live with dignity, respect, and proper care, especially when they’re at their most vulnerable.

By familiarizing yourself with these rights, staying vigilant for signs of abuse or neglect, and knowing how to respond if violations occur, you become a powerful advocate for your loved one and for all nursing home residents. Remember that speaking up about suspected abuse or neglect may not only protect your family member but could prevent harm to other vulnerable residents as well.

If you believe your loved one’s rights have been violated in an Arizona nursing home, we encourage you to reach out for a free, confidential consultation with our experienced nursing home abuse attorneys. At Miller Kory Rowe, we understand the emotional and legal complexities of these cases and are committed to helping families find justice and peace of mind.