Clicklaw Wikibooks - User contributions [en]

Acknowledgements for Legal Issues in Residential Care

2014-08-15T18:07:07Z

Seniors First BC:

{{Legal Issues in Residential Care: An Advocate's Manual TOC}}
This e-manual was researched and written by [[Charmaine Spencer]]. A special thanks to Martha Jane Lewis for spearheading the idea of the book, providing legal supervision and ongoing support.

In developing this e-manual we have drawn on the knowledge and experience of key stakeholders in health care and law, government agencies, community groups, family councils and in some cases residents themselves. These people have allowed us to identify key issues, content, and resources.

This e-manual is based on an approach first used by the Advocacy Centre for the Elderly (ACE) in Toronto, Ontario where their manual became a practical information tool useful to many stakeholders. We would like to thank ACE for the initial idea of creating the e-book as well as their support. We have drawn on their quarter century experience in legally advocating on behalf of older adults in long term care settings.

The BC Centre for Elder Advocacy and Support thanks all those individuals and organizations that generously gave their scarce time to participate in the review of the manual. Their comments and responses helped shape the final content. The special efforts given by lawyers Heather Campbell, Kevin Smith (BCCEAS), and Krista James (Canadian Centre for Elder Law) have been greatly appreciated.Thank you to Kim Carter and staff of the BC Ombudsperson Office, Community Legal Assistance Society (Mental Health Law Program), and Alison Leaney of the Public Guardian and Trustee Office.

We also benefited from the insights and support of advocacy staff at the Alzheimer Society of British Columbia, Al Jina (Park Place Seniors Living), Kim Slater and the Vancouver Island Association of Family Councils, and Sherry Baker, BC Association of Community Response Networks.

This project was made possible with financial support of the Law Foundation of British Columbia. The BC Centre for Elder Advocacy and Support gratefully acknowledges the Foundation for its generous support of this work.

{{REVIEWED | reviewer = [[BC Centre for Elder Advocacy and Support]], August 2014}}
{{Legal Issues in Residential Care: An Advocate's Manual Navbox}}

Charmaine Spencer

2014-08-15T17:57:14Z

Seniors First BC:

<noinclude>{{Template:Clicklaw Wikibooks Contributor}}</noinclude>{{Contributor | bio = '''Charmaine Spencer''' is a lawyer and adjunct professor with the Gerontology Research Centre at Simon Fraser University. Charmaine wrote the [[Legal Issues in Residential Care: An Advocate's Manual]] on behalf of [[BC Centre for Elder Advocacy and Support | BC CEAS]].

| name = Charmaine Spencer
| image = [[image:avatar.png|150px|left|link=|Charmaine Spencer]]
| organization = Simon Fraser University, BC CEAS
| website = [http://www.sfu.ca/gerontology www.sfu.ca/gerontology]
}}
<noinclude>__NOGLOSSARY__
[[Category:Contributor Bio|Spencer]]
</noinclude>

Charmaine Spencer

2014-08-15T17:56:44Z

Seniors First BC:

<noinclude>{{Template:Clicklaw Wikibooks Contributor}}</noinclude>{{Contributor | bio = '''Charmaine Spencer''' is a lawyer and adjunct professor with the Gerontology Research Centre at Simon Fraser University. Charmaine wrote the [[Legal Issues in Residential Care: An Advocate's Manual]] on behalf of [[BC Centre for Elder Advocacy and Support | BC CEAS]].

| name = Charmaine Spencer
| image = [[image:avatar.JPG|150px|left|link=|Charmaine Spencer]]
| organization = Simon Fraser University, BC CEAS
| website = [http://www.sfu.ca/gerontology www.sfu.ca/gerontology]
}}
<noinclude>__NOGLOSSARY__
[[Category:Contributor Bio|Spencer]]
</noinclude>

Charmaine Spencer

2014-08-15T17:56:07Z

Seniors First BC: Created page with "<noinclude>{{Template:Clicklaw Wikibooks Contributor}}</noinclude>{{Contributor | bio = '''Charmaine Spencer''' is a lawyer and adjunct professor with the Gerontology Research..."

<noinclude>{{Template:Clicklaw Wikibooks Contributor}}</noinclude>{{Contributor | bio = '''Charmaine Spencer''' is a lawyer and adjunct professor with the Gerontology Research Centre at Simon Fraser University. Charmaine wrote the [[Legal Issues in Residential Care: An Advocate's Manual]] on behalf of [[BC Centre for Elder Advocacy and Support | BC CEAS]].

| name = Charmaine Spencer
| image = [[image:avatar.JPG|150px|left|link=|Charmaine Spencer]]
| organization = Simon Fraser University, BC CEAS
| website = [http://www.sfu.ca/gerontology www.sfu.ca/gerontology]
}}
<noinclude>__NOGLOSSARY__
[[Category:Contributor Bio|S]]
</noinclude>

Acknowledgements for Legal Issues in Residential Care

2014-08-15T17:48:19Z

Seniors First BC:

{{Legal Issues in Residential Care: An Advocate's Manual TOC}}
This e-manual was researched and written by Charmaine Spencer. A special thanks to Martha Jane Lewis for spearheading the idea of the book, providing legal supervision and ongoing support.

In developing this e-manual we have drawn on the knowledge and experience of key stakeholders in health care and law, government agencies, community groups, family councils and in some cases residents themselves. These people have allowed us to identify key issues, content, and resources.

This e-manual is based on an approach first used by the Advocacy Centre for the Elderly (ACE) in Toronto, Ontario where their manual became a practical information tool useful to many stakeholders. We would like to thank ACE for the initial idea of creating the e-book as well as their support. We have drawn on their quarter century experience in legally advocating on behalf of older adults in long term care settings.

The BC Centre for Elder Advocacy and Support thanks all those individuals and organizations that generously gave their scarce time to participate in the review of the manual. Their comments and responses helped shape the final content. The special efforts given by lawyers Heather Campbell, Kevin Smith (BCCEAS), and Krista James (Canadian Centre for Elder Law) have been greatly appreciated.Thank you to Kim Carter and staff of the BC Ombudsperson Office, Community Legal Assistance Society (Mental Health Law Program), and Alison Leaney of the Public Guardian and Trustee Office.

We also benefited from the insights and support of advocacy staff at the Alzheimer Society of British Columbia, Al Jina (Park Place Seniors Living), Kim Slater and the Vancouver Island Association of Family Councils, and Sherry Baker, BC Association of Community Response Networks.

This project was made possible with financial support of the Law Foundation of British Columbia. The BC Centre for Elder Advocacy and Support gratefully acknowledges the Foundation for its generous support of this work.

{{REVIEWED | reviewer = [[BC Centre for Elder Advocacy and Support]], August 2014}}
{{Legal Issues in Residential Care: An Advocate's Manual Navbox}}

Seniors First BC

2014-08-15T17:47:28Z

Seniors First BC:

<onlyinclude>{{Servicebox
| service_description = The '''BC Centre for Elder Advocacy and Support''' (BCCEAS) is a non-profit organization helping older adults. They operate an Elder Law Clinic in Vancouver and a toll-free Seniors Advocacy and Information Line (SAIL) that provides information and referrals.

'''Website:''' Click on "[http://bcceas.ca/category/resources/ Resources]" for videos, fact sheets and a training manual.

| website = [http://www.bcceas.ca/ bcceas.ca]
| phone = 1-604-437-1940 <br /> Toll-free: 1-866-437-1940
| clicklaw_label = '''Find on Clicklaw'''
| clicklaw_address = [http://www.clicklaw.bc.ca/helpmap/service/1080 BCCEAS on Clicklaw HelpMap]
}}</onlyinclude>

==Clicklaw Wikibooks from BC CEAS==

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|- valign="top"
| [[File:Legal_Issues_in_Residential_Care_cover_image.jpg|x200px|link=Legal Issues in Residential Care: An Advocate's Manual]]<br /><div class="center">''[[Legal Issues in Residential Care: An Advocate's Manual|Legal Issues in Residential <br>Care: An Advocate's Manual]]'' </div>
|- valign="top"
|}

<noinclude>
__NOGLOSSARY__
__NOTOC__
</noinclude>

Acknowledgements for Legal Issues in Residential Care

2014-08-15T17:46:28Z

Seniors First BC:

{{Legal Issues in Residential Care: An Advocate's Manual TOC}}
This e-manual was researched and written by Charmaine Spencer. A special thanks to Martha Jane Lewis for spearheading the idea of the book, providing legal supervision and ongoing support.

In developing this e-manual we have drawn on the knowledge and experience of key stakeholders in health care and law, government agencies, community groups, family councils and in some cases residents themselves. These people have allowed us to identify key issues, content, and resources.

This e-manual is based on an approach first used by the Advocacy Centre for the Elderly (ACE) in Toronto, Ontario where their manual became a practical information tool useful to many stakeholders. We would like to thank ACE for the initial idea of creating the e-book as well as their support. We have drawn on their quarter century experience in legally advocating on behalf of older adults in long term care settings.

The BC Centre for Elder Advocacy and Support thanks all those individuals and organizations that generously gave their scarce time to participate in the review of the manual. Their comments and responses helped shape the final content. The special efforts given by lawyers Heather Campbell, Kevin Smith (BCCEAS), and Krista James (Canadian Centre for Elder Law) have been greatly appreciated.Thank you to Kim Carter and staff of the BC Ombudsperson Office, Community Legal Assistance Society (Mental Health Law Program), and Alison Leaney of the Public Guardian and Trustee Office.

We also benefited from the insights and support of advocacy staff at the Alzheimer Society of British Columbia, Al Jina (Park Place Seniors Living), Kim Slater and the Vancouver Island Association of Family Councils, and Sherry Baker, BC Association of Community Response Networks.

This project was made possible with financial support of the Law Foundation of British Columbia. The BC Centre for Elder Advocacy and Support gratefully acknowledges the Foundation for its generous support of this work.

{{REVIEWED | reviewer = BC Centre for Elder Advocacy and Support, August 2014}}
{{Legal Issues in Residential Care: An Advocate's Manual Navbox}}

Legal Issues in Residential Care: An Advocate's Manual

2014-08-15T17:42:31Z

Seniors First BC:

{{Cover Thumbnail
|filename = Legal_Issues_in_Residential_Care_cover_image.jpg
|title = ''Legal Issues in Residential Care: An Advocate's Manual''}}{{Clicklaw Wikibooks Badge}}
{{Export_Badge_BCCEAS
|SavedBookName = Legal_Issues_in_Residential_Care
}}
'''''Legal Issues in Residential Care: An Advocate's Manual''''' wikibook is from the BC Centre for Elder Advocacy and Support. Learn more about [[Clicklaw Wikibooks]].

== Contents ==

*'''[[Introduction and Forward to Legal Issues in Residential Care|Introduction and Forward]]'''
*'''[[Acknowledgements for Legal Issues in Residential Care| Acknowledgements]]'''

=== Chapter One - Statutory Framework ===

*'''[[Overview of Legal Issues in Residential Care|Overview]]
**[[Overview of Legal Issues in Residential Care#What is Residential Care?|What is Residential Care?]]{{·}}[[Overview of Legal Issues in Residential Care#When is it Residential Care?|When is it Residential Care?]]{{·}}[[Overview of Legal Issues in Residential Care#What is Complex Care?|What is Complex Care?]]{{·}}[[Overview of Legal Issues in Residential Care#Funding: Three Types of Facilities|Funding: Three Types of Facilities]]{{·}}[[Overview of Legal Issues in Residential Care#Knowing the Specific Parties|Knowing the Specific Parties]]

*'''[[Legal Frameworks of Residential Care|Legal Frameworks of Residential Care]]
**[[Legal Frameworks of Residential Care#The Statutory Framework for Care Staff|The Statutory Framework for Care Staff]]{{·}}[[Legal Frameworks of Residential Care#The General Statutory Framework in Residential Care|The General Statutory Framework in Residential Care]]

*'''[[Other Key Laws and Regulations in Residential Care|Other Key Laws and Regulations]]
**[[Other Key Laws and Regulations in Residential Care#Care|Care]]{{·}}[[Other Key Laws and Regulations in Residential Care#Financial and Related Matters|Financial and Related Matters]]{{·}}[[Other Key Laws and Regulations in Residential Care#Substitute Decision-Making|Substitute Decision-Making]]{{·}}[[Other Key Laws and Regulations in Residential Care#Privacy Matters|Privacy Matters]]{{·}}[[Other Key Laws and Regulations in Residential Care#Special Populations|Special Populations]]{{·}}[[Other Key Laws and Regulations in Residential Care#Rights, Remedies and Oversight|Rights, Remedies and Oversight]]{{·}}[[Other Key Laws and Regulations in Residential Care#Legislation Related to Funding|Legislation Related to Funding]]{{·}}[[Other Key Laws and Regulations in Residential Care#Professional Responsibility Laws|Professional Responsibility Laws]]{{·}}[[Other Key Laws and Regulations in Residential Care#Miscellaneous|Miscellaneous]]

*'''[[Chapter One Resources and Appendix in Legal Issues in Residential Care|Chapter One Resources and Appendix]]

=== Chapter Two - Residents' Bill of Rights ===

*'''[[Understanding the Bill of Rights and Residential Care|Understanding the Bill of Rights]]

*'''[[Key Bill of Rights Provisions for Residential Care|The Key Provisions]]
**[[Key Bill of Rights Provisions for Residential Care#Commitment to Care|Commitment to Care]]{{·}}[[Key Bill of Rights Provisions for Residential Care#Rights to Health, Safety and Dignity|Rights to Health, Safety and Dignity]]{{·}}[[Key Bill of Rights Provisions for Residential Care#Rights to Participation and Freedom of Expression|Rights to Participation and Freedom of Expression]]{{·}}[[Key Bill of Rights Provisions for Residential Care#Rights to Transparency|Rights to Transparency]]{{·}}[[Key Bill of Rights Provisions for Residential Care#Scope of Rights|Scope of Rights]]

*'''[[Protecting and Enforcing Rights in Residential Care|Protecting and Enforcing Rights]]

=== Chapter Three - Legal Issues in Admission and Transfer ===

*'''[[Introduction to Legal Issues in Admission and Transfer in Residential Care|Introduction to Legal Issues in Admission and Transfer]]
**[[Introduction to Legal Issues in Admission and Transfer in Residential Care#Basic Issues in Eligibility for Residential Care|Basic Issues in Eligibility for Residential Care]]{{·}}[[Introduction to Legal Issues in Admission and Transfer in Residential Care#Moving to Residential Care|Moving to Residential Care]]{{·}}[[Introduction to Legal Issues in Admission and Transfer in Residential Care#Costs|Costs]]

*'''[[Admission to the Residential Care Facility|Admission to the Residential Care Facility]]
**[[Admission to the Residential Care Facility#Agreeing to the Admission|Agreeing to the Admission]]{{·}}[[Admission to the Residential Care Facility#Demonstrating Consent|Demonstrating Consent]]{{·}}[[Admission to the Residential Care Facility#Assessing Capability to Consent?|Assessing Capability to Consent?]]{{·}}[[Admission to the Residential Care Facility#What Kind of Decision is Admission to a Residential Care Facility and Who Makes It?|What Kind of Decision is Admission to a Residential Care Facility and Who Makes It?]]

*'''[[Terms in Admission Agreements and Contracts in Residential Care|Terms in Admission Agreements and Contracts]]

*'''[[Common Legal Matters in Contracts in Residential Care Admission and Transfer|Common Legal Matters in Contracts]]
**[[Common Legal Matters in Contracts in Residential Care Admission and Transfer#Payment Default and Guarantees|Payment Default and Guarantees]]{{·}}[[Common Legal Matters in Contracts in Residential Care Admission and Transfer#Signing as a Substitute Decision-Maker (SDM)|Signing as a Substitute Decision-Maker (SDM)]]{{·}}[[Common Legal Matters in Contracts in Residential Care Admission and Transfer#Other Areas|Other Areas]]

*'''[[Contractual Protections in Admission and Transfer|Contractual Protections]]

*'''[[Consenting to Admission to a Care Facility|Consenting to Admission to a Care Facility]]
**[[Consenting to Admission to a Care Facility#Screening|Screening]]{{·}}[[Consenting to Admission to a Care Facility#Assessing Capacity for Admission |Assessing Capacity for Admission]]{{·}}[[Consenting to Admission to a Care Facility#Consent|Consent]]{{·}}[[Consenting to Admission to a Care Facility#Use of the Mental Health Act to Admit Older Adults to Residential Care|Use of the Mental Health Act to Admit Older Adults to Residential Care]]

*'''[[First Appropriate Bed Policy|First Appropriate Bed Policy]]
**[[First Appropriate Bed Policy#What is "Appropriate"?|What is “Appropriate”?]]{{·}}[[First Appropriate Bed Policy#The Effect of Declining an Offered Placement|The Effect of Declining an Offered Placement]]

*'''[[Advance Care Planning for Residential Care|Advance Care Planning]]

*'''[[Care Plans and Legal Issues in Admission and Transfer|Care Plans]]

*'''[[Admission Process for Special Individuals or Circumstances|Admission Process for Special Individuals or Circumstances]]
**[[Admission Process for Special Individuals or Circumstances#Admission of Veterans|Admission of Veterans]]{{·}}[[Admission Process for Special Individuals or Circumstances#Admission of Aboriginal Residents|Admission of Aboriginal Residents]]{{·}}[[Admission Process for Special Individuals or Circumstances#Admission of Spouses with Different Care Needs|Admission of Spouses with Different Care Needs]]{{·}}[[Admission Process for Special Individuals or Circumstances#Admission of Sponsored Immigrants Needing Care|Admission of Sponsored Immigrants Needing Care]]

*'''[[Chapter Three Resources and Appendix in Legal Issues in Residential Care|Chapter Three Resources and Appendix]]

=== Chapter Four - Legal Issues when Living in Residential Care ===

*'''[[Common Care Issues when Living in Residential Care|Common Care Issues]]
**[[Common Care Issues when Living in Residential Care#Care Plans|Care Plans]]{{·}}[[Common Care Issues when Living in Residential Care#Communication|Communication]]{{·}}[[Common Care Issues when Living in Residential Care#Care Conferences|Care Conferences]]{{·}}[[Common Care Issues when Living in Residential Care#Staffing|Staffing]]{{·}}[[Common Care Issues when Living in Residential Care#Quality of Care|Quality of Care]]{{·}}[[Common Care Issues when Living in Residential Care#Continence Care|Continence Care]]{{·}}[[Common Care Issues when Living in Residential Care#Risk Taking|Risk Taking]]{{·}}[[Common Care Issues when Living in Residential Care#Private Communication|Private Communication]]{{·}}[[Common Care Issues when Living in Residential Care#Paid Companions in Residential Care|Paid Companions in Residential Care]]{{·}}[[Common Care Issues when Living in Residential Care#Renovations and Closure of Facilities|Renovations and Closure of Facilities]]

*'''[[Six Pressing Issues when Living in Residential Care|Six Pressing Issues]]
**[[Six Pressing Issues when Living in Residential Care#Medications|Medications]]{{·}}[[Six Pressing Issues when Living in Residential Care#Control Over Visiting|Control Over Visiting]]{{·}}[[Six Pressing Issues when Living in Residential Care#Abuse and Neglect|Abuse and Neglect]]{{·}}[[Six Pressing Issues when Living in Residential Care#Resident to Resident Harms|Resident to Resident Harms]]{{·}}[[Six Pressing Issues when Living in Residential Care#Reporting Responsibilities|Reporting Responsibilities]]{{·}}[[Six Pressing Issues when Living in Residential Care#Restraints|Restraints]]

*'''[[Chapter Four Resources and Appendix in Legal Issues in Residential Care|Chapter Four Resources and Appendix]]

=== Chapter Five - Rights, Remedies and Problem Resolution ===

*'''[[The Need for Effective Remedies and Problem Resolution in Residential Care|The Need for Effective Remedies and Problem Resolution]]

*'''[[The Basic Recourse Process under CCALA|The Basic Recourse Process under CCALA]]
**[[The Basic Recourse Process under CCALA#Concerns About Raising Concerns|Concerns About Raising Concerns]]{{·}}[[The Basic Recourse Process under CCALA#Reporting Protections|Reporting Protections]]{{·}}[[The Basic Recourse Process under CCALA#Threats of Being Sued|Threats of Being Sued]]

*'''[[Starting Points for Problem Resolution in Residential Care|Starting Points for Problem Resolution]]
**[[Starting Points for Problem Resolution in Residential Care#Residents Rights|Residents Rights]]{{·}}[[Starting Points for Problem Resolution in Residential Care#Family and Resident Councils|Family and Resident Councils]]

*'''[[Operator Responsibilities in Residential Care|Operator Responsibilities]]

*'''[[Directing Residential Care Concerns to Health Authorities|Directing Concerns to Health Authorities]]
**[[Directing Residential Care Concerns to Health Authorities#Patient Care Quality Office|Patient Care Quality Office]]{{·}}[[Directing Residential Care Concerns to Health Authorities#Patient Care Quality Review Board|Patient Care Quality Review Board]]{{·}}[[Directing Residential Care Concerns to Health Authorities#Community Care Licensing Offices|Community Care Licensing Offices]]{{·}}[[Directing Residential Care Concerns to Health Authorities#Local Ethics Committees|Local Ethics Committees]]{{·}}[[Directing Residential Care Concerns to Health Authorities#The BC Care Aide and Community Health Worker Registry|BC Care Aide and Community Health Worker Registry]]

*'''[[Directing Residential Care Concerns to External Bodies|Directing Concerns to External Bodies]]
**[[Directing Residential Care Concerns to External Bodies#Directing Concerns to External Bodies|Directing Concerns to External Bodies]]{{·}}[[Directing Residential Care Concerns to External Bodies#Directing Concerns to Review Boards|Directing Concerns to Review Boards]]{{·}}[[Directing Residential Care Concerns to External Bodies#Addressing Systemic Concerns: BC Seniors Advocate|Addressing Systemic Concerns: BC Seniors Advocate]]

*'''[[A Final Note on Rights, Remedies and Problem Resolution in Residential Care|A Final Note on Rights, Remedies and Problem Resolution]]

*'''[[Chapter Five Resources and Appendix in Legal Issues in Residential Care|Chapter Five Resources and Appendix]]

=== Chapter Six - Consent and Capacity ===

*'''[[Introduction to Consent and Capacity in Residential Care|Introduction]]
**[[Introduction to Consent and Capacity in Residential Care#Consent: An Area of Confusion|Consent: An Area of Confusion]]{{·}}[[Introduction to Consent and Capacity in Residential Care#Mental Capacity to Consent|Mental Capacity to Consent]]{{·}}[[Introduction to Consent and Capacity in Residential Care#Presumption of Capability|Presumption of Capability]]{{·}}[[Introduction to Consent and Capacity in Residential Care#Misuses of Presumptions| Misuses of Presumptions]]{{·}}[[Introduction to Consent and Capacity in Residential Care#How is Capability Determined?|How is Capability Determined?]]{{·}}[[Introduction to Consent and Capacity in Residential Care#Understanding Tests of Incapability|Understanding Tests of Incapability]]

*'''[[Health Care Consent in Residential Care|Health Care Consent]]
**[[Health Care Consent in Residential Care#The Conditions of Health Care Consent|The Conditions of Health Care Consent]]{{·}}[[Health Care Consent in Residential Care#Who Must Seek Consent for Health Care?|Who Must Seek Consent for Health Care?]]{{·}}[[Health Care Consent in Residential Care#What is Meant by “Health Care”?|What is Meant by “Health Care”?]]{{·}}[[Health Care Consent in Residential Care#Consent Rights|Consent Rights]]{{·}}[[Health Care Consent in Residential Care#The Consent Process|The Consent Process]]{{·}}[[Health Care Consent in Residential Care#How Does a Person Give Consent?|How Does a Person Give Consent?]]{{·}}[[Health Care Consent in Residential Care#Exceptions to Requiring Consent|Exceptions to Requiring Consent]]{{·}}[[Health Care Consent in Residential Care#Health Care at the Margins|Health Care at the Margins]]{{·}}[[Health Care Consent in Residential Care#Areas of Confusion Around Health Care Consent in Residential Care|Areas of Confusion Around Health Care Consent in Residential Care]]{{·}}[[Health Care Consent in Residential Care#Information Rights|Information Rights]]{{·}}[[Health Care Consent in Residential Care#Exploiting Consent Loopholes?|Exploiting Consent Loopholes?]]

*'''[[Care Planning in Residential Care|Care Planning]]
**[[Care Planning in Residential Care#Consent and Care Plans|Consent and Care Plans]]{{·}}[[Care Planning in Residential Care#Rights Associated with Care Plan Consent|Rights Associated with Care Plan Consent]]{{·}}[[Care Planning in Residential Care#Advance Care Planning - Advance Care Plan and Advance Care Directives|Advance Care Planning - Advance Care Plan and Advance Care Directives]]{{·}}[[Care Planning in Residential Care#Consent and Advance Care Directives|Consent and Advance Care Directives]]{{·}}[[Care Planning in Residential Care#Common Areas of Misunderstanding for Advance Health Care Consent|Common Areas of Misunderstanding for Advance Health Care Consent]]

*'''[[Personal Care and Consent in Residential Care|Personal Care and Consent]]
**[[Personal Care and Consent in Residential Care#What is Personal Care?|What is Personal Care?]]{{·}}[[Personal Care and Consent in Residential Care#Determining a Resident's Capacity to Make Personal Care Decisions|Determining a Resident’s Capacity to Make Personal Care Decisions]]

*'''[[Other Consent Issues in Residential Care|Other Consent Issues]]
**[[Other Consent Issues in Residential Care#Intimacy and Sexual Relations|Intimacy and Sexual Relations]]{{·}}[[Other Consent Issues in Residential Care#What Constitutes Consent in the Context of Intimacy and Sex?|What Constitutes Consent in the Context of Intimacy and Sex?]]

*'''[[Chapter Six Resources and Appendix in Legal Issues in Residential Care|Chapter Six Resources and Appendix]]

=== Chapter Seven - Substitute Decision-Making ===

*'''[[Introduction: A Right to Decide in Residential Care|Introduction: A Right to Decide]]

*'''[[Types of Substitute Decision-Making in Residential Care|Types of Substitute Decision-Making]]
**[[Types of Substitute Decision-Making in Residential Care#Statutory Substitutes - Temporary Substitute Decision-Making for Health Decisions|Statutory Substitutes - Temporary Substitute Decision-Making for Health Decisions]]{{·}}[[Types of Substitute Decision-Making in Residential Care#Other Tools by Which People are Given Authority as Substitutes|Other Tools by Which People are Given Authority as Substitutes]]{{·}}[[Types of Substitute Decision-Making in Residential Care#Court Appointed Substitutes - Adult Guardianship/Committeeship|Court Appointed Substitutes - Adult Guardianship/Committeeship]]{{·}}[[Types of Substitute Decision-Making in Residential Care#Substitute Decision-Making Through Instructions - Advance Care Directives|Substitute Decision-Making Through Instructions - Advance Care Directives]]

*'''[[Chapter Seven Resources and Appendix in Legal Issues in Residential Care|Chapter Seven Resources and Appendix]]

==About the BC Centre for Elder Advocacy and Support==

The BC CEAS is a non-profit charitable organization located in British Columbia, Canada. We are committed to:

* Protecting the legal rights of older adults;
* Increasing access to justice for older adults;
* Informing the public about elder abuse; and
* Providing supportive programs for older adults who have been abused.

:[[File:BC Centre for Elder Advocacy and Support Logo.jpg|frameless|none|300px|link=]]

:1199 West Pender Street
:Vancouver, BC V6E 2R1
:Telephone:604.688.1927
:Email: info@bcceas.ca
:Website: [http://www.bcceas.ca www.bcceas.ca]

{{Legal Issues in Residential Care: An Advocate's Manual Navbox}}
{{Creative Commons for BC CEAS
|title = Legal Issues in Residential Care: An Advocate's Manual
|author=
}}

__NOTOC__
<noinclude>__NOGLOSSARY__</noinclude>
[[Category:Navigation Page]]
[[Category: Legal Issues in Residential Care: An Advocate's Manual]]

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2014-08-15T17:42:05Z

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Key Bill of Rights Provisions for Residential Care

2014-08-15T17:03:23Z

Seniors First BC: /* Scope of Rights */

{{Legal Issues in Residential Care: An Advocate's Manual TOC|expanded = chapter2}}

==Commitment to Care==

1. An adult person in care has the right to a care plan developed

:(a) specifically for him or her, and
:(b) on the basis of his or her unique abilities, physical, social and emotional needs, and cultural and spiritual preferences.

Section 1 emphasizes a commitment to using an individualized approach to whatever care and support will be provided to the resident, and how it will be provided. The approach to care is expected to be shaped by the resident’s unique abilities (who they are and have been, what they are able to do, where they are able to make their own decisions, and where they may need some support). The approach to care is expected to focus on more than just the person’s physical needs, but also their emotional and social needs as a person. The resident’s cultural and spiritual preferences are also important.

Social needs might include, for example who they prefer to sit with at the dining room, who they want to associate with within the facility, their continued connection with friends or the community, or who they do not like to visit. In some cases, requirements in the residential care regulations can affect the opportunities that an operator and staff have to provide more individualized care and support.([[{{PAGENAME}}#References|1]])

Cultural and spiritual preferences include opportunities to participate in the facility or outside in activities or rituals meaningful to that resident. Cultural preferences may also include matters such as food preferences, alternative or complementary therapies, their preferred method of information sharing, and preferred approach to end of life care.

==Rights to Health, Safety and Dignity==

2. An adult person in care has the right to the protection and promotion of his or her health, safety and dignity, including a right to all of the following:

:(a) to be treated in a manner, and to live in an environment, that promotes his or her health, safety and dignity;
:(b) to be protected from abuse and neglect;
:(c) to have his or her lifestyle and choices respected and supported, and to pursue social, cultural, religious, spiritual and other interests;
:(d) to have his or her personal privacy respected, including in relation to his or her records, bedroom, belongings and storage spaces;
:(e) to receive visitors and to communicate with visitors in private
:(f) to keep and display personal possessions, pictures and furnishings in his or her bedroom.

Section 2 identifies how the resident is to be treated. The key aim of the section focuses on the care facility’s role to promote each resident’s dignity, health, and safety, as well as safeguard residents if these rights or freedoms are being infringed. These three (dignity, health, and safety) are inter-related concepts that often work together. Several types of specific rights are identified in this part including: autonomy rights and non- discrimination; self expression and recognition of personhood and life history; rights to communication and association; freedom from abuse or neglect, as well as protection from these harms.

There are many areas of care where dignity is involved. One is continence care (assistance going to the bathroom). The British Columbia Ombudsperson noted:

:''“As with eating, going to the bathroom is one of the most basic of personal needs. Failing to respond to this need in a timely way offends human dignity. To ensure fair treatment, a specific standard should be established that balances the needs of seniors, the expectations of families and the capacities of facility operators.”'' ([[{{PAGENAME}}#References|2]])

A second area key to promoting dignity in residential care is the use of physical, chemical or environmental restraints. As the British Columbia Ombudsperson has noted:

:''“Regardless of the circumstances or the method used, restraining someone reduces that person’s individual liberty and affects his or her dignity.”''([[{{PAGENAME}}#References|3]])

===Privacy===

Section 2 acknowledges and protects personal privacy is several contexts (privacy when receiving care, privacy in communication, privacy in physical space and environment, and privacy of personal information and records). “Privacy” in residential care has several related meanings, including the right to be treated in a dignified manner when receiving care, irrespective of whether a person seems to be mentally aware, and the right to control over certain aspects of one’s life (e.g. meals, visitors, mail, information, records). In other contexts, privacy can mean the right be left alone (e.g. to choose to not participate).

In section 2, safety is viewed as one important consideration but it is not the only consideration. Personal privacy needs to be respected in all aspects of the residents’ lives. Common examples of respecting privacy in residential care include when staff and others:

* provide personal or health care (e.g., putting in dentures) in private, not in public areas of the facility
* knock before entering the resident’s room, and waiting for the resident to answer
* ask permission before cleaning a resident’s room or anything else that belongs to the resident, or touch a resident’s personal belongings.

Respecting privacy in residential care is often shown by what people do not do. That includes, for example, when staff:

* do not use the resident’s possessions (e.g. wheelchair or walker) for someone else without their permission,
* do not share personal and confidential information about the resident without consent, or
* do not talk with each other unnecessarily about residents’ lives.

Issues about limits on personal privacy issues can come when care facilities ban smoking or alcohol consumption by residents. Sometimes an operator may try to enforce the policy by having the staff search a resident’s room under pretext of “cleaning”, and seize “contraband” possessions without permission.In some cases, family members’ possessions might be searched. Whether these are reasonable limits will depend on the particular circumstances, the actions taken and the specific risks involved.

Physical privacy is often an issue for residents in the private hospitals which tend to have double and quadruple occupancy rooms for residents. Privacy is becoming an increasingly important issue in residential care because of developing technologies that allow for continuous monitoring of a person, falls detection, as well as video surveillance by family or the operator.

==Rights to Participation and Freedom of Expression==
[[File:African senior.jpg | right | frame | link=| <span style="font-size:60%;">Copyright www.shutterstock.com</span>]]
3. An adult person in care has the right to participate in his or her own care and to freely express his or her views, including a right to all of the following:

:(a) to participate in the development and implementation of his or her care plan;
:(b) to establish and participate in a resident or family council to represent the interests of persons in care;
:(c) to have his or her family or representative participate on a resident or family council on their own behalf;
:(d) to have access to a fair and effective process to express concerns, make complaints or resolve disputes within the facility;
:(e) to be informed as to how to make a complaint to an authority outside the facility;
:(f) To have his or her family or representative exercise the rights under this clause on his or her behalf.

Section 3 focuses on the president’s personal involvement and family involvement in the resident’s individual care and the broader systemic issues affecting this resident and others in the facility. It recognizes autonomy, and joint decision making in care. Each resident has the right to participate fully in making any decision concerning any aspect of his or her care, including any decision concerning his or her admission, discharge or transfer to or from a long-term care home or a secure unit and to obtain an independent opinion with regard to any of those matters.

Section 3 stresses the importance of residents being able to freely express views, plus participate in the development and implementation of any plans for their care. It includes personal and supported involvement, where the resident and family shape the care by working with the staff and have a right to accept, revise or turn down what is being proposed. The term “family” here means whomever the resident wants to include. Section 3 of the Bill of Rights also recognizes resident and family councils as important mechanisms to help improve individual and collective care within the facility.

Section 3 also stresses the importance of residents, family or representatives having effective opportunities and avenues for raising concerns if and when problems arise, as well as having these addressed at that point. In many cases, that right can only be exercised by first knowing about the internal and external complaint mechanisms. However the mechanisms must also be appropriate to the circumstances of residents and others advocating on their behalf.

==Rights to Transparency==

===Rights to transparency and accountability===

4. An adult person in care has the right to transparency and accountability, including a right to all of the following:

:(a) to have ready access to copies of all laws, rules and policies affecting a service provided to him or her;
:(b) to have ready access to a copy of the most recent routine inspection record made under the Act;
:(c) to be informed in advance of all charges, fees and other amounts that he or she must pay for accommodation and services received through the facility;
:(d) if any part of the cost of accommodation or services is prepaid, to receive at the time of prepayment a written statement setting out the terms and conditions under which a refund may be made;
:(e) To have his or her family or representative informed of the matters described in this clause.

Section 4 of the Bill of Rights focuses on information that is expected to be readily available for the resident and family. The terms “transparency and accountability” in the title is somewhat unorthodox, in that the term is more commonly used in the context of government actions.

Information expected to be available from the operator would include fees, charges, and rules, internal and external policies. The information expected to be available from health authorities and Ministry of Health would include specific information on the facility (inspection record), laws affecting residential care, plus any health authority, or Ministry of Health or other Ministry rules and policies that apply in this area. In theory, access to this information aids self advocacy or advocacy on behalf of the resident.

One of the positive features of this “right to access” is that it may reduce problems in interpretation. People can see both the wording and rationale behind the policy, which may help in understanding whether a different (e.g. less restrictive, more supportive) approach could be used with a particular resident or residents generally.

Some parts of Section 4 are consumer rights (e.g. s. 4 (c) and (d); these may look out of place in a Bill of Rights. However, this explicit statement is intended to address a common problem raised by the BC Ombudsperson Office of when residents moved into a care facility without knowing the costs, or what services were included. Residents and families are often unaware of Residential Care Rate Structure, or Rate Reductions and Waivers.([[{{PAGENAME}}#References|4]])

==Scope of Rights==

This section sets out the scope of the rights, describing what limitations, if any, there are on the listed rights.

5. The rights set out in clauses 2, 3 and 4 are subject to:

:(a) what is reasonably practical '''given the physical''', mental and emotional circumstances of the person in care,
:(b) the need to '''protect''' and '''promote''' the health or safety of the person in care or another person in care, and
:(c) The '''''rights of other persons in care'''''.

The Scope of Rights section is very notable in that there are only two identified “limits” on the residents’ rights. The first is the person’s capabilities (for example, which might make it difficult to actively participate). The second justifiable limit under the Bill of Rights is ''where it can be demonstrated'' that an action to respect one resident’s right would negatively affect the health and safety of another resident or the rights of others residents. The needs or interests of staff or the provider are not relevant in this context and are not a legitimate limit on these rights. Mere possibility or conjecture that it might affect other residents’ health or safety would not be acceptable limits.

==References==
#See RCR, s. 64 (1) Food Service Schedule.
#Ombuds, Best of Care.
#Ombuds, Best of Care.
#Ombuds Best of Care.

{{REVIEWED | reviewer = BC Centre for Elder Advocacy and Support, June 2014}}
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Acknowledgements for Legal Issues in Residential Care

2014-08-15T16:54:48Z

Seniors First BC:

{{Legal Issues in Residential Care: An Advocate's Manual TOC}}
This e-manual was researched and written by Charmaine Spencer. A special thanks to Martha Jane Lewis for spearheading the idea of the book, providing legal supervision and ongoing support.

In developing this e-manual we have drawn on the knowledge and experience of key stakeholders in health care and law, government agencies, community groups, family councils and in some cases residents themselves. These people have allowed us to identify key issues, content, and resources.

This e-manual is based on an approach first used by the Advocacy Centre for the Elderly (ACE) in Toronto, Ontario where their manual became a practical information tool useful to many stakeholders. We would like to thank ACE for the initial idea of creating the e-book as well as their support. We have drawn on their quarter century experience in legally advocating on behalf of older adults in long term care settings.

The BC Centre for Elder Advocacy and Support thanks all those individuals and organizations that generously gave their scarce time to participate in the review of the manual. Their comments and responses helped shape the final content. The special efforts given by lawyers Heather Campbell, Kevin Smith (BCCEAS), and Krista James (Canadian Centre for Elder Law) have been greatly appreciated.Thank you to Kim Carter and staff of the BC Ombudsperson Office, Community Legal Assistance Society (Mental Health Law Program), and Alison Leaney of the Public Guardian and Trustee Office.

We also benefited from the insights and support of advocacy staff at the Alzheimer Society of British Columbia, Al Jina (Park Place Seniors Living), Kim Slater and the Vancouver Island Association of Family Councils, and Sherry Baker, BC Association of Community Response Networks.

This project was made possible with financial support of the Law Foundation of British Columbia. The BC Centre for Elder Advocacy and Support gratefully acknowledges the Foundation for its generous support of this work.

{{REVIEWED | reviewer = BC Centre for Elder Advocacy and Support, June 2014}}
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