Punishment and Involuntary Isolation

Have you ever noticed that in almost every facility that there is a group of residents that are sitting in wheelchairs or other chairs near the nursing stations of hallways?  These residents either need constant supervision or in some cases, they’ve been placed there by nurses and CNAs that needed a ‘break’.

Some residents that wander are sometimes placed in chairs with personal alarms attached to their clothing and the chair.  When the resident tries to stand and walk away, the alarm sounds.  The resident is then placed back in the chair. While this can often be a safety precaution, it can sometimes be used as a way to ‘punish’ a resident for wandering around the home.  Most of the time, residents are not confined in this way, but it has happened.

Punishment is when any resident is put in a situation that restricts them from any activity based on their previous behavior, much like a child is punished when they have done something a parent or caregiver considers wrong or bad. Federal regulations are in place to protect nursing home residents from this type of action.  If a resident is found to be suffering punishment at the hands of staff, the staff member and home can be fined up to losing their license and perhaps facing imprisonment.

Involuntary isolation can be used by staff without realizing that is what they are doing.  When a resident is placed in their room for any reason other than by request (or personal care/sleeping), or in another area where they are isolated from other residents – this is involuntary isolation.  Sometimes this happens when a resident is being very loud or behaving in a bizarre manner.  A CNA or nurse will place the ‘misbehaving’ resident in their room until they ‘quiet down’.

While no harm may be meant, it is not only illegal, but unfair to the resident. Being left alone with no human interaction can exaggerate their behavior from the emotional stress of isolation which in turn may lead to even more isolation. Before placing a resident alone in their room or other area think on how you would feel if you were left in an area alone – no one to talk to, nothing to do, and possibly away from your call bell.  Residents with dementia may not realize they even have access to a call bell if one is given to them.

If you are unsure if a resident is being isolated unfairly, you may wish to speak with your supervisor. If you are still unsure or are afraid to come forward, you can make an anonymous call to your local health department with your concerns.