Basic Client Rights

All people have human, civil, and legal rights regardless of any disease, disability, or condition.
They keep their rights when they move into a residential facility and/or begin to receive long-term care services. Federal and state laws specifically protect the rights of vulnerable adults.
Person-centered care promotes these rights by giving choice and control to the person who is receiving support. By knowing, promoting, and protecting client rights, you help them maintain safety, independence, self-respect, and dignity.

Freedom from Abuse and Neglect

Clients have the right to live free from abuse. Sadly, vulnerable adults are often the victims of abuse.
Each year, Adult Protective Services and facility compliance agencies investigate over 39,000 reports
of abuse and neglect. As a Home Care Aide, you must understand, recognize, report, and prevent abuse. See Module 5, Lesson 2: Mandatory Reporting and Preventing Mistreatment on page 101 for the facts about abuse and your responsibilities.

Self-Determination

The loss of home, work, strength, function, and/or health can limit a person’s sense of freedom and
independence. A client’s well-being and quality of life depend on them continuing to make decisions
about their daily lives. All clients have the right to control their life decisions, including the right to:

direct their own service plan and changes in the service plan;
refuse treatment, medications, or services;
choose their activities, schedules, clothing, and hairstyle;
participate in religious, political, civic, recreational, and other social activities;
decide who they want to spend time with and when;
decide what they want to eat and when; and
refuse to perform services for others such as housework or yardwork. Home Care Aides support these rights by knowing the client’s preferences and honoring their choices. You can learn about a client’s preferences from their service plan and by communicating with them. Sometimes a client may make a choice you do not personally agree with. However, unless they ask you to do something inappropriate or unsafe, you must respect and follow their choices.

Balancing a Client’s Right of Choice and Safety

Clients have the right to make their own choices, even if those choices are not the healthiest or safest. Consider these examples:

Example 1: Sasha lives with diabetes, and they want to eat a bag of candy for lunch.
Example 2: Dani has not taken a shower for several days and does not want to take a shower today, either.

When a client’s personal choice could be unhealthy or unsafe for themselves or others, follow these
steps:

Explain to the client why you are concerned.
Offer safe alternatives that could meet the client’s desire while allowing them to make the final choice.
Report your concerns to the appropriate person in your care setting (the client’s preference will be noted in the service plan).
Document your concerns, what you did, and who you reported it to. How could you follow these guidelines to balance choice and safety in the examples of Sasha and Dani?

If you are concerned that a client’s actions put them or others in immediate danger, call 911.

A Client’s Right to Make Healthcare Decisions

This has been addressed previously by a video earlier in the module, but this is a very important topic and deserves to be re-iterated.

In Washington State, all adults have the right to make their own decisions about medical care. Before receiving treatment, the client must understand the purpose, benefits, alternatives, and potential risks. The client’s healthcare provider explains these. Then, the client decides whether they want the treatment or not. This process is called “Informed Consent.” The client’s service plan explains services and treatment that the client has consented to receive. However, the client has the right to accept or choose not to receive any treatment at any time.

The Right to Refuse Treatment

Clients have the right to refuse treatment, medications, or services at any time. No one can force a client to do anything the client does not want to do. If a client refuses treatment, medications, or
services, follow the guidelines for balancing choice and safety (explain your concerns, offer safe alternatives, report, and document). For more information about a client choosing not to take medication, see Module 11, Lesson 2: Medication Assistance and Medication Administration on page 245.