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My mother was transfered from a Hospital to a Rehabilitation Center around 7:30 pm last night As her daughter and legal representative I stayed with her to complete and sign all the documents for admision and almost at 11:30 pm y askd if they need some more information or something else need to be one the nurse say No. For my Surprise today I requested an airmatress and the nurse supervidsor said that following her pictures she might not b able to get. a airmatress. I asked what pictures she was talking about and I could saw some of them of my nude mother breast, groint, and butt. I aske why I was not informe so I can decide or not to have those pictures taken and why they wait unto I left to take the pictures.The answer from the nurse is that as a policy of the clinic they need to take pictures of any possible wound. I felt almost violated as if the pictures were taken to me taking in considertion that my mom have ALzaimer. No further comments were done by the clinic personel , just that they will come back to me. I stay all day until 9:00pm and nobody gave me an answer about that policy or SOP of the clinic. Is this a legal issue? Do somebody has gone trouigh this situation? Hope to hear some feedbacks as Im to the point to take her out from there tomorrow morning. Thanks!

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@chimonger - yep "informed" is the key word here...My mom's in a n.h. & I brought her 3 cupcakes from Publix for V.Day - Sat we visited & they were nowhere to be found - she never mentioned she ate the cupcakes never mentioned them at ALL in fact - but I found out quickly do NOT bring in anything valuable - heck even clothes that are labeleld w/mom's name don't get returned to her sometimes! But back to the topic, yep, "informed" is what it's all about!
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If someone is sleeping, or, being moved about in the bed to do bedding or nightgown changes, getting bathed, etc., pictures these days can be taken
and the patient does not even realize it's being done.
[[gotta love technology]]
Maybe the staff thot she might be too upset if she knew it was happening.

OR....she may have been in a confused state related to the move [very common], and it got done before she had her wits back
--in which case, even a person who normally remembers and tells all, could forget to mention that,
and may not ever remember it--even if staff DID try to inform her.

Pictures document skin condition at time of entry to facility:
---as protection for both facility and patient.
---it means the difference between getting coverage for special equipment or treatments for skin conditions, for instance

IMHO, that facility was NOT following proper procedure, IF they failed to inform a sentient, conscious patient that they were taking pictures of her body as part of hospital procedure--it would have been proper to inform the POA, too.
"Informed" is part of that process
...sounds like they MIGHT have failed to inform either her or the POA.
That is a kinda significant omission, IMHO, if they forgot to do that.

They do need to document any skin conditions that might warrant an air mattress or special bedding or treatment,
in order to get insurance to cover it
--otherwise, those special items come out-of-pocket,
NOTE: Families can never be sure equipment, clothes, other items will stay in the patient's room for their use--I have seen all sorts of patient equipment get moved, used by other patients, whether it was paid for by insurance or out-of-pocket.
Other mobile patients wander in and move things; staff in a bind needing equipment in a hurry, might borrow something like a wheelchair or walker, etc., and it gets forgotten to return, and does not get found until later...
.
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Um, @chimonger - I guess in some facilities they do - but WHY didn't they take pics of my mother - I KNOW they didn't because mom would defiantely have told me if they had. She tells me everything & that she definately wold've told me!
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Yep. SOP. THough, pictures should be carefully framed to allow who it is, yet, not be too revealing. It is about protecting institution and patient both.
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our PTs often use photos of wounds not just for liability but also to document progress or lack thereof in wound care - it can be a lot more helpful as well as more efficient than measuring and describing verbally, and you don't end up wondering if it really is smaller or better or worse than last time you looked. These go in the medical record and are "protected health information" under HIPAA as noted above.
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Since you stayed with your mother to "complete and sign all the documents for admission", I'm hoping you have copies of what you signed. If you do - check over them carefully. It's my guess that somewhere in there you gave permission for photographs to be taken (either on, or shortly after admission), as this is fairly standard procedure. However, if this is the case, you should raise your concerns and insist that at the very least that the paperwork is properly explained to you before you sign it (this will not obviously help you - but it may help others in the future). If you don't have copies - ask for them - you are entitled !! And lastly, if you did not give consent - take it further. If they can do this - what else will they do ??
Oh, and consider moving Mom if this is the case, and at all possible - you only get one Mom, and she's worth it. Good luck. Let us know how you get on.
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@purplesushi I'm fully aware it wasn't "nude" pcs, HOWEVER I fully believe they should've asked/let her know they were going to take those pics! Im a Certified Medical Assistant & Hospice volunteer so I'm aware of all of that! When I said my husband was going to make sure we'll or more importantly ME sinceI'm 11 yrs younger, he meant moving to a retirement village so I'll be ok when his time comes, oh, & BTW, I'm proactive enough that when Dad was in the same facility as mom's in, I drove mom to her lawyer's ofc to draw up new DPOA & Healthcare Surrogate "just in case" & boy am I glad I did that - because now look what's happened...
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@krusso, it wasn't "nude pictures" of her mom, per se - they took pictures of the WOUNDS on her mother's body - there is a huge difference. It appears that the family was not properly informed of the nursing home's procedures and policies, and while unfortunate, their taking pictures of the wounds is not illegal if her mother did not have an Advanced Directive or Medical POA signed stating she was unable to give her consent. If they obtained her mother's signature, it is perfectly within bounds. If she felt her mother did not have the capacity to make an informed decision, then a medical POA should have been obtained prior to needing one, or at the very least a family member should have been there when her mother was transferred to the SNF and should have been present to ask questions & voice concerns at that time. Your husband is correct in wanting to get all the necessary paperwork done ahead of time so there are no questions about who will do what when the time comes. Unfortunately, most people don't think of these things until the time is NOW, and then it is too late in some circumstances.
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Well, TheirDaughter, intersting isn't quite the word I'd have used. Taking pics of her mom nude IS out of bounds - esp w/o her consent or knowledge!!!Whether getting old sucks or not is not the issue - this woman is in a terrible situation & I was there w/Dad & there right now w/mom!!!when mom was admitted & because she had "capacity"someone walked in, said Mrs. Simonetti, can you sign some paperwork? she said ok, or something like that, & that was that! Can't guarantee this won't happen to ANY of us - hubby (he's 11 yrs older than me - I'm 52)he wants us to get our $hit together NOW before we're in that situation. But like I said, Nochoice29 should get legal council if she feels it's necessary.
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This is really interesting. When I first read it I thought it sounded way out of bounds. However, it's helpful to read the responses. Still, getting old really sucks. It seems like you lose so much control over everything and I hope this doesn't happen to my mom or me at some point.
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You should probably ask to speak to the facility director about your concerns.
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My mother I think was admitted around 6:30 pm - I don't think it should matter when a patient is admitted - same rules should apply - unless of course it's 3 in the morning - duh, but otherwise 7:30 pm is still withiin reasonable hours. Irregardless of "normal" staff or not it shouldn't matter - in a good rehab center there are rules & procedures & I don't think pictures WITHOUT the family's consent was ok at all.
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This could have been handled better but
Seeing she was addmitted "after hours"
They staff wouldn't normally do it.
They should have tried to been a bit
Modest with taking the photos.

The thing odd to me is they said no to
A low loss mattress .....due to the
pictures....... usually pictures are used
To document something......they are
Documenting something that is not
there?

Low loss can be used for other things...
How about the heel of the feet..etc?

Another reason is if she must be in bed and
a whole host of other things.....talk to the
Dr about it.....he is the one that will have
to sign the rx.

Good luck
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Nochoice29 - Ummmm, ok, this tells me a lot. My mom was admitted to a "rehab ctr" aka "nursing home" ugh, BUT, the ONLY way you knew it was my mom's paperwork was by her initials O.S. first name is Olga - I was NOT there when they had her sign the paperwork & because of that, they took control of her social security, which is back in my hands as rep payee - thank God I take after Dad (he passed on in late '09)Took me a solid SIX months to get ONE lousy social security check back to mom - but the home never took any pictures, HOWEVER, since they were taken WITHOUT your permission or knowledge, I would consult an elder care lawyer - Pronto! Purplesushi may be right, but they SHOULD have told you! God, what is wrong with these "rehab centers" - Ugh!!!Personally I HATE the one mom's in, the only reason she's there is because it's between their home & ours & Dad was there, so when mom got sick I thought she'd have that "connection." If my husband needs care he's NOT going to this home! But anyway, yes, if I were you I'd pursue this since they're pictures of your mom nude - granted they're wounds, but when my mom had wounds on her palm, leg, etc., even a pressure sure on her bottom, the NEVER took pictures - I'm sure I'd have heard about that one - mom tells me everything - which is good! Take care & try to breathe, Nochoice29...
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Unless their legal department or clinic director can show you the policy I too would take my mother out of there. As a nurse, I can understand why they took photos, to make sure no one could say they had caused injury, but as your mom's legal rep, you needed to have been informed, and signed off on this practice. I had my mother at a nursing care facility and they did not take photos. Consult an attorney if you are still feeling uneasy. My best to you and your mother.
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Never thought about this being done, but it makes sense...however, I think it should be openly and frankly discussed with the patient if they are able to understand or with the caregiver so there are no surprises. The fact that no one would discuss this with you makes be very uncomfortable. It's sad that in this sue-happy world, we all have to be subjected to what may appear to be invasive actions which might strike fear into anyone...especially a patient with dementia!
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My experience has been that facilities tell LO/caregivers many things after the fact; no longer wait until after the fact if possible...review and keep a copy of the "patient rights."
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"I stayed with her to complete and sign all the documents for admision..." ---NoChoice29

A document informing you of the photography possibility and/or seeking your approval, was probably among those documents you signed for admission.
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This is absolutely the policy now, and they should have informed you of this. The photos are used to document the condition your mother was in when she arrived at the center (this eliminates the "she didn't have that ____when she got here...." arguments or accusations) and also to compare against later to document the progress of the wound healing. Look at the admission paperwork - there should be a HIPAA-mandated notice within that paperwork that states photos may be recorded to document care, etc., and either your mother or an authorized representative signed this form prior to her admission. HIPAA laws forbid the photographs from being released to anyone not directly associated with your mother's care without her consent. Welcome to the digital age.
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Photos like this are pretty standard and when you do the paperwork for them for admission there is a release to allow for this or a waiver of liability on it. It is SOP by & large. They could have handled it better but it may have been a very difficult, erratic situation at the time for all involved. You probably don't have an opt-out on it either if this is considered within standards of care in your area.
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If I were you and my Mom needed one of those air mattresses you can just buy one online. My Mom never had any sores but I have her on a hipsaver pad all the time. I hope they at least covered up parts of her, sounds ridiculous but I have heard of it too, crazy. good luck
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I understand the importance of taking pictures of of bruises, sores, etc. but ONLY with the permission of the caregiver or the patient if the patient is lucid. It should have been discussed and if you are not comfortable of the way this was handled...speak up now! It is important to establish boundaries of what is acceptable and do not just accept it as "normal". What else is "normal" to them that could be unacceptable to you or your loved one? You are there to oversee the care your loved one is receiving...
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While I can understand a nursing home/rehab center wanting to protect themselves against those that would frivoulously suing, it it unconscionable that they did not inform you of this policy and ask if you wanted to be present during the exam. We as consumers -- especially in the healthcare field dealing with nursing homes, assisted living and in-home caregivers -- need to become better educated and learn to ask questions no matter how inconsequential they may seem
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Yes, as my husband was moved from the Hospital to the Rehab Center, after filling out several forms, the nurse gave me a permission form to sign, that they can check him out and take pictures of any bruises, sores etc. for documentation. It is for their protection, and I understood that, especially since he had hurt his knee the day before the stroke. It's also for your benefit, if something shows up later then you are able to point out that this is new and it happened while your mother was in their care.
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This happened to my mother when she was admitted to the ER from a nursing home. The ER used them to show me that the nursing home was neglecting their duties with my mother and I used them to make a complaint with the Ombudsman as well as to get her into another facility.

It sounds to me like it is a standard practice, but if you have any questions ask the Ombudsman to investigate.
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Perhaps it is standard policy to take pictures but unless the wounds are actually on her private parts, they should be very judicious about how they take the photos. In older days, we simply documented in writing and measured wounds. I can't imagine that pictures actually tell more of the story, especially depth and wound character, unless they have a very special camera and skills. But I guess the 'cover your butt' legal atmosphere has taken over. Still, pictures should provide for the patient's modesty and dignity. It may be the policy, but if the pictures were too intrusive and you feel that her privacy was violated, you could register a complaint with them to make them more sensitive about how they take those pictures.
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I believe this is pretty standard nowadays. Your mother's pictures are proof of her condition at the time of entering the facility. Should she become worse, there is proof that the condition worsened while in their care. Should she become better - there is also proof of that. The former is the liability issue the nurse spoke of. These pictures are part of your mom's record and should normally be kept safe and secure by the facility.
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I do know when my Mother was moved from the hospital to Rehab Facility two nurses came in to "look at" her and they had a camera. We ask what was going on. We were told they have to document any wounds, bruises,bedsores, etc. upon arrival. They were very gentle and checked Mother over thoroughly. She had nothing of interest and no pictures were taken. '

The nurse later explained it was for liability issues and had Mother a wound, this way they could be sure of its progress while there. You know, this is what it looked like when she got here and now it looks like this.

It made perfect sense, they need to know what they are dealing with in order to help the patient.
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