A Caregivers Perspective on an the

Patient’s Bill of Rights

Author: Mark Parkinson RPh:  President  AFC-CE

Credit Hours 1- Approximate time required: 60 min.


Educational Goal:

To present an alternative utilitarian point of view of the Patient’s bill of rights. 

Educational Objectives:

Present the patient’s bill of rights as a communication tool that needs to be better utilized by care homes.

Suggest alternative wording to the tradition wording of the patient’s bill of rights. 


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   The information presented in this activity is not meant to serve as a guideline for patient management. All procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this article should not be used by care providers without evaluation of their patients’ Doctor. Some conditions and possible contraindications may be of concern. All applicable manufacturers’ product information should be reviewed before use. The author and publisher of this continuing education program have made all reasonable efforts to ensure that all information contained herein is accurate in accordance with the latest available scientific knowledge at the time of acceptance for publication. Nutritional products discussed are not intended for the diagnosis, treatment, cure, or prevention of any disease.



A Caregiver’s Perspective on the

Patient’s Bill of Rights

Image result for caregiver frustrationAdult foster care homes are a business in which the borders on the individual’s rights tend to blur. It’s easy to start your business thinking you will respect the rights of each and every resident in your care. Related imageBut when you’re in the caregiving trenches day after day, it becomes easier for caregivers to cross the line. Corners get cut, caregivers get burned out, patients get difficult to manage, and the rights of individuals become forgotten.


Government officials understand the pitfalls and pressures of caregiving. That is why the Patient’s Bill of Rights was written and its principles enforced. It is the government’s job to ensure that the rights of all individuals are not forgotten. That’s what we the people hired them for: to protect everyone’s rights.   

Caregivers in adult foster care homes are in a special situation in regards to the rights of individuals. By establishing a business in your home and being eligible for government reimbursements for services (Medicare and Medicaid), we agree to give up some of our individual rights. We agree to have the government control some of our actions, and we agree to choose the rights of residents over our own.

I remember when the Patient’s Bill of Rights started to be enforced in my care homes. It got my patriotic dander up. I was angry. This was MY home, MY life, MY rights. I was raised by ultra-conservative spud farmers from Idaho who taught me not to let the government take away any of my rights. I was young, reactionary, and stupid. Over the years, I have come to realize that I got it all wrong.

Take a closer look at the Patient’s Bill of Rights. It’s more than a list of dos and don’ts. It’s a guide to good caregiving, it’s the doorway to excellent customer service, and it’s a gold standard for business practices.  Instead of being restrictive, it’s a shield. It prevents bad thing from happening to you, your residents, and your business. It’s time to take another look at the Patient’s Bill of Rights from a wiser point of view.

Looking from a Different Point of View

I advise you to review the Resident’s Bill of Rights not from the perspective of an administrative rule the government is forcing you to comply with but rather as a caregiver tool - a tool that will make you a better caregiver and make your care business healthier. Do it right and your residents and their families will be happier customers. Doing it right leads to easier caregiving and a stronger business.

The following are excerpts from the Oregon Department of Human Services publication A Guide to Oregon Adult Foster Care Homes, page 7. I have written a few of my thoughts on how to use these to make you a better caregiver and healthier business. Hopefully they will inspire you to see the Patient’s Bill of Rights as the potent caregiver tool that it is so you can make your own career-improving observations.

 The Resident’s Bill of Rights

When you move into an adult foster home, you do not give up any of your civil rights nor any rights as an Oregon citizen. Caregivers must respect your privacy, dignity, independence and your right to make choices. Each adult foster home must post the Residents’ Bill of Rights in the home and discuss those rights with each resident at the time of admission.

My Notes:

When a resident moves in, the orientation / welcome speech includes all of the thoughts above except rewrite it to sound more like a quality of care guarantee.  Something like:

Welcome to our home. We want it to feel like your home, too. You will not have to give up any of the rights and civil privileges that you have become used to as an Oregon citizen. We as your caregivers guarantee your privacy and independence to make choices and will do everything in our power to maintain your dignity.  We are going to post this promise of your Resident’s Rights for everyone to see. If you have any questions or concerns, just ask us. Or you can have anyone else check up on us. We want the whole world to know how we are striving to take care of you and your rights.

(I give you permission to copy any or all of “My Notes” for your own or business use.)

All residents have the right to:

(a) Be treated as adults with respect and dignity;

(b) Be informed of all resident rights and all house policies;

My Notes:

We guarantee that you have the following rights:

(a) We will treat you as an adult; that means you will be treated respect and dignity.

(b) We will make sure you understand all your resident rights and all our house policies so that you will be comfortable and secure here.


(c) Be encouraged and assisted to exercise constitutional and legal rights including the right to vote;

(d) Be informed of their medical condition and the right to consent to or refuse treatment;

(e) Receive appropriate care and services and prompt medical care as needed;

My Notes:

(d) We will inform you of any medical condition that comes to our attention. We will work for you in dealing with them. If you do not want or are concerned with any treatment, we will work as your advocate to find another treatment that you are not opposed to. We believe you have the right to refuse any treatment. 

(e) We guarantee that you will receive all needed care and services as soon as possible.


(f) Be free from abuse;

(g) Complete privacy when receiving treatment or personal care;

My Notes:

(f) You have a right not to be abused from any person or business. If you feel threatened or taken advantage of from any source, tell us or someone else. We will be your advocate in protecting you. If you feel we are abusing you, please let us know so we can correct and improve our methods. If you feel uncomfortable talking to us directly, please talk about it with someone else.

(g) Just like in your own home, we will maintain your privacy when you receive personal care and treatments.


(h) Associate and communicate privately with any person of choice and send and receive personal mail unopened;

(i) Have access to and participate in activities of social, religious and community groups;

My Notes:

(h) We want you to feel you can associate and communicate with any person you choose to, and we will help provide the means to do so. We will deliver your mail to you unopened as soon as we receive it.

(i) We will help you have access to and participate in social, religious, and community activities.


(j) Have medical and personal information kept confidential;

(k) Keep and use a reasonable amount of personal clothing and belongings, and to have a reasonable amount of private, secure storage space;

My Notes:

(j) Your privacy is very important to us. We will not knowingly reveal any personal or medical information to unauthorized personnel without your permission.

(k) We want you to feel free to bring in with you any personal clothing and belongings. It will make the transition easier for you. You can bring as many things as there is room for, and we will do our best to keep your belongings safe and secure.


(l) Be free from chemical and physical restraints except as ordered by a physician or other qualified practitioner. Restraints are used only for medical reasons, to maximize a resident’s physical functioning, and after other alternatives have been tried. Restraints are not used for discipline or convenience;

My Notes:

(l) We want you to be safe and secure here in our home. We have set things up so you will be free from chemical and physical restraints of any kind except those that are deemed medically necessary by a qualified medical practitioner. As your advocate, we will ensure that any restraints ordered by your doctor will only be for your safety and physical wellbeing. They will be used only after other alternatives have been tried. We promise that restraints will never be used as a punishment or for our convenience.


(m) Manage their own financial affairs unless legally restricted;

(n) Be free from financial exploitation. Providers must not charge or ask for application fees or non-refundable deposits or solicit, accept or receive money or property from residents other than the amount agreed to for services; 

My Notes:

(m) You will be able to manage your own financial affairs to the full extent of the law.

(n) We want you to be free from financial exploitations. You will never be charged for hidden fees or non-refundable deposits. We will not ask for or accept any money or property other than what we have both agreed to for our services. We also want to protect you from others who would financially exploit you. If you feel threatened or coerced in any way by anyone, please tell us and we will help you make things right as long as you live with us.


(o) A written agreement regarding services to be provided and the rates to be charged. Providers must give at least 30 days’ written notice before a rate change and before any change in their home’s ownership;

(p) Not to be transferred or moved out of the adult foster home without 30 days’ written notice and an opportunity for a hearing. Providers may transfer residents only for medical reasons or for the welfare of the resident or other residents, or for nonpayment;

My Notes:

(0) We will provide a written agreement for the services we will give you. Our rates will be clearly written. We will let you know at least 30 days in advance of any changes to our agreement.

(p) We further promise never to transfer or move you out without at least a 30-day notice unless it is medically necessary, or for the safety and welfare of the other occupants of the home or for nonpayment. You have the right for a hearing regarding the transfer.


(q) A safe and secure environment;

(r) Be free of discrimination in regard to race, color, national origin, gender, sexual orientation or religion;

My notes:

(q) We feel you have a right to feel safe and secure, and we will do everything in our power to make it that way.

(r) You have a right not to be discriminated against. We do not care what race, color, national origin, gender, sexual orientation, or religion you are. You will be treated equally and fairly by us.


(s) Make suggestions or complaints without fear of retaliation; and

(t) Be free of discrimination in regard to the execution of an advance directive, Physician’s Order for Life-Sustaining Treatment (POLST) or do not resuscitate (DNR) orders.

My Notes:

(s) We want to be continually improving. We want you to help us by making suggestions. Rest assured that we will never retaliate for any complaint you have about anything.

(t) We respect the choices you make. We will honor and obey any advance directive, Physician’s Order for Life-Sustaining Treatment (POLST), or do not resuscitate (DNR) orders.


The Caregiver’s Perspective

In order to survive and thrive, adult foster care homes have to be able to turn restrictions into advantages. Seeing the resident’s rights as a guide to quality caregiving is one way to do that. It also helps you set a performance standard for training purposes, and it can be a real marketing asset if cooperated with instead of fought against.  One note of caution before you post your own version of the Resident’s Bill of Rights: Check with your local government agency. Even if the agency won’t allow any modification, you can still be creative when you explain the Bill of Rights to your residents.

Related image


The Resident’s Bill of Rights is more than just a list of dos and don’ts. It’s a standard of caregiving and a resource that can be used to elevate your care home to the next level. I suggest that instead of fighting against it or brushing over it, creatively embrace it. Use it to make your caregiving career all that much better.

As always, good luck in your caregiving

Mark Parkinson



  1. Residents' Rights. The National Long Term Care Osbudsman Resource Center. http://ltcombudsman.org/issues/residents-rights
  2. Resident’s Rights: An Overview. The National Consumer Voice for Quality Long-Term Care. March 2007. http://theconsumervoice.org/uploads/files/long-term-care-recipient/ResidentRights.pdf
  3. Adult Foster Home General Information. Rouge Valley Council of Governments, Senior and Disability Services. http://www.homecarechoices.org/adultfh1.htm#Bill of Rights

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