How should a facility handle a resident who refuses a recommended treatment?

• A. Coerce the resident to accept the recommended treatment
• B. Respect the resident's decision if they have capacity, document the refusal, provide information on risks and alternatives, involve family as appropriate, and reassess capacity if needed
• C. Ignore the refusal and proceed
• D. Immediately seek court order without discussion

Answer: (B)

Respecting a resident’s autonomy and ensuring informed decisions when they have capacity is the key idea. If a resident understands the recommended treatment, its risks, benefits, and alternatives, and can appreciate the consequences of their choice, they have the right to accept or refuse. The best approach is to honor the decision while making sure it’s informed: openly discuss what the treatment involves, what could happen if they choose not to proceed, and any reasonable alternatives; answer questions clearly; and document the refusal in the chart. Involve family or a trusted support person as the resident desires or as appropriate for support, and reassess the resident’s capacity if questions about understanding arise or circumstances change.

If a resident lacks capacity to decide, involve the appropriate surrogate decision-maker or legally authorized representative and follow the resident’s known preferences or best interests. A court order is not the first step and is used through proper legal channels when needed, rather than as an immediate response. This approach protects the resident’s rights, supports informed choice, and helps prevent coercion.