If a resident refuses care, what should you do?

• A. Force care to complete task
• B. Respect autonomy, explain purpose, document refusal, report to nurse, offer alternatives if possible
• C. Ignore refusal and proceed
• D. Blame the resident

Answer: (B)

When a resident refuses care, the important idea is to honor their right to autonomy while keeping safety and communication at the forefront. Start by calmly acknowledging their decision and briefly explain the purpose of the care and its potential benefits so they can make an informed choice. If they still refuse, document the refusal clearly in the chart with the date and time, what was refused, and any reason the resident offered. Then report the refusal to the nurse or supervisor so they can assess and determine next steps. Offer alternatives if possible—for example, a different time, a less invasive method, or adapting the approach—while respecting the resident’s wishes. Do not coerce or force care, do not ignore the refusal, and do not blame the resident. If the resident has cognitive impairment or lacks decision-making capacity, follow facility policy and involve the appropriate surrogate or power of attorney as needed, ensuring any decisions align with advance directives.