Question

Joseph Vidrine
Joseph is a 66-year-old resident of the facility. He was admitted to
Fontenot a little over a year ago after he had suffered several minor
strokes. He requires close monitoring and some assistance with dressing
and bathing, but is able to get around independently. Joseph is from
Mamou, a rural community that has limited long-term care services.
Hence, his sister decided that Fontenot would be the best place to meet his
needs. Joseph never married but had a few long-term relationships over the
course of his life. He participates in several activities and helps out with

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minor chores at the facility. He also enjoys transporting residents in
wheelchairs to and from the dining room. Joseph is personable, outgoing,
and friendly.

Phyllis Landry
Phyllis was born and raised in Opelousas and has never lived anywhere
else. She is an attractive and vivacious 70-year-old woman who has been
living in the nursing home for the past 5 years, ever since she was
widowed. Her husband died of complications in the aftermath of an
automobile accident. Phyllis is a severe diabetic and has some cardiac
issues resulting from her diabetes that had remained uncontrolled before
she was admitted to Fontenot. Otherwise, she is alert, oriented, and mobile.
She needs assistance with her insulin injections, monitoring of her heart
condition, and treatment of occasional minor bruises. After the loss of her
husband, she had no source of income and had to go on Medicaid. She is
alone, with no children or relatives living nearby. Phyllis is an outgoing
individual. Many of the male residents find her attractive, but she has not
expressed an interest in other men since her husband’s death. She does
miss having a man to take care of her, though. Before moving into
Fontenot, Phyllis was an active member of the community. Now she
enjoys helping out at birthday parties and other social activities held at the
nursing home.
Joseph and Phyllis became friendly during BINGO games when
Joseph would pay more attention to her game than his own and make her
win. Gradually, they found themselves physically and emotionally
attracted to each other. Joseph feels that Phyllis needs him because she had
once stated that she liked men who take charge, which reminded her of her
late husband. Joseph and Phyllis have started spending more and more
time together. Now they commonly refer to each other as boyfriend and
girlfriend. From time to time they get into arguments when Phyllis feels he
is ignoring her or when Joseph believes she is not following his advice.

Nancy Leblanc
Nancy, a 36-year-old female, was admitted to Fontenot about 4 months

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ago after being in and out of the hospital a few times because of
complications from her AIDS diagnosis. She was assigned to share the
room with Phyllis. Nancy has four children between the ages of 3 and 15
who live with Nancy’s mother in another state.

Jealousy and Tensions
Joseph has been frequently visiting Phyllis and Nancy in their room.
Phyllis, however, feels that he pays more attention to Nancy, which then
leads to arguments between Phyllis and Joseph and creates tensions
between all three. During the arguments, Joseph innocently points out that
he is only helping a new resident better adjust to the nursing home
environment. At times, Joseph has been found sitting outside on the swing
with Nancy or helping her mark off her cards at the BINGO games. More
recently, Joseph has been inviting her to join him during snack time.
Nancy too likes Joseph’s company and enjoys her walks with him on
Fontenot’s grounds where flowers are in full bloom.
Joseph has told some of the staff that Phyllis is too controlling and that
they have broken up their relationship. Phyllis, however, still refers to him
as her boyfriend and accompanies him to some of the activities and social
events. Joseph and Nancy, on the other hand, have said to the staff that
they are just friends and like to hang out together.

Just Friends?
The other day, a CNA on her lunch break saw Nancy sitting in the garden
with her legs crossed over Joseph’s lap, but she did not think much of it.
Another resident told the social worker that she “caught them” sitting in a
“lovers’ position” and they were startled. Two members of the Kiwanis
Club also saw “something” and were a little taken aback and mentioned it
to the administrator. One resident told the activity director that he thought
Joseph and Nancy “go a little too far” in their public displays of affection.
Another resident was amused when he recounted, “Just the other day Joe
was grabbing at her as they walked down the hall.”

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Spillover and Commotion
Phyllis accosts the administrator in the hallway and asks, “What kind of a
place is this? Isn’t it against nursing home rules?” She has also commented
to some other residents, “They both need to be thrown out of this place.”
When Phyllis confronts Nancy about her relationship with Joseph, Nancy
adamantly denies there is anything romantic and states that they are just
friends. When she confronts Joseph, however, he retorts, “You have been
giving me a hard time, Phyllis, and I have news for you—Nancy and I are
gonna have a baby, and we’re gonna get married.” Phyllis could not
believe it. She seems devastated, and the social worker has to calm her
down. But, when asked why she was so upset, she simply refused to talk.
At the next resident council meeting, Phyllis makes a bold appeal that
both Joseph and Nancy are a disgrace and must be ousted from the facility.
In response, Joseph barked at her, “Just shut up.” The president of the
resident council told the activity director that there were some real bad
feelings between Joseph and Phyllis just because Joseph liked Nancy.
Later the same day, in a fit of rage, Phyllis throws Nancy’s few
belongings out into the hallway and curses incessantly for several minutes.
Several staff members, a few residents, and two visiting volunteers gather
at the scene to witness the commotion. The social worker, activity director,
and administrator are called to the scene; they take the three residents apart
to calm the situation. The social worker, activity director, and
administrator together hold counseling sessions with the three residents
who are threatened with eviction for disrupting the facility’s living
environment. The social worker is adamant that Nancy and Phyllis should
no longer stay in the same room, but both residents have refused to
separate.

Mother, I Am Pregnant
Approximately a month later, Nancy’s children and mother, Colette, arrive
at the nursing home to visit Nancy. With great enthusiasm Joseph
announces to them his plans to marry Nancy. Taking Colette aside, Nancy
quietly whispers, “Mother, I am pregnant.” Nancy’s mother and children
are shocked and infuriated. Without saying a word, Colette heads straight
to the administrator’s office and demands answers. The administrator is

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equally shocked at the news, and the meeting does not go well. Colette
wants to know why the facility has failed to fulfill its responsibility to
protect its residents. She declares that she is ready to meet with a lawyer to
sue the facility. Finally, in a burst of anger, she screams out, “Who will
take care of this baby? You?” She stomps out of the administrator’s office.
Taking her grandchildren, she leaves the facility.

Should it be against the facility’s rules for residents to pursue
romantic relationships? How should a nursing home policy address
resident conduct?
2. Based on the information on the romance between Joseph and
Nancy, what, if anything, should the nursing home administrator
have done? Did the facility have an obligation to inform Joseph that
Nancy was HIV positive?
3. Did the facility have a right to move Nancy or Phyllis to a different
room even though both had refused to move?
4. Does Nancy’s mother have any rights in this situation? Does the
threat of a lawsuit have merits? Is the nursing home liable for
Nancy’s pregnancy?
5. How should the administrator handle Nancy’s pregnancy? What role
would some of the department heads have?

Answer 1

1.The residents who are staying in the nursing homes who needs medical care most of the time can be found with a new relationship in the facility itself. Romantic relationship cannot be restricted by a policy,facility, nursing centers ,etc., when both the individual are aware of the outcome and consent for it.A nursing home while admitting residents should have got a consent regarding the sexual intimacy or romantic relationship and inform them to abide to it.In case of misconduct as per tye the policy ,rules and regulations appropriate actions will be taken. Recently some of the centers have got legal authority that these type of relationship are every individual's personal choice and an external force cannot intrude.

2.The nursing home should protect a resident from any type of of abuse (physical,verbal ,sexual abuse)They have no obligation to disclose a confidential medical condition of one resident to other. But these type of scenario can put Joseph to contract a deadly infection with the knowledge of the facility by not alerting and protecting the residents.

3.No, the facility have no rights to move the resident from their room if they both mutually accept it.In certain cases this is not practicable and applicable where two residents in the same room can cause any injury ,assault, abuse to one another.

4.Nancy's mother have no direct rights in this situation because the resident is a major and can take decision if mentally sound and solely responsible for any consequences out of the incidents. Tye lawsuit can hold merits because as tye resident is infectious the responsibility of taking care of tye newborn goes to spouce or close family members.Here the mother has to take responsibility of this child too where she has no legal obligation to necessarily accept it.The nursing home cannot be liable because the pregnancy is a result of known action by the resident.