Nursing Homes: Informed Consent for Residents
All adults, including nursing home residents, have the right to help decide what medical care they want to receive. If an adult cannot make their own choices because of a mental or physical condition, only an appointed representative for that adult can give consent.
By law, health care providers must explain health conditions and treatment choices to the patient or their representative. This is part of a process called "informed consent."
Some health care requires written consent. This means the patient or resident has signed a form stating they understand their condition and the proposed treatment, and that they agree to the treatment.
Not all medical treatments require written informed consent. Still, health care providers should make every effort to explain a treatment and ensure the patient or resident understands.
FAQs (frequently asked questions)
All residents have a right to be informed about their care and to take part in care planning. Wisconsin Admin. Code ch. DHS 94 requires written informed consent for residents being treated for:
- Alcohol abuse or dependency.
- Developmental disability.
- Mental illness.
- Other drug abuse or dependency.
Wisconsin Stat. § 50.08 also requires written informed consent for any resident with a degenerative brain disorder (such as Alzheimer's disease) who needs a psychotropic drug that requires a black box warning. View Informed Consent for Psychotropic Medications for Nursing Home Residents.
A degenerative brain disorder is the loss or dysfunction of brain cells to the point that the person cannot adequately provide their own care.
See Wis. Stat. § 55.01(1v) for the state's formal definition.
Psychotropic medications with a black box warning require written informed consent.
"Psychotropic medication" means an antipsychotic, an antidepressant, lithium carbonate, or a tranquilizer. See Wisconsin Stat. § 50.08(1)(d).
A black box warning is the most severe medication warning required by the U.S. Food and Drug Administration. All antipsychotics and antidepressants, as well as many other psychotropic drugs, have a black box warning. It's sometimes called a "boxed warning" or a "black label warning." It's named for the black border around the warning.
Yes, if the medication is a psychotropic medication and has a black box warning, you must get written consent. If the resident refuses, the drug may need to be stopped. This may take some time if the medication needs to be reduced gradually.
Wisconsin Stat. § 50.08(4)(a) allows oral consent to be used before written consent if:
- An emergency puts a resident at risk of physical or emotional harm.
- A resident puts others at risk of physical harm.
- Time and distance make it impossible to get written informed consent before giving the medicine.
- A physician has determined that the resident or others will be harmed if the drug is not given before written informed consent is obtained.
Oral consent must be entered in the resident's medical record and is valid for 10 days.
The nursing home must make a good faith effort to get oral consent from the patient's appointed representative. If the nursing home isn't able to reach the representative, the nursing home may give the medication for up to 24 hours.