Follow
Share

Over the past 6 months, 1 client has recurring bouts of C Diff. The family wishes to keep this quiet and not let anyone there know about their Mother's condition. Is there a moral responsibility to notify the facility management in order to protect the other residents?

This question has been closed for answers. Ask a New Question.
Just about sign away your confidentiality when you're in a public nursing facility. A hospital and nursing home require signs for patients that need extra precautions. I don't see how this is any different.
Helpful Answer (0)
Report

My mom had C-Diff when we were caring for her in her own home. That is an unmistakable odor. I can't imagine a health care professional not recognizing it. Unless there are varying degrees to the condition that I'm not aware of. It was a dreadful odor. That has been my experience. Even if no one could detect it, I would think it'd be best to be completely transparent about this.
Helpful Answer (0)
Report

YES YOU HAVE TO REPORT IT. This place ought to be shut down if they keep it quiet, this will be headline news in the local paper and lawsuits galore when it gets out. It's like Typhoid Mary, harboring the disease and silent about it so she could make her 50 cents a day or whatever, as a cook, and killing untold numbers of people  - like, shhhhh keep it under your hat!
Helpful Answer (1)
Report

Every individual who has come in contact with this person with C-Diff MUST be made aware of it. Plus, if they visit the person, they must wear a protective article of clothing. And while I know that this  is not a hospital setting, I will just say that they are loaded with germs/infections and it's not uncommon for people to pick them up.
Helpful Answer (2)
Report

My dad just got out of a rehab facility where the flu hit hard. At first it was just the ones that had the flu that were sequestered in their rooms then EVERY patient had to be whether they had the flu or not. Nurses, aids, housekeep, and visitors had to wear masks before they were even allowed in. If I found out one of my dad's roommates had the flu or C-dif the facility would have moved dad or the roommate to a different room! Could be the family doesn't want to bother or deal with this. If anyone in that facility gets it without knowing Big Time law suit!! If you don't want to get in trouble with the family do it anonymously. But management NEEDS to know. Who cares about the &%#@ family?? They certainly don't care about anyone else!!
Helpful Answer (4)
Report

Did the patient's family give you this information? Try talking to them first and advising them of their responsibility to other residents in the facility.
I would see it as their responsibility to inform management. It would seem to be a legal obligation so that to other residents plus staff can be protected. Tell them they could face legal action if others are affected because of this infection.
How does the family know about this infection? Who diagnosed it? does the family not want Mom to be not isolated or are they afraid she will be asked to leave if she has a communical disease?
I don't know if this is a notifiable disease but will do a search and come back if it is..
Helpful Answer (2)
Report

You have a right to have your private business kept private. Do you know if the person next to you on the bus has TB, HIV, one of the Heps, meningitis, head lice..? Should people be required to wear different coloured badges according to which bugs they're carting around on them?

In all institutions where the spread of infection among immuno-compromised or otherwise vulnerable people is a critical problem the answer is good infection control, and that in turn benefits from good reporting structures. But if individuals can't rely on their medical records being confidential they will go to considerable lengths to conceal symptoms and that becomes incredibly problematic. This here ALF should have clear Standard Operating Procedures so that all care and nursing staff know what to do in a given situation, but since they haven't, or anyway haven't told this independent caregiver what they are, she'd better run and find out.
Helpful Answer (2)
Report

You can't just ignore a duty of confidentiality because it feels like the right thing to do for the greater good. CNAs cannot discuss their clients' confidential business with anyone without their clients' express permission; and this lady could get not just fired but sued if she does. She needs to get advice and instructions from people at a higher level of authority.
Helpful Answer (2)
Report

Legalities and HIPAA... really...?   I don't know, so I'm curious how this would work.  

From the common sense perspective:  how would anyone here feel about their mother or father contracting C dif in their independent living because one resident didn't want that info out...? Some things fall under "protecting the common good." I don't know the particular legal language, but I would be astonished if this type of incident would fall under some HIPAA protection.

This can endanger other residents, actually potentially lead to deaths of other residents. That can't be protected, can it...?
Helpful Answer (0)
Report

C dif is commonly traded around any institution like a senior residence building or hospital.

Tell them immediately. She probably contracted it from there to begin with. Only when everyone is on board can they take the precautions needed to contain it.
Helpful Answer (1)
Report

Well - DUH!

If you're asking, it's because you know you have to. Good Golly, isn't it highly contagious? I'd worry about contracting it myself.

Lord have mercy - go tell the desk 'yesterday'.
Helpful Answer (2)
Report

Check out cdc.gov for their recommendations. C. difficile infections can occur more easily in the elderly when antibiotics are overused. The infection is spread by contacting a person (even if they don't seem sick) or a surface or even laundry. Make sure ALL your clients are bathing regularly and are wearing clean clothes. Caregivers should wear gloves when picking up dirty laundry and while cleaning bathrooms.
Helpful Answer (0)
Report

Kathy - I’m going to approach this from another angle...... to me there are 2 different but intertwined issues: what IL means and what your legal standing & exposure (pun intended) is in all this.

This is Independent Living, right? If so, residents should have an anticipation of total privacy but within whatever terms of the contract of the IL. If the signed by the resident contract requires management to be informed of a communicable disease, then the resident or their dpoa needs to let them know. It’s not your position to tell management or other residents.

I’d imagine as it’s an IL, They have their own apt, efficiency or mini townhome, so it’s all separate living from others. They are not sharing a room or bathroom. If they don’t want to interact with their neighbors or go to the daily communal meal or shopping trips, arts & crafts activities, etc. they don’t have to. If this is what’s happening, their self segregating, so risk of their chronic C. diff spreading is low. Hopefully their doing this. But whatever the case, I’d suggest that you in writing express your concerns as a caregiver to the dPOA as to the Universal Precaution standards (like G’ma1954 wrote) required for C Deff.

How you do the letter depends on how you are hired. If your with an agency, they will have a reporting system, which you need to follow. Most agencies have taken a new look at all this now due to flu outbreak 😷 😷. But if your an independent contractor, well I’d be concerned that if the c Deff spreads your going to be blamed for enabling spread and will loose your other clients. You’d be toast on getting new clients too.

Jjariz is spot on about concerns for liability. Can you resign C Deff client?
Helpful Answer (3)
Report

I'm not sure why the family would object except there is something in the contract that would not allow their loved one to be in the facility or have to be quarantined because of this. C-diff is nothing to hide or be casual about, protective measures need to be in place for everyone that deals with this patient. It is sooooo dangerous to every person that comes in contact with it. I bet that the facility has a hippa release that covers their right to know. If not who in their right mind would work or place loved ones there? Oh no big deal, he has aids and likes to spit at people but we don't want anyone to know, ya think! It is your obligation as a caregiver to protect all of your patients and this means telling about this highly contagious infection, you just do not know the immune system of every person coming through the facility or if they have good hygiene, how would you feel if a new mom made a delivery then went to her car where dad and baby were waiting, starts breastfeeding never having washed her hands and ends up in the ER with a dying baby, all because the family wants to keep it quite. Have you seen the measures hospitals take with c-diff patients? Sorry to rant but, honestly I am beyond freaked out at this family and you to risk others lives by this hiding of a potential death sentence to others. I bet they could be sued to the moon if someone dies from this undisclosed communicable infection and you can bet that every single person at the facility from room cleaner to administrator will be named. You do have a moral obligation to protect others in the facility, paying resident or paid employee all the same.

I pray you read this then go make a 6 month long wrong, right. Please do this before someone dies.
Helpful Answer (4)
Report

You have to follow HIPPA regulations If the facility is not on a list that they can be informed of medical conditions you can not legally inform them. You might also check the regulations of the facility. If it states in their regulations that they must be informed of any "communicable disease" then you would have to tell the family that they have to inform the facility or you will have to.
It may also depend upon who you are being paid by. Is it the family or the facility? This would determine who your employer is.
You can however place a cart by the door and require everyone that enters the room to put on a gown, a mask and and gloves. (I bet they would get the idea)
You also need to follow Universal Precautions entering this room then going into the other rooms.
Helpful Answer (6)
Report

I had to look it up and found this definition for "C Diff." : Clostridium difficile (klos-TRID-e-um dif-uh-SEEL), often called C. difficile or C. diff, is a bacterium that can cause symptoms ranging from diarrhea to life-threatening inflammation of the colon.
Helpful Answer (5)
Report

My dad passed away with C-Diff. You have to have pre-cautions in place. Bleach kills the spores on surfaces like the toilet, light switches, railings, handles on wheelchairs, door knobs, etc., washing clothes and the person that has it has to have medication and have a probiotic. Yogurt and probiotics put back the good bacteria that were killed by antibiotics. It is good to eat a good yogurt everyday and or take a probiotic on a regular schedule even if you do not have c-diff.
Helpful Answer (2)
Report

I think you'd better consult the infected client's doctor on where to draw the line between your duty of confidentiality and your duty of disclosure. You have a real ethical dilemma and I don't blame you for finding it difficult to know what to do.

Meanwhile, since this has been going on for six months and your other two clients are fine, your infection control procedures are evidently iron-clad. Well done. Trouble is, what if other people's aren't?
Helpful Answer (5)
Report

Yes, you absolutely must make them aware as this can be life threatening to the elderly and those with underlying medical disorders (I know, I'm one of them). Often times the facilities don't want to know on the record because they need to report cases in some states.
You said your patient has reoccurring bouts of C-diff? My loved one had this same problem after catching it in a hospital after surgery several years ago. He had it over & over again, more like a chronic condition. They'd put him on the antibiotic, and usually a probiotic. Once his symptoms subsided, they'd take him off all the meds. He didn't stop having episodes of C-diff until he stayed on the probiotic (his was florastor) after the infection was gone. He's been on the florastor for almost a year without any further occurrences of C-diff. You might want to try leaving your client on the probiotic full-time. Best of luck to you and your patient!
Helpful Answer (3)
Report

Who diagnosed this? It should absolutely be part of her medical records and the facility should be informed. Her overall care could be changed due to this diagnosis and the precautions that are necessary to protect herself and others will be set in place.
Helpful Answer (5)
Report

Oh goodness, yes please inform management. That person should not be sharing a bathroom with other people. Management can take the appropriate precautions and maybe even use this as an opportunity to provide staff education on infection control and c.diff precautions. While infection control in services are mandatory twice a year (if I remember correctly) it certainly cannot hurt to assure new & old staff are re-trained on proper hand washing and infectious waste removal.
I would inform them ASAP as everyone in the place is at risk. 
Helpful Answer (9)
Report

IMO, yes. Other caregivers are taking care of all the patients.
As I remember, C Diff is not killed by alcohol hand gel. You HAVE to wash with soap and water.
If no other nurses or aides know, are they using the gel thinking everything is OK?

If it was YOUR mother in the next bed would you want to know?
Report it.
Helpful Answer (11)
Report

Definitely they should know. C. Diff in the elderly can be life threatening. Everyone should be taking extra sanitary precautions. I caught both C. Diff and MERSA when I worked in an ER in 2005. Both could have been prevented if the facility had been made aware early on.
Helpful Answer (11)
Report

If your loved one was in this facility how would you want it handled?
Moral, legal, whatever, the facility management should absolutely know this. Why don't they already? Pretty serious thing to be dealing with--special hygiene precautions should be in place.
Helpful Answer (9)
Report

I'd worry more about the legal responsibility.
Helpful Answer (6)
Report

This question has been closed for answers. Ask a New Question.
Ask a Question
Subscribe to
Our Newsletter