Staff Contact

North Carolina Division of Aging and Adult Services

Definitions

1. Abuse means the willful (A) infliction of injury, unreasonable confinement, intimidation, or cruel punishment with resulting physical harm, pain or mental anguish; or (B) deprivation by a person, including a caregiver, of goods or services that are necessary to avoid physical harm, mental anguish, or mental illness. (Older Americans Act, Section 102 [13])



2. A Complainant is an individual who files one or more complaints with the ombudsman program.



3. A Complaint is a concern brought to, or initiated by, the ombudsman for investigation and action by or on behalf of one or more residents of a long term care facility relating to health, safety, welfare or rights of a resident. One or more complaints constitute a case. (Administration on Aging, National Ombudsman Reporting System)



4. Durable Power of Attorney is a document in which you give someone the legal authority to act for you. You may name your spouse, an adult child, a relative, or trusted friend to be your agent. The actions of your agent authorized by your power of attorney are considered legally to be your actions.



5. Financial Exploitation means the illegal or improper act or process of an individual, including a caregiver, using the resources of an older individual for monetary or personal benefit, profit or gain. (Older Americans Act, Section 102 [26])



6. Guardianship may be necessary if a person becomes incapacitated, either temporarily or permanently, their family, friends, business associates, creditors, or the state may need to petition the court to have them declared incompetent and to have a guardian appointed. The following are 3 types of guardianship.
• A guardian of the estate manages your property and business affairs.
• A guardian of the person performs duties relating to your care, custody, and control. A guardian of the person has the right to approve medical, psychological, legal, or other professional care and treatment.
• A general guardian takes care of both your property and your person.



7. Health Care Power of Attorney is a person who would have the right to control the decisions about a person’s medical care. To make these decisions, you must be competent and able to communicate. If a person is not competent or able to communicate, someone else must make these decisions for them. A health care power of attorney allows a person to choose who will make medical decisions for them if they cannot make them themselves.



8. Incompetent adult means an adult or emancipated minor who lacks sufficient capacity to manage the adult’s own affairs or to make or communicate important decisions concerning the adult’s person, family, or property whether the lack of capacity is due to mental illness, mental retardation, epilepsy, cerebral palsy, autism, inebriety, senility, disease, injury, or similar cause or condition. (North Carolina General Statute 35A-1101) (*Competence is a legal presumption. A court can only override competence. It is a decision made by a clinician-usually by physician. NC Division of Aging and Adult Services Legal Resource Center)



9. Involuntary Seclusion means separation of a resident from other residents or from his or her room against the resident’s will or the will of the resident’s legal representative. Emergency or short-term monitored separation will not be considered involuntary seclusion…is used for a limited period of time as a therapeutic intervention to reduce agitation… (HCFA Interpretive Guidelines)



10. Living Will is a declaration that you desire to die a natural death. You do not want extraordinary medical treatment or artificial nutrition or hydration used to keep you alive if there is no reasonable hope of recovery. A living will gives your doctor permission to withhold or withdraw life support systems under certain conditions.



11. Mental Abuse includes, but is not limited to, humiliation, harassment, and threats of punishment or deprivation. (HCFA Interpretive Guidelines)



12. Physical Abuse includes hitting, slapping, pinching, kicking, etc. It also includes controlling behavior through corporal punishment. (HCFA Interpretive Guidelines)



13. Restraint is the use of physical, mechanical or chemical means to prevent harm occurring to a patient.



14. Sexual Abuse includes, but is not limited to, sexual harassment, sexual coercion or sexual assault. (HCFA Interpretive Guidelines)



15. Verbal Abuse refers to any use of oral, written or gestured language that includes disparaging and derogatory terms to residents or their families, or within their hearing distance, to describe residents, regardless of their age, ability to comprehend, or disability. (HCFA Interpretive Guidelines)

LTC Ombudsman Program