What should a CNA do if a resident refuses care or treatment?

• A. Respect autonomy, document the refusal, inform the nurse, and attempt to revisit later if appropriate.
• B. Force the care to be administered to avoid risk of harm.
• C. Ignore the refusal and continue with the procedure.
• D. Delay discussing with nurse and document as completed.

Answer: (A)

Respecting a resident’s autonomy and handling refusals correctly is essential. When a resident declines care or treatment, the CNA should acknowledge the choice, ensure the decision is informed (the resident understands the implications), and then proceed to proper documentation and escalation. Document the refusal promptly with specifics: what was refused, the date and time, the resident’s stated reasons, and any alternatives or information given. Inform the supervising nurse right away so they can assess capacity, discuss risks, and determine the next steps. If appropriate, plan to revisit the discussion later, since a patient’s mind can change or concerns can be addressed.

It’s important to never force care, ignore the refusal, or mark it as completed. If the resident cannot understand or lacks decision-making capacity, follow facility policies and involve the nurse, a guardian, or advance directives as required.