Up one levelSuddenly, in the spring of 2003, we residents of a lifecare retirement community, The Forest At Duke, in Durham, North Carolina, were faced with the impact of abiding by the rules and regulations of HIPAA. One day in March 2004, [my friends and I] were joined by a friend and resident of the retirement home whom we had "lost track" of for over two months. It turned out that she had been quite ill for several weeks and had subsequently been transferred in and out of the hospital and rehabilitation center before being discharged to The Forest at Duke. To our amazement, we were unaware of her difficulties. After a serious discussion, she admitted, "I felt so abandoned."
This struck us as completely inconsistent with the usual atmosphere of caring that is so prevalent at this retirement home. Therefore we set our course to find a way to minimize the impact of HIPAA on our way of life. The process that we have devised centers around a resident locator book that contains the name of each resident and a voluntary listing of a confidant for each resident. This confidant is allowed to be informed when the resident enters the health care system or is moved within the system to another location. No medical diagnoses or treatment are in the book — only location. If appropriate, the entry may include the suitability or desire for visits, telephone calls, or "notes only."
This system works within the guidelines of HIPAA and yet helps preserve the wishes of the extended family. And, by keeping the system voluntary, those who do not wish to participate are not forced to identify a confidant.
Caroline Becker Long, MD '50