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Client Abandonment and Potential Ethical Concerns

Kathleen D. Weissberg, OTD, OTR/L, CMDCP, CDP, CFPS

July 23, 2019

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Question

Can you explain client abandonment and any potential ethical concerns regarding changing employment?  

Answer

For a variety of reasons, such as leaving a practice to pursue other career opportunities or relocating for family reasons, clinicians may decide to end their relationships with clients. There is nothing unethical about such departures. Maintain their focus on the welfare of the client, even when, as clinicians, they decide to end their relationships with employers or patients is key. Adequate notice is necessary to prevent treatment disruptions, but even when given adequate notice, employers may be tempted to pressure or threaten departing clinicians to stay or give unreasonable amounts of notice.  Caution managers of care-giving facilities that it is unethical to try to exert moral pressure on clinicians to continue once they have indicated their plans to leave. However, professionals must be mindful of the fact that such departures may result in former clients being left without the appropriate care. When clinicians leave a caseload without coverage by an appropriately qualified professional, it is called client abandonment. Prior to departing, a professional must make effective efforts to provide for the patient's continuing care. The more seamless the transition for the patient, the better.

Examples of misconduct may include the following:

  • failing to give sufficient notice to employers when leaving a position
  • failing to provide an interim plan for each client
  • failing to complete all remaining reports, billing slips, and other required paperwork
  • withholding paperwork so that the clinician's successor does not have access to the client's entire record
  • removing materials, records, protocols, and other administrative materials without the consent of the administrator of the facility or organization
  • maligning, in the presence of clients, the facility or organization the professional is leaving
  • recruiting clients for the new employment setting

A professional who is leaving a facility should, if requested, assist the organization with the recruitment of a replacement and should offer to participate in the orientation of replacement personnel as necessary.  Therapists who leave an organization or facility should attempt to sever ties with the employer amicably. Employers should cooperate in every way with departing clinicians in order to safeguard the well-being of clients. When the therapist’s departure has been precipitated by difficulties in workplace relationships or what the clinician regards as deficiencies in working conditions, there may be increased potential for behavior that violates the principles and rules of the Code of Ethics. Professionals in such situations should avoid engaging in behaviors that might be viewed as retaliatory or slanderous. Angry and spiteful words, obstructive actions, and uncooperative or aggressive behavior are potentially very harmful to clients and reflect badly on the profession. If a clinician is dismissed for cause, the employee's responsibility to clients terminates with the dismissal, and the facility assumes all responsibility for seeing that no clients suffer harm as a result of the departure.

 


kathleen d weissberg

Kathleen D. Weissberg, OTD, OTR/L, CMDCP, CDP, CFPS

In her 30+ years of practice, Dr. Kathleen Weissberg has worked in rehabilitation and long-term care as an executive, researcher, and educator.  She has established numerous programs in nursing facilities; authored peer-reviewed publications on topics such as low vision, dementia quality care, and wellness; and has spoken at national and international conferences. She provides continuing education support to over 40,000 individuals nationwide as National Director of Education for Select Rehabilitation. She is a Certified Dementia Care Practitioner, a Certified Montessori Dementia Care Practitioner, and a Certified Fall Prevention Specialist.  She serves as the Region 1 Director for the American Occupational Therapy Association Political Action Committee and adjunct professor at Gannon University in Erie, PA. 


Related Courses

Supporting the LGBTQ Senior in Healthcare
Presented by Kathleen D. Weissberg, OTD, OTR/L, CMDCP, CDP, CFPS
Recorded Webinar

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This presentation reviews the definitions of supervision as well as APTA guidance related to supervising assistants, students, and aides in various healthcare environments. Documentation guidelines for Medicare are reviewed as these relate to what an assistant can complete versus a therapist. The use of students and rehab aides in long-term care is reviewed in accordance with Medicare guidelines. Real examples of common supervisory ethical dilemmas from the field, including the appropriate action steps to take in each one, are highlighted. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA

Bullying Among Older Adults: Not Just a Playground Problem
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In this session, participants learn the definition and incidence of bullying in adult living communities and day centers, including what older adult bullying looks like in this population. Characteristics of older adult bullies, as well as their targets and gender differences, are explored. The reasons why bullying occurs, as well as the five different types of bullies, are defined. Interventions for the organization, the bully, and the target are reviewed to help communities minimize (and prevent, where possible) bullying and mitigate the effects on the target. Addressing bullying behavior among older adults is critically important for enhancing the quality of life and promoting emotional well-being; strategies to create caring and empathic communities for all residents and staff members are reviewed.

Health Literacy: Effective Client Communication and Education
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