Working at my first job in a long-term-care facility, I commonly hear residents complain that they shouldn't be there and they want to leave. Sometimes I can't tell whether they miss their families, or they're confused, or they feel trapped because they didn't agree to moving in. Or maybe they've changed their minds about staying and should be allowed to leave. Should I document every time a resident tells me she wants to go home?-T.M., MISS.

Documenting residents' complaints is very important. If someone consistently asks to "go home," document her requests and tell both facility administrators and the resident's family about them.

Unless a person is declared incompetent in a court hearing, she retains her autonomy. She can decide whether to consent to treatment, which treatments to accept, and whether to change her mind about staying in the facility. A facility that detains a competent person against her will could be charged with false imprisonment. On the other hand, letting a resident leave when she has no safe place to go can be abandonment.

The facility would be wise to work with the resident's family to make sure she's safely transferred to others who can provide the care she needs. If she has no family to provide support, the facility should contact the division of family services. If the resident leaves, document where she's going and what support she'll receive-the facility should provide a special document for this purpose. Your documentation should also reflect whether she's left against the facility's advice.

When a resident doesn't seem to understand the consequences of her decision to leave, a court hearing may be necessary to determine competency. The family or the facility may initiate the hearing. If the resident is declared incompetent, she loses the right to decide to leave; the court will appoint a guardian-preferably a family member-to determine what's in her best interest.