Despite spending $14.2 million against smoking in 2013, the Department of Health protects smoking rights at nu
While Pennsylvania commits millions of dollars every year to anti-smoking initiatives, a quirk in state regulations means the Department of Health advocates on behalf of people who refuse to quit.
Under state guidelines, long-term health care facilities, including nursing homes, must accommodate residents' preferences when possible. Those preferences range from requesting who they share a room with to when they eat their meals to selecting a medical treatment plan.
That same regulation extends to important life decisions, including a patients' right to smoke. Unless a smoking ban was in place when a smoker is admitted, nursing homes cannot revoke their right to light up, according to regulations.
That rule extends to patients who can no longer be trusted alone with open flames, such as stroke victims with limited movement or people with unsteady hands. Instead, nursing homes must take precautions when they go smoke, such as providing them with lead aprons so they don't set themselves on fire and being supervised by nurses.
Those rules have slowed Cedarbrook's transition toward becoming a nonsmoking facility. The Lehigh County-owned nursing home stopped accepting smokers in 2008, but smokers already living on the premises were grandfathered in. As a result, six smokers still live at the South Whitehall Township campus, said interim Administrator Edwin Keys. While a few of them get around in powered wheelchairs, none of them requires nursing supervision while smoking, he said.
"The rights of a resident in a nursing home should be as close as possible to their rights in their own home," Keys said.
The transition has already been completed at the Fountain Hill campus, where residents are prohibited from smoking. Employees, however, are allowed to smoke in designated areas during their breaks, said Deputy Administrator Mary Hazard.
Data from the Centers for Disease Control and Prevention state smoking is the leading cause of preventable deaths in the world, and more than 480,000 people die annually in the United States from the effects of cigarette smoking.
Pennsylvania spent $14.2 million on anti-smoking initiatives in 2013, the most recent year the CDC lists. That funded, among other projects, two 24-hour help lines — one in Spanish, the other in English — providing tips and support for people trying to quit. In the Lehigh Valley, government programs provided nicotine patches to adults and taught children about the dangers of smoking.
State regulations prevent nursing home residents from being forced to quit smoking cold turkey. However, individual nursing homes can choose to gradually begin barring tobacco use, said Amy Worden, the Department of Health's press secretary.
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"The Department of Health strongly believes that smoking in nursing home facilities is detrimental to the health and well-being of some of our most vulnerable citizens," Worden said.
Creating a smoke-free climate may be easier said than done. Gracedale, the Northampton County-owned nursing home in Upper Nazareth Township, does not bar new residents from smoking on the grounds. Millard D. Freeman, who recently resigned as the facility's administrator, said starting that process could cost the county.
Key to cutting losses at Gracedale is keeping the occupancy rate high, something the county is finally accomplishing after years of struggling. Since a high percentage of Gracedale residents are smokers, Freeman said, a ban could threaten that turnaround.
"I would be concerned about what impact it would have on our census," Freeman said.
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