Up in Smoke: Smoking Policies in Nursing Homes Critical for Safety

Recently, a resident caught fire while sitting in his wheelchair on an outside patio at a Chicago area nursing home. His shirt first went up in flames and other residents attempted to come to his aid to extinguish the flames. The resident, while still on fire, then wheeled himself back into the facility where the staff put out the fire with an extinguisher. The resident was then apparently wheeled back out to the patio and CPR was not performed until the first responders arrived. This incident was caught on videotape and the actions of the facility have been called into question.

Nursing homes are required to establish smoking procedures and protocols for residents who smoke. These policies include, but are not limited to, routinely assessing whether a resident can safely handle a cigarette, when and where the resident can smoke, determining how the facility will store the smoking materials, and providing appropriate supervision while residents smoke. 

While many facilities have these policies, it is not uncommon for facilities to ease up on some of these procedures and defer to the resident or his/her family regarding smoking decisions. Unfortunately, this can have serious adverse consequences for the resident, other residents and the facility, as many residents and their families do not appreciate the risk of unsupervised smoking in a population that may have diminished capacity and poor judgment and coordination. This incident also illustrates the need to have fire safety training for staff so that they understand how to handle such critical situations.


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