Self-determination and residents who smoke: A dilemma for the nursing home social worker

Nursing home social workers were surveyed regarding facility smoking policy and its compatibility with their professional values and ethics. Respondents were randomly selected from Georgia and Minnesota nursing home associations. Almost all respondents agreed that nursing homes are the resident’s home and that residents have the right to make decisions that may not be in their best interest, i.e., continuing to smoke. At smoke-free facilities, significantly more social workers believed that residents should not have the right to make their own decisions regarding smoking (chi-square = 4.90, p = 0.03). Less than 14% of these social workers struggled ethically with their facility’s smoke-free policy. Social workers personal smoking behaviors had significant influence on their perception of this dilemma.