Informed consent, capacity and patient rights for care staff

For nurses, CNAs, medical assistants and home care staff: respect consent, support capacity, handle refusals and escalate within your scope.

For: Nurses, CNAs, medical assistants, home health aides and assisted living staff

  • 2 contact hours
  • 8 modules
  • 9 interactives
  • 4 job aids
  • Updated October 11, 2026

What you will be able to do

  • Identify the four elements of valid informed consent and distinguish express, implied and emergency consent in everyday care.
  • Distinguish decision-making capacity from legal competence and recognize changes that must be reported to the nurse.
  • Determine who may make decisions for a person who lacks capacity, using agents, guardians, state default surrogate rules, advance directives and POLST.
  • Respond to a refusal of care, including refusals by or about minors, within your scope of practice and without coercion.
  • Uphold resident and patient rights, including freedom from restraints and HIPAA limits on sharing information with family.
  • Document consent and refusal observations objectively and escalate concerns to the right person on time.

Learn what makes consent valid, how decision-making capacity differs from legal competence, who decides when a person cannot, and how advance directives and POLST forms fit in. You will practice responding to refusals, family pressure, minors' consent questions and restraint suggestions through realistic U.S. care scenarios.

Built for nurse aides, medical assistants, home health aides, assisted living staff and nurses who want a clear, practical refresher. Every module separates what frontline staff do (notice, respect, report, record) from what belongs to providers and licensed nurses.

Consent is not a signature on a form. It is the everyday practice of asking, listening and honoring choices. This course ties that practice to the federal rules behind it, including 42 CFR 483.10, 42 CFR 482.13, the Patient Self-Determination Act and the HIPAA Privacy Rule, and flags where your state's laws differ.

What you’ll be able to do Monday morning

  1. Explain each task and wait for agreement before you start, every time.
  2. Look up where advance directives, POLST forms and the decision-maker are recorded for the people you care for.
  3. Respond to a refusal with stop, ask, offer, tell the nurse and document.
  4. Refer family questions about results and prognosis to the nurse or provider using a ready script.
  5. Speak up when a restraint, covert medication or forced care is suggested.

Curriculum

8 modules · 25 lessons · about 2 contact hours

01What makes consent valid, and what is your part in it?Free preview14 min
  1. What are the four elements of valid consent?
  2. What kinds of consent will you see at work?
  3. What is your role when consent is incomplete?
  • Sort activity: What kind of consent is this?

Diagram · In practice checklist · 2-question knowledge check

02How is decision-making capacity different from competence?14 min
  1. What is decision-making capacity?
  2. Capacity and competence: who decides which?
  3. How do you support a person to decide?
  • SBAR builder: SBAR: a refusal that may be a change in condition

Diagram · In practice checklist · 2-question knowledge check

03Who decides when a person cannot, and which documents speak for them?15 min
  1. Who can make decisions for someone else?
  2. Advance directives and the Patient Self-Determination Act
  3. What is POLST, and how is it different?
  • Decision tree: Who can decide?
  • State rules selector: Default surrogate laws: check your state

Diagram · In practice checklist · 2-question knowledge check

04What do you do when a patient or resident says no?14 min
  1. Why is the right to refuse so strong?
  2. A five-step response to a refusal
  3. Informed refusal and the limits of persuasion
  • Branching scenario: A refused bath and a pushy relative

Diagram · In practice checklist · 2-question knowledge check

05Who can consent for minors, and when can teens consent for themselves?12 min
  1. The general rule: parents consent for minors
  2. When can a minor consent alone?
  3. Handling a parent's request for information

Diagram · In practice checklist · 2-question knowledge check

06How do patient and resident rights protect choice, and why are restraints a consent issue?13 min
  1. Which rights do nursing home residents and hospital patients hold?
  2. What counts as a restraint?
  3. What does an aide do when a restraint is suggested?
  • Spot the issue: Spot the rights problems in a night shift report

Diagram · In practice checklist · 2-question knowledge check

07When can you share information with family, and who counts as a personal representative?12 min
  1. What does HIPAA allow you to share with family and friends?
  2. Who is a personal representative?
  3. Practical scripts for family questions
  • Matching activity: Match the person to their role

Diagram · In practice checklist · 2-question knowledge check

08What should you document, and when do you escalate?13 min
  1. What makes a good consent or refusal note?
  2. When do you escalate, and to whom?
  3. Using SBAR for consent and rights concerns
  4. How does consent look different across care settings?
  • Spot the issue: Spot the problems in a refusal note
  • Self-assessment: How consent-centered is my practice?

Diagram · In practice checklist · 2-question knowledge check

Final assessment: 23 questions, 80% to pass, then your certificate

Try it now, no account needed

A refused bath and a pushy relative

A branching scenario from this course. Your choices are not saved.

Free sample activity

A refused bath and a pushy relative

You are Wojtek Lisowski, a home health aide in Tuscaloosa, Alabama. Mr. Elias Fairweather, 79, is alert. Today he says he does not want his bath. His niece, visiting from out of state, says, "He smells. Just get him in the tub."

Inside the course

Practice activities

  • Sort activity1
  • Decision tree1
  • Branching scenario1
  • Spot the issue2
  • Matching activity1
  • Self-assessment1
  • SBAR builder1
  • State rules selector1

Job aids you keep

  • Consent and Refusal Care ChecklistChecklist
  • SBAR and Stop-and-Watch Report: Consent, Refusal or Change in ConditionTemplate
  • Consent and Rights Reflection WorksheetWorksheet
  • In-Service Sign-Off Record: Informed Consent, Capacity and Patient RightsLog

Credit and approval status

Certificate of completion

This course awards a certificate of completion for 2 contact hours of instruction. It is not approved or accredited by any board of nursing, nurse aide registry, state agency or continuing education accreditor. Nursing homes must train staff on resident rights, and some states set their own in-service or continuing education rules. Check with your employer, staff development coordinator, board or state agency whether this course meets your specific requirement.

Pathways we may pursue include nursing continuing professional development accreditation, review by state agencies that accept nurse aide in-service content, and social work continuing education review. None of these approvals exists today; the course page will show an approval only after it is granted.

Our full approvals list

State notes

Consent law is largely state law. Federal rules (42 CFR 483.10, 482.13, 489.102 and the HIPAA Privacy Rule) set a floor, but states decide most of the details you meet at work:

  • Default surrogates: who may decide when there is no agent or guardian, and in what order. Examples: Florida Statutes section 765.401 (guardian, spouse, adult child, parent, adult sibling, adult relative showing special care, close friend, then a licensed clinical social worker chosen by a bioethics committee); Texas Health and Safety Code section 313.004 (spouse, adult children, parents, nearest living relative). Some states have no general default surrogate statute.
  • Advance directive forms: required wording, witnesses and notarization differ by state.
  • POLST programs: names (POLST, MOLST, POST, MOST and others), forms, and who may sign differ by state.
  • Minors: the age of majority, emancipation, mature minor recognition and which services minors may consent to alone are all set by state law.
  • Restraints and patient rights: many states add patient bill of rights and assisted living rules on top of federal standards.

This is not a state-specific edition. Ask your employer which state laws and forms apply where you work, and use the state lookup in Module 3.

Questions about this course

Does this course count toward continuing education or a state requirement?

This course awards a certificate of completion for 2 contact hours of instruction. It is not approved or accredited by any board of nursing, nurse aide registry or continuing education accreditor today. Many employers use courses like this for in-service or orientation, but they decide what counts. Check with your employer, board or state agency before relying on it for a specific requirement.

Who is this course for?

It is written for nurse aides, medical assistants, home health aides, assisted living staff and nurses who want a practical refresher on consent, capacity and patient rights. Examples come from nursing homes, hospitals, clinics and home care. Each module explains what frontline staff do and what belongs to licensed nurses and providers, so it works across roles.

Is this course specific to my state?

No. It teaches the federal rules and the common framework, then flags where states differ, especially on default surrogates, advance directive and POLST forms, and minors' consent. A state lookup shows verified examples. Always confirm local rules with your employer, because consent law is largely state law.

How long does it take?

Plan on about 2 hours, including eight short modules, interactive scenarios, knowledge checks and a final assessment. You can pause and return at any time. The final assessment has 23 questions, and you need 80% to earn your certificate. You can retake it if needed.

Will this course teach me to assess capacity or obtain consent for procedures?

No. Capacity is a clinical judgment and procedure consent belongs to the treating provider. This course teaches you to support people's choices, recognize and report changes, and escalate consent concerns. Nurses and providers should follow their own professional standards and facility policies for those clinical tasks.

What will I receive at the end?

After passing the final assessment you can download a certificate of completion showing the course title, 2 contact hours and your completion date. You also get four printable job aids: a consent and refusal checklist, an SBAR and stop-and-watch template, a reflection worksheet and an in-service sign-off record.

This course is general education and training awareness from CE Courses Hub on informed consent, decision-making capacity and patient rights. It is not legal, medical or professional advice and does not replace your employer's policies, your state's consent and surrogate laws, your licensing board's or registry's rules, or advice from a qualified professional. Completing it earns a certificate of completion for the stated contact hours; it is not approved or accredited by any licensing board, state agency or accreditor unless an approval is shown on the course page. Check with your board, employer or state agency whether this course meets your specific requirement.