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Physical, mental, or social changes in the life of an elderly person may result in a loss of self-sufficiency. Deciding how to compensate for changes-a process that often involves family members, tends, or health professionals-frequently leads to consideration of long-term care. Most of the existing literature on ethics and decision making, however, focuses on acute care and does not necessarily-apply to issues involved in choosing long-term care.
This volume explores the concept of safety as applied in the long term care context. Chapters examine the way in which the quest for safety may work either synergistically or adversely upon other worthy social goals. Among the initiatives considered are promoting the decision-making autonomy of patients/clients and their surrogates, enhancing the quality of care and quality of life available to long term care residents, and providing fair compensation for injured victims when serious harm occurs. Questions addressed that are of concern to legal and ethical theorists, social science researchers, and patient/client advocates include: To what extent do litigation and/or regulation accomplish the safety and other legitimate objectives of public policy in the long term care arena? Do the costs of various approaches outweigh the benefits in promoting safety and other goals? How do litigation and regulation compare with alternative approaches to achieving the same goals, in terms of an acceptable cost/benefit balance?
This evidence-based text is designed to help the undergraduate nursing student in a critical care rotation and for nurses new to critical care. Each clinical chapter has application to the AACN Synergy Model, identifying and matching patient characteristics and nurse competencies, leading to optimal patient outcomes.
Long-term care can be vexing on a personal as well as social level, and it will only grow more so as individuals continue to live longer and the population of aged persons increases in the United States and around the world. This volume explores the ethical issues surrounding elder care from an ecological perspective to propose a new theory of global justice for long-term care. Care work is organized not just nationally, as much current debate suggests, but also transnationally, through economic, labor, immigration, and health policies established by governments, international lending bodies, and for-profit entities. Taking an epistemological approach termed “ecological knowing,” Lisa A. Eckenwiler examines this organizational structure to show how it creates and sustains injustice against the dependent elderly and those who care for them, including a growing number of migrant care workers, and how it weakens the capacities of so-called source countries and their health care systems. By focusing on the fact that a range of policies, people, and places are interrelated and mutually dependent, Eckenwiler is able not only to provide a holistic understanding of the way long-term care works to generate injustice but also to find ethical and practicable policy solutions for caring for aging populations in the United States and in less well-off parts of the world. Deeply considered and empirically informed, this examination of the troubles in transnational long-term care is the first to probe the issue from a perspective that reckons with the interdependence of policies, people, and places, and the first to recommend ways policymakers, planners, and families can together develop cohesive, coherent long-term care policies around the ideal of justice.
Elder Abuse and Its Prevention is the summary of a workshop convened in April 2013 by the Institute of Medicine's Forum on Global Violence Prevention. Using an ecological framework, this workshop explored the burden of elder abuse around the world, focusing on its impacts on individuals, families, communities, and societies. Additionally, the workshop addressed occurrences and co-occurrences of different types of abuse, including physical, sexual, emotional, and financial, as well as neglect. The ultimate objective was to illuminate promising global and multisectoral evidence-based approaches to the prevention of elder maltreatment. While the workshop covered scope and prevalence and unique characteristics of abuse, the intention was to move beyond what is known about elder abuse to foster discussions about how to improve prevention, intervention, and mitigation of the victims' needs, particularly through collaborative efforts. The workshop discussions included innovative intervention models and opportunities for prevention across sectors and settings. Violence and related forms of abuse against elders is a global public health and human rights problem with far-reaching consequences, resulting in increased death, disability, and exploitation with collateral effects on well-being. Data suggest that at least 10 percent of elders in the United States are victims of elder maltreatment every year. In low- and middle-income countries, where the burden of violence is the greatest, the figure is likely even higher. In addition, elders experiencing risk factors such as diminishing cognitive function, caregiver dependence, and social isolation are more vulnerable to maltreatment and underreporting. As the world population of adults aged 65 and older continues to grow, the implications of elder maltreatment for health care, social welfare, justice, and financial systems are great. However, despite the magnitude of global elder maltreatment, it has been an underappreciated public health problem. Elder Abuse and Its Prevention discusses the prevalence and characteristics of elder abuse around the world, risk factors for abuse and potential adverse health outcomes, and contextually specific factors, such as culture and the role of the community.
Designated a Doody's Core Title! Winner of an AJN Book of the Year Award! p>Bethel Ann Powers gives a comprehensive and thoughtful examination of the ethical issues that arise in long-term care. The first two chapters set the stage by exploring the pre-nursing home experiences of families living with dementia and, in contrast, how residents and family members experience life in the nursing home. The following chapters contain detailed hypothetical cases that include questions, possible actions, and insightful commentary to illustrate practical approaches to understanding common ethical issues affecting nursing home residents.
Caring for elders outside of institutions is the fastest growing sector of US health care. Building on their research study at the Park Ridge Center, editors Holstein and Mitzen, together with a team of experts, examine the complexities involved in developing an ethics for community-based long-term care. They also challenge policymakers to make home care a more viable option for older people in need. Chapters address many of the ethical and practical problems that arise in the care of older people with physical and mental disabilities--including how to allocate scarce funds, how to keep good caregivers, how to balance concerns of autonomy, risk and safety, and worker stress. The volume is an excellent resource for practitioners, policymakers, and students.
This book is designed to present an overview of common geriatrics ethical issues that arise during patient care and research activities. Each chapter includes a case example and practical learning pearls that are useful in day-to-day patient care. Coverage includes a brief overview of geriatric epidemiology, highlighting the high rates of dementia, use of surrogate decisions makers at the end-of-life, relocation from home to long-term care facilities, and low health literacy in the geriatrics population. Sections are devoted to issues around capacity, surrogate decision making, end-of-life care, hemodialysis in the elderly, and futility as well as challenges presented by independence questions, such as dementia care, driving, feeding, and intimacy in nursing homes. The text also addresses questions around recognizing, reporting, and treating elder abuse and self-neglect, ethics related to research and technology in the geriatric population, and the use of e-mail, Facebook, and open notes. Written by experts in the field, Ethical Considerations and Challenges in Geriatrics is a valuable tool for trainees at a variety of levels including medical students, residents, and fellows. In addition, it provides practical guidance and a useful reference for practicing geriatricians, primary care physicians, geriatric nurses, social workers, nursing home workers, hospice care employees, and all medical health professionals working with the elderly.
Pamphlet is a succinct statement of the ethical obligations and duties of individuals who enter the nursing profession, the profession's nonnegotiable ethical standard, and an expression of nursing's own understanding of its commitment to society. Provides a framework for nurses to use in ethical analysis and decision-making.