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maturing family > ch 31 - common legal and ethical issues > Flashcards

ch 31 - common legal and ethical issues Flashcards

1
Q

conditions/circumstances that result in a higher than usual responsibility of HCPs to ensure consent is informed (7)

A
  • impaired sensory functioning
  • low educational level
  • low/limited health literacy
  • low literacy of any kind
  • questionable cognitive status
  • complex procedure (surgery of any kind)
  • participation in research
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2
Q

examples of representatives for advanced care planning

A
  • power of attorney
  • health care proxy
  • guardians and conservators
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3
Q

legal rep: Legally appointed to act on behalf of another

in ways specifically indicated in a legal document

A

power of attorney

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4
Q

legal rep: Authority to act on a person’s behalf when he or she has lost capacity to make decisions and
has not documented what he or she wants

A

health care proxy

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5
Q

legal rep: Individual, agencies, or corporations appointed to take care, custody, and control of an incapacitated person and assure needs are met

A

guardians and conservators

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6
Q

purpose of power of attorney

A
  • general POA for business
  • durable POA for medical decisions
  • made in advance of need
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7
Q

purpose of health care proxy

A

-how decisions are made when pt is incapacitated or POA hasn’t been selected

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8
Q

purpose of conservator

A

manage finances

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9
Q

purpose of guardians of the person

A
  • helps incapacitated person make decisions
  • ensures pt safety and wellbeing
  • can provide consent for pt
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10
Q

people who are more likely to abuse/neglect

A
  • family member
  • one with mental/emotional illnesses
  • abuser of alcohol/substances
  • h/o family violence
  • cultural acceptance of interpersonal violence
  • caregiver frustration
  • social isolation
  • impaired impulse control of caregiver
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11
Q

people who are more likely to be abused/neglected

A
  • cognitively impaired
  • dependent on abuser
  • physically/mentally frail
  • abused caregiver in earlier life
  • women living alone or in household with family
  • h/o being abused
  • behavior considered aggressive, demanding or unappreciative
  • living in institutional setting
  • feels deserving of abuse due to personal inadequacies
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12
Q

types of abuse of older adult (7)

A
  • physical
  • sexual
  • psychological
  • medical
  • financial
  • discrimination
  • abandonment
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13
Q

type of abuse: physical force that results in threat of or infliction of bodily injury, physical pain, or impairment

A

physical abuse

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14
Q

type of abuse: nonconsensual sexual contact of any kind

A

sexual abuse

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15
Q

type of abuse: inflict of anguish, pain, of distress through verbal or nonverbal acts, including intimidation or enforced social isolation

A

psychological abuse

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16
Q

type of abuse: subjecting person to unwanted medical Tx or procedures

A

medical abuse

17
Q

type of abuse: illegal or improper use of another’s funds, property or assets

A

financial abuse

18
Q

type of abuse: illegal cultural or social behaviors that are demeaning, belittling, or withholding of full rights to persons, especially those at risk of physical, emotional, or sexual abuse

A

discrimination

19
Q

type of abuse: desertion of person by individual who had assumed responsibility for providing care or assistance

A

abandonment

20
Q

factors increasing risk of elder abuse (6)

A
  • cultural/societal tolerance violence, especially against women
  • shame and embarrassment
  • fear of retaliation
  • fear of institutionalization
  • social isolation
  • unacceptability of emotional expression, especially fear or distress
21
Q

latino cultural variations increasing risk for abuse/neglect

A
  • expectation of men to neglect self on behalf of others if necessary
  • role expectation of women to tolerate abuse and focus on service of others
  • need to protect family of shame
  • emphases on family instead of outsiders
  • extreme level of guilt if not able to provide care to older members of family
22
Q

asian/pacific islander cultural variations increasing risk for abuse/neglect

A
  • ability to endure violence as symbol of strength and honor
  • not familiar with terms of abuse
  • psychological abuse considered worst type of abuse
  • strong belief of duty to care for parents may result in excessive burdens
  • unacceptability to express emotions
23
Q

chinese cultural variations increasing risk for abuse/neglect

A
  • must be kept in family
  • disrespect biggest form of mistreatment
  • cultural disparities in expectations between younger and older adults
24
Q

asian indian cultural variations increasing risk for abuse/neglect

A
  • children leaving family home may be considered elder abandonment
  • oldest son handles all finances
  • physical abuse uncommon as old age is respected
25
Q

japanese cultural variations increasing risk for abuse/neglect

A
  • psychological abuse considered worst type of abuse
  • often reported daughters-in-law cause emotional neglect, or emotional/physical abuse
  • lack of caring for elder is socially unacceptable
  • suffering expected to be done in stoic manner
  • self-blame
  • those who expose family “shame” may be considered traitor
26
Q

korean cultural variations increasing risk for abuse/neglect

A
  • financial exploitation not considered abuse
  • high tolerance for neglect
  • placing in nursing home considered shameful and abuse
27
Q

viatnamese cultural variations increasing risk for abuse/neglect

A
  • family problems kept at home
  • neglect brings shame to family
  • psychological “silent Tx” most serious
28
Q

health problems that victims of violence often experience

A
  • bone/joint problems
  • digestive problems
  • depression/anxiety
  • chronic pain
  • HTN and CVD
29
Q

Results from failure of action by person with responsibility to provide care

A

neglect by caregiver

30
Q

People fail to meet their own basic needs in
manner in which the average person would in
similar circumstances

A

self neglect

31
Q

interventions for potential questions of right to decision making

A
  • clarify issues at hand and present conflicts
  • discuss situation with pt
  • participate in assessment of elder’s capacity
  • clarify type of POA that is held
  • document to whom and what health info can be released
32
Q

volunteer or paid staff member

responsible for acting as advocate for vulnerable residents in institution

A

ombudsman

33
Q

S+S physical abuse (2)

A
  • unexplained bruising/lacerations in various locations and in various stages of healing
  • fractures inconsistent with functional ability
34
Q

S+S sexual abuse (3)

A
  • bruises or scratching in genital/breast area
  • fear/unusual amount of anxiety related to routine exam of genital area
  • torn undergarments or presence of blood
35
Q

S+S medical abuse (1)

A

-caregiver repeatedly requesting procedures that are not recommended or not desired by pt

36
Q

S+S medical neglect (2)

A
  • unusual delay between when health problem began and when help was sought
  • repeated missed appts without reasonable explanation
37
Q

S+S psychological abuse (3)

A
  • caregiver does all of talking when pt is capable
  • caregiver appears angry/frustrated when pt seems frightened/hesitant
  • caregiver or pt aggressive toward one another or nurse
38
Q

S+S neglect by self or caregiver (6)

A
  • weight loss
  • uncharacteristic neglected grooming
  • evidence malnutrition/dehydration
  • fecal/urine smell
  • inappropriate clothing to situation/weather
  • insect infestation
39
Q

one who maintains or promotes a cause; defends, pleads, or acts on behalf of another; and fights for someone who cannot fight for him or herself

A

advocacy

maturing family (36 decks)

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