Ethics and Ageing Flashcards
why are ethics important to this population group?
- more reluctant to speak up for themselves because of fear of being treated poorly or ostracized
- population aging
- health care resource: when elders get pushed down the wait list because younger people take priority. Deciding who gets the resources. Ageism
- living older, using more health care resources. Who gets the resources?
The Nature of Ethics
- Relationships
- Context
- Values and beliefs
- Ethical principles
what is an Ethical Violation?
incompetent care or deliberate wrong doing
What is an Ethical Distress?
feelings of guilt, concern or distaste arise out of actions or inactions imposed on a person
What is an Ethical Dilemmas?
tension between two or more actions of equal moral
worth
Nature of ethics: relationships
- how are we will patients, colleagues, families organizations and society. Ethics shaped by our current relationship. DIfferent justifications
- Relations ethics takes into account power and authority, values, beliefs, and wishes of those involved in the ethical decisions. What is the power struggle? your patient is the head of neurology, you may treat them better.
Nature of Ethics: Context
in the hospital the clients supplies for care are all covered and applied by health care services. ie catheters or dressings. Then they go home and now they have to pay for it on their own. Where might they get supplies? can they afford it? is it clean?
Financial resources
what is a value?
- is defined as that which is desirable or esteemed for its own sake; something we prize or hold dear. ie your integrity, you can value your beliefs
What are beliefs?
Don’t confuse with faith. is defined as the conviction that
something is true.
what are the four ethical principles?
- Autonomy: they right to chose for yourself
- Distributive Justice: equality regardless of situation
- Beneficence: duty to benefit others
- nonmaleficence: duty to do no harm
difference between equality and equity
equality: everyone gets the same amount of stuff
equity: everyone gets just what they need
Relational practice
how do you chose to show compassion and respect to the client you currently have a relationship with.
qualities of a nurse: relational ethics
- capable of working with uncertainty and ambiguity
- engaging with complex ambiguious experiences and knowing that we do not have all the answers
- authenticity, responsiveness, mutuality in interactions
- honouring of differences
what is elder abuse?
- Defined as maltreatment of older adults
- Can be intentional or unintentional
- Can result from the actions or inaction of others
WHO definition of elder abuse
“…single or repeated acts, or lack of appropriate action, occurring within a relationship where there is an expectation of trust, which causes harm or distress of an older person”
Cultural and Socioeconomic Factors
- Frail, weak and dependent
- Erosion of bond: no family connections anymore
- Restructuring
- Distribution of power
- Migration
- Paternalistic societies
Difference between assault and battery. Must report them!
Assault: uttering threats
Battery: touching against an elder’s will
** this is okay if they are certified or incompetent
types of abuse
- physical
- emotional
- sexual
- financial
- neglect
what is psychological abuse? biggest type
- Attempts to dehumanize or intimidate older adults
- Verbal or non-verbal
- Reduces sense of self-worth or dignity
- Threatens psychological and emotional integrity
what is physical abuse?
- Non-accidental use of physical force to coerce or to inflict bodily harm
- Physical discomfort, pain or injury
- Injury does not have to be experienced ** ie. being pushed may not leave a mark
What is financial abuse?
- Financial manipulation or exploitation
- Includes theft, fraud, forgery or extortion
- Often accompanied by other forms of abuse (psychological, physical, denial of rights)
- Perpetrator usually a trusted person in senior’s life
what is neglect?
Failing to care for or meet the needs of dependent older adults
ACTIVE
- Intentional withholding of basic necessities
PASSIVE
- Not providing basic necessities because of lack of experience, information, or ability. Can be physical, psychological or financial
what is sexual abuse?
- Sexual behavior directed towards and older adult without their full acknowledgement
- Include sexual assault, sexual harassment, and rape
- Purpose to exert power and control or to demean
person - Includes both physical and psychological
components
risk factors of abuse
- Vulnerability
- Gender
- Psychosocial Factors
- Caregiver Factors
- Dependency
- Past History of Abuse
- Environmental and Systemic Factors
Consequences of elder abuse
- Compounds the effects of marginalization (already marginalized, makes it worse)
- Damage self-worth and dignity and increase their social
isolation - Affects those around them
- Physical Injuries
Characteristics of perpetrator
- Substance Abuse
- Psychiatric Disorder
- History of family violence
- Dependency on the older adult
- Poor social network
- Stress
characteristics of a victim
- Social Isolation
- Chronic Illness
- Functional Limitations
- Cognitive Impairment
- Sharing living arrangements with perpetrator
- Female gender
why are elders at risk for legal concerns?
- Vulnerability
- Frailty
- Exposure to risks
- Age related changes
- Family caregiving
- Resources for seniors in their community
capacity vs competency
Capacity: you may lack competence but you can still perform your ADLs, still capable.
Competency: Degree of mental ability that is required to make decisions
Living decisions
culture plays a role in this decision
your personal decision on how you want your life to end
factors influencing end of life decisions
Culture Family members values and beliefs Economics Generational differences Values and beliefs regarding age, illness and death
Legal issues, why are they at risk for vulnerability
- live with more chronic illnesses which can impair cognition (communication & judgment)
- are often living with changed economic resources
- often live alone and are “easy targets” for the unscrupulous.
what is the nurses duty
Malpractice/Unprofessional Conduct CARNA – Nursing Practice Standards Health Professions Act Confidentiality Code of Ethics Documentation
competency
Capacity to make decisions
Guardianship vs. Trusteeship
informed consent
Procedures
Invasion of Privacy
Photos
Medical records for study
know chart!
..
whats the difference between Enduring power of attorney and trustesship
EPOA- made someone your power of attorney when youre of sound mind
Trusteeship: government and court makes decisions on what happens
personal directives
Survives mental infirmity/physical disability (unlike a POA)
Must describe the limits of the authorities (financial, property, health care, etc)
Must be in writing and usually made with a lawyer
what is the nurses roles in personal directives
Supporting client decision making
Interpreting and following through with the clients wishes
rights of the older adults
Residents have the right to be free of
unnecessary physical or chemical restraints.
Residents have the right to participate in care
planning meetings.
When a resident experiences any deterioration in
health, or when a physician wishes to change the
resident’s treatment, the facility must inform
the resident
the resident’s physician
The resident’s legal representative or interested
family member
what is advanced care planning
Advance care planning is a process by which people
can think about their values about future
healthcare choices; explore medical information
that is relevant to their health concerns;
communicate wishes and values to their loved
ones, their agent/representative and their
healthcare team,
and record those choices
A Voice at the end of life
