Legal and Ethical Concerns/Abuse and Neglect Flashcards
key issues for the elderly
1 . autonomy and rights
2 . advance directives
3 . legal issues specific to long term care settings
4 . ethical issues in gerontological nursing
5 . MAiD
autonomy and right
competency
- the ability to fulfill ones role and handle ones affairs in a responsible manner
decision making capacity
- a measure of a persons ability to make and informed and logical decision about a particular aspect of their health care
trusteeship
- applies when an older adult no longer has the capacity to make a decision on financial matters
guardianship
partial guardianship
- the incompetent person continues to make limited decisions
full guardianship
- the person loses all their right to make decisions
advance directives
def.
- legally binding documents that allow competent people to document what medical care they would or would not want to receive if they were not capable of making decisions and/or communicating their wishes
advance directives examples
medical orders for scope of treatment (MOST)
- DNR under MOST
representation agreement/ living will
legal issues specific to long term care settings
nursing home residents rights in Canada are primarily legislated at the provincial/territorial level
- ethical issues are associated with questions about safety vs freedom of the residents
ethical issues in gerontological nursing
- use of restraints
- artificial nutrition and hydration
use of restraints
physical restraint
- immobilizes or reduces the ability of pt to move
use of artificial nutrition and hydration (ANH)
AHN: methods of bypassing the upper GI system to deliver nutrition
ex:
- percutaneous endoscopic gastrostomy (PEG) tube
- jejunostomy tube
- nasogastric (NG) tube
- total parenteral nutrition (TPN) via a central intravenous catheter
- hypodermoclysis (subcutaneous delivery of fluids
MAiD
eligible for MAiD only if the meet ALL the criteria
- person has a grievous and irremediable medical condition only if ALL the criteria
role of RN in MAiD
- limited to aiding the physician or NP in the provision of medical assistance in dying
- RN are not allowed to prescribe, compound, dispense, or administer any substance intended for the purpose of MAiD
role of RN regarding legal and ethical issues
- Promote Advance Care Planning
- Implement Advance Directives
- Facilitate Decisions about Care
- Promoting Caregiver Wellness
senior abuse
refers to a wide variety of harms to older adults that are committed by a person(s) they know and would have normally have reason to trust
perpetrator
- mental illness
- alcoholism
- hostility
- financial dependency on the victim
victim
- cognitive impairment/ dementia
- problem behaviors
- disability (physical, communicative)
- physical dependency
- financial dependency
- shared living arrangements
- isolation or lack of social supports
physical abuse
p. 164
inflicting, or threatening to inflict, physical pain or injury on a vulnerable elder, or depriving someone of a basic need
sexual abuse
p. 164
nonconsensual sexual contact of any kind, coercing an elder to witness sexual behaviors
emotional abuse
spiritual abuse
denial of a residents right to spiritual practices
financial exploitation
p. 164
illegal taking, misuse, or concealment of funds, property or assets of a vulnerable elder
neglect definition
the refusal or failure by those responsible to provide food, shelter, health care or protection for a vulnerable elder
key points
- Legal and ethical challenges for older adults are often best managed with early and open communication between family members and caregivers.
- The nurse’s role is to provide information and support, and refer to further assistance.
- BCCNM has a Duty to Report Standard based on the Health Professions Act
- There are many reasons why residents do not report elder abuse
- There are many reasons why residential care staff do not report elder abuse
- Reporting elder abuse is everyone’s moral responsibility and the nurse’s professional legal responsibility
