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Gero Final > Legal and Ethical Issues in Aging > Flashcards

Legal and Ethical Issues in Aging Flashcards

1
Q

Define competence

A

A legal term, indicates an individual has ability to understand the nature and consequences pf decisions

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2
Q

Define Capacity

A

Ability to make a specific decision

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3
Q

Define Informed Consent

A

Only possible due to presumption adults are competent.

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4
Q

To have the capacity to make a decision, the patient mush have what three things?

A
  1. Be able to understand relevant info and the implication of various treatment choices
  2. Reflect on information in accordance with personal values and draw conclusions
  3. Make and communicate a choice to healthcare professionals
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5
Q

If there is no advanced directive, how can decisions be made for an individual?

A

Decisions may be made based off of what the patient has previously stated.

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6
Q

Legal competency and capacity to make healthcare decisions are determined by whom?

A

The court, but it can be quite lengthy

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7
Q

Ethics committees may serve as what?

A

More practical intermediaries than going all the way to court

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8
Q

What is the goal of informed consent?

A

To promote patient autonomy

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9
Q

What does informed consent generally include?

A

What a reasonable patient would want to know or a reasonable healthcare provider should discuss.

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10
Q

What is usually discussed during an informed consent meeting?

A

The patients diagnosis, risks and benefits of the proposed procedure, alternative treatments that may be available, risks and benefits of forgoing proposed treatment.

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11
Q

What does POLST stand for?

A

Physician Orders for Life Sustaining Treatment

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12
Q

What is an advanced directive?

A

Morally and in some jurisdictions legally binding document that adults can express their wishes regarding end of life decisions for a future time when they are unable to do so for themselves.

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13
Q

What are two common forms of Advanced directives?

A

Living wills, and durable power of attorney for heath care

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14
Q

Why were advanced directives developed?

A

In response to concern patients were being forced to undergo unwanted, futile, uncomfortable, or degrading treatments to preserve life at all costs against patients wishes.

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15
Q

What is the patient self-determination act?

A

Requires healthcare facilities to inform patients about right to complete an advance directive

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16
Q

What are the components of a durable power of attorney?

A

individual appoints someone to make their health decisions if he or she looses the ability to do so, is effective any time the patient has temporary/permanent absence of decisional capacity. Proxy has legal authority to interpret wishes based on medical circumstances.

17
Q

What are the components of a Living will?

A

Prospective declaration, outlines wishes for those with no one to appoint as a proxy, can also provide guidance for DPAHC about treatment preferences and EOL care and wishes. Effective only at end of life.

18
Q

Define DPAHC

A

Durable power of attorney for health care.

19
Q

Is a DPAHC restricted to specific situations?

A

No, It is not restricted and can make decisions as need arises not limited to situations thought of previously.

20
Q

Is a Living will restricted to specific situations?

A

Yes, it provides specific instructions about treatments and interventions that the individual would or would not want in specific circumstances. Its usefulness is limited because the circumstances have to be though of before hand.

21
Q

What is the goal of a DNR/DNI?

A

To support patient autonomy and prevent non-beneficial interventions

22
Q

What is the survival rate of field CPR?

A

10 - 15 %

23
Q

What are DNR protocols based on?

A

Three value considerations

24
Q

What are the three value considerations that a DNR is based on?

A

self-determination, well-being, and equity

25
Q

What do DNR orders fail to do?

A

Prevent self-determination and prevent non-beneficial interventions

26
Q

What are problems with DNR’s?

A

Discussions occur infrequently, and often don’t involve the patients family, or after it is too late for the patient to participate

27
Q

What is a POLST?

A

Out of hospital order that indicates the patients preferences for resuscitation and scope of treatment

28
Q

Who is the POLST intended for?

A

Seriously ill patients

29
Q

What two things does CA combine to make a combined directive?

A

LW and DPAHC

30
Q

What is the legally recognized format for a living will in California?

A

The advanced health Care Directive

31
Q

Does CA recognize a POLST?

A

Yes

32
Q

What are non-skilled Nursing tasks?

A

ADL’s, Ambulating, assistance with elimination, feeding dysphagia patients, I&O’s, Vital Signs

33
Q

What are skilled nursing tasks?

A

Assessment and evaluation, IV, I&O (Iv feeding, and wound drainage), medication, patient education, pt care assignments, sterile technique, use of nursing process, follow up assessment of delegated tasks.

34
Q

A disabled 75 yr. woman in California has a monthly income of $500.00. Which of these is she eligible for?

  • social security
  • Supplemental security income
  • medicare
  • medical
A

All of them

35
Q

Medicare part A covers which of the following.

  • hospital fees
  • outpt services
  • indefinite long term care coverage
  • hospice
  • home heath care
A

Hospital
Hospice
Home Health
(Part A is the three H’s)

36
Q

Medicare part B covers which of the following?

a. Indefinite long term care
b. outpatient medical appointments
c. eyeglasses
d. hearing aids
e. dental work

A

b. outpatient medical appointments

37
Q

You are the charge nurse of a LTD. Which of the following would you delete to an UAP/CNA?

A. Quarterly update of nursing care plans
B. Pain assessment of prostate CA pt
C. Vitals on a resident who fell yesterday
D. Skin assessment of resident with stage 1 decubitus

A

C. Vitals on a resident who fell yesterday

Gero Final (4 decks)

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