Geriatrics Ethics Assignment Writers
What is Geriatrics?
Geriatrics is a subdiscipline of medicine that focuses on the provision of healthcare to elderly persons. The elderly person in this case can be of any age. Most family members who seek geriatric help for their loved ones do so if being the primary caregivers becomes overwhelming for them.
Additionally, if it becomes unclear which drugs are appropriate for their increased list of prescribed drugs and when these elderly persons become frail or impaired, it is advisable to seek the services of a geriatrician.
Doctors are specially trained to handle a list of problems that are associated with geriatric patients. Problems associated with elderly persons are mainly caused by circulatory and mental deterioration.
Others are a result of deterioration of the sensory system that comes with old age and the most common problems are falls, coronary heart disease, dementia, delirium, and poly-pharmacy.
Common Geriatrics Conditions
- Dementia – dementia is the condition in which the thought process of a person slows down. Dementia commonly results in stupor, apathy, and confusion. Common characteristics of dementia are poor hygiene, impaired judgment, memory loss that can be both short-term and long-term, and disheveled appearance.
- Delirium – delirium can be defined as mental faculties disorder that is usually temporary. Characteristics of delirium include delusions, hallucinations, restlessness, and excitement. Delirium is more of a syndrome than a disease and is usually a result of an underlying medical condition.
- Falls – frequent falls that may lead to disability or death. this is more common in people above 65 years. The degree of injuries varies from minor bruises to fatal trauma.
- Polypharmacy – polypharmacy is the use of five or more types of drugs by a person daily. These medications are used concurrently and on a long-term basis.
- Coronary heart disease – this is a type of heart disease that occurs as a result of the failure of blood arteries to deliver sufficient oxygenated blood to the heart. It occurs as a result of a build-up of plaque in the lining of the bigger arteries.
Elderly persons suffer from health conditions and problems meaning they have multiple prescribed drugs. Medications, diseases, and illnesses affect the elderly differently compared to younger adults.
One of the key roles of geriatricians is to develop, prevent and manage care plans that are specific to the health problems associated with the elderly patients.
With the use of the current trends, it has been predicted that there will be a surge in the number of clinicians needed to take care of elderly persons with medical and psychosocial issues.
These issues may lead to ethical dilemmas. Clinicians need to familiarize themselves with ethical dilemmas experienced when taking care of elderly patients. Examples of such challenges are:
- Responding to request for intervention
- Recommending nursing home care
- Ensuring informed consent and confidentiality
- Promoting advance care planning
- Use of advance directives
- Determining capacity to make decisions
- Surrogate decision making
- Using cardiopulmonary resuscitation and do not resuscitate orders
- Withholding and withdrawing interventions
- Allocating healthcare resources
Ethical dilemmas are likely to occur due to poor communication between the clinician and patient. Management of geriatric problems usually raises ethical issues. For instance, having a home care nurse is likely to compromise the privacy of the old person. There are several benefits attached to attending day centers.
Likewise, the autonomy of the elderly patient must always be a priority when planning to admit them to a care home for the elderly. It is not right to assume their family members will always do what is best for them and decide on their behalf.
One of the problems in assessing the ability of an elderly person to make decisions for themselves is whether on consent for treatment, management of their affairs, or participating in research.
Cognitive ability is not always the same as competency. Due to this, several meaningful tools have been developed to investigate specific situations. Change in how the elderly interact with their environment is likely to cause ethical dilemmas as a result of the stress caused by the illness and caregiving.
Elderly patients are highly dependent on others. This is because they may be physically, mentally, or emotionally disabled. The situation is further worsened by previous dysfunctions coexisting.
This has an impact on the family who may be their managers. In addition, the family is burdened with the person’s care. In such a scenario, social help needs to be reinforced.
Ethics can be defined as a set of principles that guide the conscientious conduct of a person. Ethics includes honoring the decision of a person and doing the right thing. Ethical principles in geriatrics include justice, autonomy, fidelity, non-maleficence, and beneficence.
Ethical principles in Geriatrics
- Autonomy – this is the right of an individual to determine and choose their destiny. In geriatrics, autonomy means the following:
- a patient has the right of self-determination
- a patient has the right to be informed of the pros and cons of the medical decisions made.
- Autonomy does not exist if a patient’s behavior or actions is against the law or endangers the health and safety of the public
- a patient has the right to deny or accept treatment and diagnostic work-up such as unwanted touching
- if a patient is incapacitated, surrogate decision-making is allowed if the wishes of the patient are not known or unclear.
- Justice – justice in geriatrics involves sharing burdens and benefits on a fair and equal basis. This entails equitable distribution of treatment and resources, making decisions based on objectives and not emotions, and being lawful and fair.
- Beneficence – this involves doing good and the right thing on behalf of the patient instead of the healthcare workers. It means focusing on the welfare of the patient, doing all that can help medically, and doing right by the patient.
- Non-maleficence – this involves protecting the safety of the patient and ensuring no harm is caused to the patient. It involves avoiding any harm and withholding treatment if it is not likely to give the desired results or if it does not improve the welfare of the patient.
- Futility of treatment – any treatment given should be clinically realistic. It should align with the goals of the patient. Treatment and interventions that are likely to prolong the suffering of the patient should be avoided.
- Confidentiality – healthcare providers should conform to the state laws on disclosure to third parties and public health.
- Patient-physician relationship – patient-physician relationships that are likely to jeopardize treatment and decisions should be disclosed. The relationship between a physician and patient should be characterized by trust, fidelity, and confidentiality.
- Telling the truth – healthcare providers have a responsibility of being honest and telling the truth instead of offering encouragement. Physicians should always communicate an honest prognosis.
- limited resources – it is important to acknowledge that health care resources are usually limited. Decisions and allocations made should be done in a manner that does not discriminate.
- Non-abandonment – once a physician establishes a therapeutic relationship with their patient, they should not abandon the patient. In cases where the physician and patient/proxy do not agree on the course of treatment, they should be guided by the ethics committee or the department of health or ombudsman. Termination of patient care should only be done if the patient or proxy is fully informed and has been given enough time to make arrangements for alternative treatment.
- Fidelity – fidelity involves honoring commitments, being faithful and loyal.
Some of the attributes that make the elderly vulnerable are:
- Health status
- Loneliness and isolation
- Social support
- Personal losses
- Physical decline
- Economic and social challenges
- Cognitive impairment
- Environmental factors
- Employment history and education
- Less likely to report abuse
Family caregivers should also learn and understand these attributes for them to be able to make prior arrangements for the needs of their loved ones and avoid possible ethical issues. Some of these ethical issues include:
- Competency and capacity
- Dignity of risk
- Elder abuse and neglect
- Informed consent
- Professional boundaries
- Bias and discrimination
- Elder abuse and neglect
- Grievances and complaints
- Personal privacy
Tips to help professionals uphold ethical principles
- Reporting cases of abuse and neglect
- Inquiring about the ethical practices of the organization
- Engaging in ethical decision making
- Reviewing their profession’s code of ethics
- staying updated on national and local laws and regulations of the healthcare professionals
- refreshing on the bill of rights on client/patient/resident
tips for family caregivers to uphold ethical principles
- they should seek professional help when necessary
- educating the family members and loved ones on how to prevent fraud
- important documents should be in place
- planning ahead and discussing the wishes of the loved ones based on both everyday and long-term needs.
Geriatrics is the branch of nursing and medicine that involves providing healthcare to the elderly. Certain attributes make the elderly population vulnerable therefore their caregivers should adhere to the ethical principles of geriatrics when attending to them
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