Ethico-Legal Considerations in the Care of Older Adults PDF

Ethico-Legal Considerations in the Care of Older Adults Importance of understanding ethical and legal principles in gerontological nursing Moral and legal principles that guide healthcare professionals in providing care to the elderly population. Laws Affecting senior citizens  RA 7432- P...

Ethico-Legal Considerations in the Care of Older Adults Importance of understanding ethical and legal principles in gerontological nursing Moral and legal principles that guide healthcare professionals in providing care to the elderly population. Laws Affecting senior citizens  RA 7432- Philippine law that seeks to promote the welfare of older persons and ensure their participation in society. -Expanded and Strengthened Senior Citizens Act of 1992.  RA 9257- Philippine law that seeks to promote the welfare of older persons and ensure their participation in society. -Expanded and Strengthened Senior Citizens Act of 2003.  RA9994- Philippine law that aims to promote the welfare of older persons and ensure their active participation in society. -Expanded Senior Citizens Act of 2010.  Increased discounts: Senior citizens are entitled to higher discounts on goods and services, including on medicines and medical services.  Free medical care: They are entitled to free medical care in government hospitals.  Senior citizen identification card: The law mandates the issuance of senior citizen identification cards, which provide access to various benefits.  Social security: RA 9257 strengthens the social security system for senior citizens.  Pensions: It provides for pension benefits for government employees and private sector workers. Ethical Principles Autonomy: Respect for patient's right to self-determination Beneficence: Doing good and promoting well-being Non-maleficence: Avoiding harm Justice: Fairness and equitable distribution of resources Veracity: Truthfulness and honesty Legal Considerations  Informed consent: Obtaining patient's informed consent for treatments and interventions  Advance directives: Respecting patient's wishes regarding end-of-life care  Confidentiality: Protecting patient's personal information  Elder abuse and neglect: Recognizing and reporting signs of abuse Ethical Dilemmas in Gerontological Nursing  Balancing autonomy and beneficence: Respecting patient's wishes while ensuring their well-being  Decision-making capacity: Assessing patient's ability to make informed decisions  Resource allocation: Prioritizing care for older adults in limited resource settings  End-of-life care: Balancing aggressive treatment with palliative care Ethical Decision-Making Framework  Identify the ethical issue  Gather relevant information  Consider ethical principles and values  Explore options and potential consequences  Make a decision  Reflect on the outcome Addressing Elder Abuse and Neglect  Recognizing signs of abuse and neglect  Reporting suspected cases to appropriate authorities  Implementing prevention strategies Cultural and Social Considerations  Respecting cultural differences and beliefs  Addressing social disparities and inequalities  Promoting social justice for older adults Continuing Education and Advocacy  Importance of staying updated on ethical and legal issues in gerontological nursing  Advocating for policies that support the rights and well-being of older adults  Nursing care in older adult 1. Chronic care 2. Acute care  Services for older adult Access Community-based In-home services services services Case Adult day care Home-delivered meals management Information and Congregate nutrition home health service referral program transportation Elder abuse protective Home hospice care services Health Homemaker service screening/wellness promotion Housing service Home maintenance and repair or chore service Access Community- In-home services service based services s Institutional respite In-home respite care care Legal assistance Personal emergency response system Multipurpose senior Telephone monitoring and centers friendly visitors Psychological counseling Retirement  Factors affecting the need for nursing home/care Characteristics of the Individual Age ,sex and culture /race Marital status Living arrangement Degree mobility Ability to perform basic activities Urinary or fecal incontinence DM Behaviour problem Memory and cognitive impairment Mood disturbance Mental status Tendency to fall Clinical prognosis Income/payment eligibility Need for special service Characteristic of the support system Family capability Age and health of spouse Presence of responsible relative Family structure of responsible relative Physician availability Amount of care  Community resources Formal community resources Informal support system Presence of long term care institution  Spirituality Among Older Persons Personal beliefs and values Connection to a higher power or something greater than oneself Meaning and purpose in life Transcendence and spirituality What the Importance of spirituality in older adults' lives? What are the Importance of spirituality in older adults' lives? 1. Improved mental health and well-being group 1 2. Enhanced quality of life group 2 3. Increased resilience to stress group 3 4. Greater sense of purpose and meaning group 4 5. Improved social connections group 5 Come up with actual implementation of the spirituality in older adult. If you’re going to implement the importance spirituality in older adult, how? FORMAL OR THERAPEUTIC COMMUNICATION conscious and deliberate process used to gather information related to a patient’s overall health status (physical, psychological, spiritual etc) and to respond with verbal and nonverbal approaches that promote the patient’s well-being or improve the patient’s understanding of ongoing care.  INFORMAL OR SOCIAL COMMUNICATION a simple chitchat has a place in nurse-patient communications.  NONVERBAL COMMUNICATION Symbols  Tone of voice  Body language  Space, distance, position Proxemics – is the study of the use of personal space in communication PUBLIC SPACE at this distance, there is no real positive or negative connection with the other person SOCIAL SPACE – is a comfortable distance for a casual relationship in which communication is at an impersonal level. If a nurse stays this far away from his patient, the message being communicated is indifference PERSONAL SPACE – the optimal distance for close interpersonal communication with another person. A nurse who communicates from within this space is usually viewed as concerned and interested  BARRIERS TO COMMUNICATION Age-related Changes All five senses tend to decline those adults of advancing age. Most likely hearing and vision changes are to affect communication, but other losses may affect how we think about older adults.  5 senses 1. Hearing: A general loss of hearing may result from disease, noise, or bone changes; gradual loss of ability to hear certain sounds such as: "S, SH, and CH" and high frequencies is common 2. Vision: Changes in vision often include reduced ability to see distant objects, objects that are too close (even faces) and certain colors; loss of ability to see to the sides (peripheral vision) is common 3. Smell and Taste: Reduced ability to smell and taste (both good and bad things) is experienced. Touch: Reduced ability to feel touch in general; also reduced ability to feel hot, cold, and pain may be experienced 4. Reaction time slows: More time is needed to "process" the information and come up with "the answer"  Geriatric Health Care Team: A Collaborative Approach A geriatric health care team is a group of healthcare professionals who work together to provide comprehensive care for older adults. This interdisciplinary team approach ensures that the unique needs of older adults are met and that they receive the best possible care Core Members of a Geriatric Health Care Team Core Members of a Geriatric Health Care Team 1. Geriatrician  A physician specializing in the care of older adults.  Diagnoses and treats age-related conditions.  Coordinates the care plan with other team members. 2. Nurse Gerontologist  A registered nurse with specialized training in geriatric care  Provides direct patient care, including medication administration, wound care, and symptom management  Educates patients and families about health conditions and self-care  Coordinates care with other team members 3. Occupational Therapist  Helps patients improve their ability to perform daily living activities, such as dressing, bathing, and eating  Assesses and addresses fine motor skills, sensory processing, and cognitive function  Provides adaptive equipment and training to promote independence 4. Physical Therapist  Works to improve mobility, balance, and strength  Develops exercise programs tailored to the individual's needs  Provides gait training and assistive device training 6. Speech-Language Pathologist  Addresses communication disorders, swallowing difficulties, and cognitive impairments.  Provides therapy to improve speech, language, and cognitive function 7. Case Manager:  Coordinates care and manages transitions between care settings.  Assists with insurance and financial matters.  Provides social support and advocacy. The significance of aging research Introduction to the NIH 2030 initiative  Key Goals of NIH 2030 Goal 1: Extend Healthy Lifespan:  Delay the onset of age-related diseases  Develop interventions to promote healthy aging Goal 2: Reduce Health Disparities:  Address health disparities among older adults  Promote health equity Goal 3: Enhance Quality of Life:  Improve cognitive function and mental health  Reduce pain and disability  Enhance social and emotional well-being  Research Priorities Neurodegenerative Cardiovascular Disease: Cancer: Diseases: Alzheimer's disease Heart failure Age-related cancers Parkinson's disease Stroke Cancer treatments and survivorship Frontotemporal dementia Vascular dementia Chronic Diseases Frailty and Sarcopenia Diabetes Understanding the mechanisms of aging-related muscle loss Arthritis Developing interventions to prevent and treat frailty Chronic kidney disease  Emerging Areas of Research  Epigenetics and Aging:  The role of epigenetic modifications in aging and age-related diseases  Microbiome and Aging:  The impact of gut microbiota on aging and age-related diseases  Cellular Senescence:  The role of senescent cells in aging and age-related diseases  Interdisciplinary Approaches:  Integrating knowledge from multiple fields to address complex aging issues  Challenges and Opportunities  Challenges:  Complexity of aging processes  Ethical considerations in aging research  Funding and resource limitations  Opportunities:  Advancements in technology and data science  Interdisciplinary collaborations  Global aging population  Challenges and Opportunities 1. Healthcare: Ensuring access to quality healthcare, including preventive care, chronic disease management, and mental health services. 2. Social Services: Providing social support, including home care, adult day care, and community centers. 3. Economic Security: Promoting financial security through pensions, savings, and social security programs.  Challenges and Opportunities 4. Housing: Ensuring safe, affordable, and accessible housing options for older adults. 5. Transportation: Improving transportation options to enable older adults to maintain independence and social connections. 6. Technology: Leveraging technology to support aging in place and improve the quality of life for older adults.  Country-Specific Programs United States  Medicare and Medicaid: Government-funded programs providing health insurance to older adults and low-income individuals.  Social Security: A federal program that provides retirement, disability, and survivor benefits. United Kingdom  NHS: The National Health Service provides healthcare to all residents, including older adults.  Care Act 2014: This legislation provides a framework for social care and support for older people.  Country-Specific Programs Japan  Long-term Care Insurance System: This system provides financial support for long-term care services, including home care and nursing home care. China  The Nine-Year Plan for the Development of the Cause of the Aged (2006-2014): This plan outlined strategies for improving the lives of older Chinese, including healthcare, social security, and housing. Thank you for listening for this semester 2024