Ethico-Legal Considerations in the Care of Older Adults PDF

ETHICO- LEGAL CONSIDERATIONS IN THE CARE OF OLDER ADULTS Learning Objectives: To analyze the different ethico-legal considerations in the care of older adult; 1. Distinguish the specific ethico-legal considerations in the care of older adult 2. Formulate a plan of care using the ethico-leg...

ETHICO- LEGAL CONSIDERATIONS IN THE CARE OF OLDER ADULTS Learning Objectives: To analyze the different ethico-legal considerations in the care of older adult; 1. Distinguish the specific ethico-legal considerations in the care of older adult 2. Formulate a plan of care using the ethico-legal considerations as framework in the care of older adults. INTRODUCTION ETHICS: declarations of right or wrong and what out to be LAW: a system of rules which a particular country or community recognizes as regulating actions of its member and which it may enforce by the impositions of penalties. BIOETHICS: application of ethics to matters of life and death ETHICAL DILEMA: a difficult problem seemingly incapable of a satisfactory solutions; situation involving two equally unsatisfactory alternatives NURSING ETHICS: application of ethical principles in the LAWS AFFECTING SENIOR CITIZENS REPUBLICT ACT NO. 7432: AN ACT TO MAXIMIZE THE CONTRIBUTION OF SENIOR CITIZEN TO NATION BUILDING, GRANT BENEFITS AND SPECIAL PRIVELAGES AND FOR OTHER PURPOSES Primary Purposes: 1. To motivate and encourage the SC to contribute to nation building. 2. To encourage their families and the community rthey live to reaffirm the valued filipino tradition of caring the senior citizen. 3. To establish a mechanism whereby the contribution of the senior citizen are maximized. 4. Adopt measures whereby our senior citizen are assisted and appreciated by the community as a whole; 5. Establish a program beneficial to the senior citizen, their families and the resyt of the community that they serve. Benefits of Senior Citizen under RA 7432 20% discount from all establishments relative to utilization of transportation, hotels, lodges, restaurant , recreational centers and purchase medicine anywhere in the country. 20% discount on admission fees on cinemas, theaters, concerts halls, carnivals and a like. Exemption from payment of individual income tax. REPUBLIC ACT NO. 9257: EXPANDED SENIOR CITIZEN ACT OF 2003 “An act granting additional benefits and privileges to senior citizens amending RA 7432.” Amended Benefits: 20% discount and exemption of Value added tax ( VAT) on: Medicines, including vaccines  Professional fees of attending physician/s in ALL private hospitals , facilities.  Medical and dental services.  Transportation fare.  Hotels, restaurants and services alike.  Leisure services  Funeral and burial services FREE Medical and Dental Services on ALL GOVERNMENT FACILITIES. Educational assistance to pursue post secondary, post tertiary and technical vocational education. Establishment of Senior Citizen Lane Mandatory PHILHEALTH COVERAGE REPUBLIC ACT NO. 9994: EXPANDED SENIOR CITIZEN ACT OF 2010 “An act granting additional benefits and privileges to senior citizens further amending RA 7432.” Additional Amended Benefits: Death Benefit minimum of 2,000 pesos shall be given to the nearest surviving relative of the deceased senior citizen MEDICATION OF OLDER ADULTS POLYPHARMACY: defined as a regular use of at least five medications. Elderly patients tend to take more medicines than others age group because of they may have several diseases or other health problems at the same time. ASSESSMENT TOOL IN POLYPHARMACY ETHICAL PRINCIPLES IN THE CARE OF ELDERLY ETHICS – is the reflective, deliberative process of examining our values, beliefs and choosing the course of action that uphold those values. NURSING ETHICS- is a systematic analysis of ethical issues emanating from nursing practice, education and research. Encompasses the values, standard and ideals of the profession. ETHICAL PRINCIPLES IN NURSING AUTONOMY- right to self determination, independence and freedom JUSTICE- obligation to fair to all people BENEFICENCE- duty to act for the benefit of other; “doing good” theory NONMALEFICENCE- do no harm; protect patients form harm if they cannot protect themselves. ETHICAL PRINCIPLES IN NURSING AUTONOMY- right to self determination, independence and freedom JUSTICE- obligation to fair to all people BENEFICENCE- duty to act for the benefit of other; “doing good” theory NONMALEFICENCE- do no harm; protect patients form harm if they cannot protect themselves. VERACITY- honest and trustworthy in dealing with people. SUBSTITUTED JUDGEMENT STANDARD- surrogate decision maker. BEST INTEREST STANDARD- decision based on what health care providers and/or families decide is best for that person. MORAL PRINCIPLES APPLICABLE TO OLDR ADULTS 1. RIGHT IN MAKING DECISION- right to information on treatment options , participation in decision making 2. RESPECT FOR THE INDUVIDUAL PERSON OLDER – adult deserves respect for their parenthood, they are. Worthy and valuable. Avoid derogatory generalizations, proclamations made on older adults. 3. CONFIDENTIALITY- professional must tell the patient diagnosis and treatment options first before sharing it to the adult children to respect the patient autonomous decision making ability. ( This can only be override if the patient has impaired decision capacity) LONG TERM CARE Involves a variety of services designed to meet a person’s health or personal care needs during a long period of time. This services help people live as dependently and safely as possible when they can no longer perform everyday activities on their own. FACILITIES FOR LONG TERN CARE SERVICES Care Homes Assisted Living Nursing Homes Retirement Care facilities TYPES OF RESIDENTS ADMITTED IN LONG TERM FACILITIES 1. Residents with cognitive impairment 2. Residents with impaired physical functioning 3. Residents with both physical and cognitive impairment PALLIATIVE CARE AND END OF LIFE CARE Is an approach that improves the quality of life patients and their families with life threatening illness through the prevention of suffering including physical, psychological and spiritual suffering. A specialized medical care that focuses on providing patients relief from pain and other symptoms of serious illness, no matter the diagnosis or stage of disease Also known as “ Symptom Management” ADVANCE DIRECTIVES Is a set of instructions someone prepares in advance of ill health that determines his healthcare wishes. a way to say health care treatments you would like to have or refuse, should you be in a position where you are seriously ill or injured and unable to make or communicate decision about your care and treatment. TYPES OF ADVANCE DIRECTIVES 1. LIVING WILLS- are legal documents; they state your wishes regarding the care or life prolonging treatments/procedure you want to receive. Living typically covers situations involving: Resuscitation (CPR) Mechanical ventilation/Intubation Tube feeding/ artificial feeding Dialysis Comfort Care Organ and tissue donation 2. MEDICAL POWER OF ATTORNEY/ DURABLE POWER OF ATTORNEY OR HEALTH CARE PROXY- this option allows to name another person as ”agent”, “designates” such as your spouse or child to make medical decision on patient behalf DO NOT RESUCITATE (DNR)- a medical order written by a doctor instructing health acre providers not to do CPR including Cardiac drugs if patients breathing stops or if aptient heart stops. DO NOT INTUBATE (DNI)- order means that chest compressions and cardiac drugs may be used, but no breathing tube will be placed. FULL CODE-mean if a person heart stopped or breathing stops, all resuscitating procedures will be provided to keep patients alive. SPIRITUALITY AMONG OLDER PERSONS Relates to the vital life essence of an individual Shows considerable importance when physical existence is threatened by disease or death Importance of Spirituality in ELDERLY CARE Gives a positive and hopeful attitude about life and illness which can improved health outcomes. Important to mental health Buffer against depression and fear Initiate the search of meaning in life Prepare one for death ROLE OF HEALTH CARE PROFESSIONALS IN SPIRITUALITY Religious belief and practices helps health care professionals provide care because these beliefs can affect the patients mental and physical health. Health care workers should SUPPORT PATIENTS RELIGIOUS BELIEVES AND PRACTICES Example: referring to clergy as request by the patient Refferences: 1. Co, K. C. D., Mendoza, O. M., Nona Rachel C. Mira, Quizon, R. R., Ma. Sandra B. Tempongko, Mamangon, M. A. M., Salido, I. T. O., & Peter W.S. Chang. (2022). Prevalence of Limited Health Literacy in the Philippines: First National Survey. Health Literacy Research and Practice, 6(2), e104-e112. https://doi.org/10.3928/24748307-20220419-01 2. Garcia, A. P., Shelley F De La, V., & Mercado, S. P. (2022). Health Information Systems for Older Persons in Select Government Tertiary Hospitals and Health Centers in the Philippines: Cross-sectional Study. Journal of Medical Internet Research, https://doi.org/10.2196/29541