Ethical Issues In Dementia

Dementia often includes symptoms such as memory loss, trouble doing normal everyday activities, and problem solving. Once the symptoms come, they will most likely stay. They will only become worse and worse over time, so it’s necessary to try and come to terms with the disease. Caregivers can try to make the person affected as comfortable as possible as their body is slowly transitioning. Because there is a loss of blood flow to the brain, signals that are necessary in order to keep the body functioning properly eventually stop being sent. The muscles will stop being sent signals to move, and sometimes the signal to breathe can even be stopped.

This ethical scenario presents an 86 year old female with numerous health issues and chronic illnesses. Mrs. Boswell’s advancing Alzheimer’s disease makes it extremely difficult to initiate dialysis, leading her physician to conclude a poor quality of life. The ethical dilemma portrayed in this case is between nonmaleficence and autonomy. Health care workers should focus on promoting the patient’s overall wellbeing and weigh the benefits and risks of the course of action, while also considering what the family declares they want done. Since the patient is deemed unable to make decisions, the goal is to collaborate with family, assess patient quality of life, address prognosis, and establish realistic care goals.

This paper is written to discuss the ethical dilemma we come across when asking our self whether or not we should place a tube feeding in a patient with a history Alzheimer’s or Dementia. Will this prolong the patients’ life or just the inevitable death? Most often a decision needs to be made regarding the placement of a tube feeding. The question is not initiated by the patient themselves. This is the reason why educating our patients are so important. In this paper I will discuss how important the role of the healthcare professional plays in advocating for a patient. To help answer this ethical dilemma several issues will be explored. I will focus on the seven principles of ethics, education, utilitarianism, top-down

Key legislation that relates to the fulfilment of rights and choices and also minimises the risk of harm to an individual with dementia is:

Long-term care assists individuals who cannot adequately perform their routine activities of daily living. These activities include dressing, bathing, walking, meal preparation, and taking medications ( Batnitzk,A.,Hayes,D.,& Vinall,P.E. 2014,(c. 5.1). These services are typically for clients over the age of 65 years old and is used to promote independence and security for those who cannot take care of their needs due to illness or debility (c.6.1). The type of provider will depend on the type of care a client needs. For instance, some elderly people that need help with food preparations or everyday activities will request to stay at home and have a family member take care of them. This is one way that long-term care is rendered but is unpaid.

As more and more elderly Americans choose to spend their later years in assisted living facilities, FRONTLINE and ProPublica examine whether this loosely regulated, multi-billion dollar industry is putting seniors at risk? Their film “Life and Death in Assisted Living” depicts different phenomenons that occurs in assisted living that America is unaware of. A testimony provided in the film describes assisted living as being “a rock that you don’t want to look under” because of the unspoken neglect and abuse of the residents in the facilities. This film focuses on the investigation and evaluation of the care provided by Emeritus’ assisted living facilities. It provides viewers with information on what makes assisted living unique, the qualifications

People who have dementia are not aware of requirements for living. They can forget to do the essential things that are vital. Taking medicines, hygiene and even eating are often forgotten. They can get lost or hurt and not understand what is necessary to correct a situation. Turning on the cooker or water and forgetting to turn it off again, locking doors, crossing streets etc can all be dangerous even deadly. In the same way as you would not think an infant capable of self care, a person with dementia cannot be either. Considering the facts that they cannot act in the manner of a

1 UNDERSTAND KEY LEGISLATION AND AGREED WAYS OF WORKING THAT SUPPORT THE FULFILMENT OF RIGHTS AND CHOICES OF INDIVIDUALS WITH DEMENTIA WHILE MINIMISING RISK OF HARM

Enhancing dignity in the care of people with dementia Professor Lesley Baillie Florence Nightingale Foundation Chair of Clinical Nursing Practice, London South Bank University and University College :London Hospitals Plan Types of dignity • Human dignity: the dignity that all humans have and cannot be taken away • Social dignity: experienced through interaction - dignity-of-self and dignity-inrelation (Jacobson 2007) • So for people with dementia: • We must acknowledge and respect their human dignity • We must recognise how their dignity is affected by how they feel and by our interactions with them  What is the meaning of dignity? How does it feel to have dignity?

According to the Alzheimer's Society diagnostic rates on average in the England are just under 48%, which despite being a two percent increase from 2012, means there are still around 416,000 people in England who are living with dementia but who are not diagnosed (Alzheimer's Society, 2014). In an effort to tackle dementia diagnosis the government in 2014 announced a £90 million package to improve services, which has lead to an increase in the number of referrals from primary care to memory assessment clinics (DoH, 2014). To meet the new demands on services it has becoming increasingly incumbent that psychologists and specialist nurses take on a new and active role in giving a diagnosis to their patients (Murphy & Gair, 2013; Page et al. 2008, & Griffths et al.

The issue of elder abuse is clearly an ethical concern. As a caregiver, the nurse has the responsibility to ensure that the environment of the patient is safe and supportive of health and wellness. In the case of an elderly patient who is too frail to engage in effective self-care, the demands upon the nurse increase as the nurse must

Nurses are expected to provide physicians with quality assessments and needs of their patients to ensure when a change from curative care to palliative care is needed and to ensure good death. Death has always caused an ethical

Nurses provide guidance and address the problems in the end-of-life decision-making process. It is the nurse’s role to explain to families and other healthcare professionals when an advance directive would be put to use. An advance directive serves as a guide for clinicians to respect and honor the autonomous decision of the patient when they are in a position to not be able to express their wishes (Roux & Halstead, 2009). Nurses could assist in ensuring the patient needs are met along with protecting their rights. The registered nurse act as client advocates in health maintenance and clinical care (Standards of Nursing conduct or practice, 2003). Advocating for patients could bring implications such as conflicts with physician and

There are many grand nursing theories that could be applied to this ethical dilemma. However, Virginia Henderson recognized death as an option when treatment is no longer an option. Virginia Henderson developed the theory of need. The theory of need defines nursing as “assist[ing] the individual, sick or well, in the performance of those activities that will contribute to health or its recovery (or to a peaceful death) that the person would perform unaided given the necessary strength, will, or knowledge” (Henderson, 1997, p. 22). “She described the

As well as medical caregivers, nurses must confront some of the most serious human dilemmas all individuals muse over, such as death and dying. Nurses often deal with extreme ethical conundrums on a daily basis. These concerns include end-of-life issues, caring for an elderly or disabled relative, the proper way to raise a child, and the degree to which a person with a mental or physical impairment has autonomy over his or her body.