Ethical Issues In Long Term Care

The majority population of long-term health facilities is comprised of geriatric patients with complex comorbidities. Studies show that one-third of these patients have cognitive impairments, and over one-half have physical limitations (Tjia, Bonner, Briesacher, McGee, Terrill & Miller, 2009). It is important to know geriatric patients have increased vulnerabilities. When patients are poor historians and family is unavailable, the nurse often becomes their only advocate during facility admissions. Adequate discharge planning is imperative for patient safety and successful transitions from hospitals to long-term care facilities. It is the equal responsibility of both care

Polypharmacy, described as an individual taking more than four medications, can be concerning with the aging population. Polypharmacy concerns include adverse drug reactions, drug interactions, higher cost, decreased mobility, decreased quality of life and cognition impairment. Those at greater risk of negative polypharmacy consequences include elderly, psychiatric patients, recently hospitalized, individuals with multiple doctors or pharmacies and people with impaired vision or dexterity. There are times that polypharmacy is at times needed to help a person with their diagnosis, an example of this is using multiple medications to treat congestive heart failure which can include digoxin, diuretics, and angiotensin-converting enzyme inhibitors

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.

One of the main ethical issues that faces health care is the security of patient information. This information is protected by laws and regulations such as HIPPA, but there are still concerns Scott, et al, 2005). Among those concerns is the new concept of electronic patient records and information. These records are designed to help hospitals and doctors get patient information more quickly, so that patients can receive treatment as soon as possible. Unfortunately, anything kept and transmitted on a computer has the potential to be hacked, so that is a serious concern for patients. Not all patients want their medical records to be available electronically, but they may not have too many options (Romano & Stafford, 2010). Opting out may not be an option for them, and if they do have that option it could reduce the speed and quality of treatment that these patients would receive. Do they want to risk that, just so they can feel as though their medical information is better protected?

“The control of pain is the key to all other care”(Raiman 1998). This is especially true within old age psychiatry as if a client is in pain it may be impossible to recognise a pure diagnosis of agitation or depression and intervene accordingly when there is the possibility that these symptoms may be reactive due to inadequate pain relief. The key to therapeutic success is how well are the symptoms being relieved. Untreated pain in the client with dementia can delay healing, disturb sleep and daily activity, reduce quality of life and prolong hospitalisation (Horgas 2003).

Recent studies indicate that limiting the use of certain medications can improve a senior's life. One study, conducted by researchers at Indiana University, finds that the prolonged use of anticholinergics may cause physical changes within the brain that could lead to dementia. Furthermore, The Canadian Foundation for Healthcare Improvement (CFHI) released information related to a program it started in 2014: This study examined how the discontinuation of antipsychotic medications affected the seniors who were taking them to treat dementia. The results indicate that seniors’ lives may improve when antipsychotic medications (that are being used to treat dementia) are discontinued.

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.

More than 5 million Americans currently have dementia in the United States and this number is projected to rise to between 8 and 13 million by 2050 (Alzheimer’s Association, 2015). Dementia is known to become more prevalent with age, increasing from 5 to 10 percent in people over 65 years of age to almost one half of people over the age of 85 (Alzheimer’s Association, 2015). Although family members provide the majority of care for people with dementia, increasing needs over time often lead to placement in a long-term care setting. Dementia is the most common reason for entry into long-term care facilities (Zimmerman, 2013) and nearly 90% of persons with dementia will have at least one stay at a nursing home in their lifetime (Grunier, 2007).

In this essay I will be elucidating and explaining the legal and ethical issues relate to health and social care. Legal and ethical issues are usually involved individuals having to abide, practise of law. Though, in most cases there will be a consequence for not abiding by the law. Within the health care setting, professionals practice, there are many regulating, jurisprudence and criterion of practice. Performing an abortion is legal, may not be considered ethical by other health care professionals or member of employers.

Nearly half of seniors do not take their medications when or how they were prescribed. There are mistakes on dosages, methods of delivery, time of delivery, what they should be taken with, and even if they should still be taken. Compounding the issue, most seniors over the age of 65 are taking between 8 and 13 different medications. Put these numbers together and it is no wonder that problems with medication management are one of the leading reasons seniors end up in the emergency room, and is the number one reason seniors end up back in the hospital after being recently discharged. According to a study published in "Pharmacotherapy", nearly 70 percent of hospitalized seniors suffered from at least one

The purpose of this paper is to critique the research article, Mohler & Meyer’s “Attitude of nurses towards the use of restraints in geriatric care: A systemic review of qualitative and quantitative study 2014. The incident I am going to discuss in this paper is of Mr. P., an 85-year-old man, admitted to this facility about 4 months ago. His history includes coronary heart disease, cataract, dementia, hypertension, macular degeneration and Alzheimer’s. Mr P. scored 28 of 30 on the Folstein Mini-Mental State Test, he missed the date and recalled 2 of 3 objects in 5 minutes (Folstein, Folstein, and McHugh 1973). His medications include; Analgesics, antihypertensions, antipsychotics

The US is an aging society like many societies around the world and as a result, there is an increase in the number of patients admitted to nursing homes. The elderly population is a fragile population that undergoes mental and physical decline in health. This increases the number of medications used, which increase the risk of adverse drug reactions due to drug-drug and drug-disease interactions. Pharmacists have become increasingly active in nursing homes by providing medication therapy management services, but the benefit in reducing prevalence of these adverse drug reactions is not fully understood. Medication therapy management is a growing field that has been incorporated by pharmacists in different states to optimize therapeutic outcomes in individual patients. Understanding the relationship between medication management and drug- drug

I blew the whistle in this situation when the lack of ethical care for residents and work ethics fell short of the normal standards. As a care provider one must always be aware of that the dignity of the client when it comes to their care. I return to my regular position after three months of working graveyards to find that the residents were being brought to the dining room in the hospital gowns. There was no regard for the resident’s dignity. Their backs were exposed and often the gown was exposing their chest. No one took in count how the resident must feel going into the dining room so exposed. The staff could of a least put on clothing over top of the gown or a sweater to hide what they were wearing. And use a lap blanket so they

According to an article written by Anna Gorman of Health Leaders Media, the use of prescription drugs is a growing concern. The article mentions Lola Cal, a patient in a geriatric unit in Santa Monica, California whose medical records show that she is on 36 different medications. Although people born from 1946 to 1964, known as the baby boomer generation, only make up 16% of the U. S. population, this generation accounts for one-third of prescription drug use. Many elderly patients take several medications to treat chronic illnesses and raise their chances for serious side effects and dangerous drug interactions. Dr. Maristela Garcia, director of the inpatient geriatric unit at UCLA Medical Center in Santa Monica states that polypharmacy is “America’s other drug problem.

Falls are a common cause of death for people over the age of 65. Following accidents, fall related mortality rate has relatively stayed constant over the last four decades. The dementia disorder continues to add an increase in fall-risk. Despite their knowledge