Ethics and Ageing

Question 1

why are ethics important to this population group?

Answer 1

• more reluctant to speak up for themselves because of fear of being treated poorly or ostracized
• population aging
• health care resource: when elders get pushed down the wait list because younger people take priority. Deciding who gets the resources. Ageism
• living older, using more health care resources. Who gets the resources?

Question 2

The Nature of Ethics

Answer 2

1. Relationships
2. Context
3. Values and beliefs
4. Ethical principles

Question 3

what is an Ethical Violation?

Answer 3

incompetent care or deliberate wrong doing

Question 4

What is an Ethical Distress?

Answer 4

feelings of guilt, concern or distaste arise out of actions or inactions imposed on a person

Question 5

What is an Ethical Dilemmas?

Answer 5

tension between two or more actions of equal moral

worth

Question 6

Nature of ethics: relationships

Answer 6

1. how are we will patients, colleagues, families organizations and society. Ethics shaped by our current relationship. DIfferent justifications
2. Relations ethics takes into account power and authority, values, beliefs, and wishes of those involved in the ethical decisions. What is the power struggle? your patient is the head of neurology, you may treat them better.

Question 7

Nature of Ethics: Context

Answer 7

in the hospital the clients supplies for care are all covered and applied by health care services. ie catheters or dressings. Then they go home and now they have to pay for it on their own. Where might they get supplies? can they afford it? is it clean?

Financial resources

Question 8

what is a value?

Answer 8

• is defined as that which is desirable or esteemed for its own sake; something we prize or hold dear. ie your integrity, you can value your beliefs

Question 9

What are beliefs?

Answer 9

Don’t confuse with faith. is defined as the conviction that

something is true.

Question 10

what are the four ethical principles?

Answer 10

1. Autonomy: they right to chose for yourself
2. Distributive Justice: equality regardless of situation
3. Beneficence: duty to benefit others
4. nonmaleficence: duty to do no harm

Question 11

difference between equality and equity

Answer 11

equality: everyone gets the same amount of stuff
equity: everyone gets just what they need

Question 12

Relational practice

Answer 12

how do you chose to show compassion and respect to the client you currently have a relationship with.

Question 13

qualities of a nurse: relational ethics

Answer 13

1. capable of working with uncertainty and ambiguity
2. engaging with complex ambiguious experiences and knowing that we do not have all the answers
3. authenticity, responsiveness, mutuality in interactions
4. honouring of differences

Question 14

what is elder abuse?

Answer 14

• Defined as maltreatment of older adults
• Can be intentional or unintentional
• Can result from the actions or inaction of others

Question 15

WHO definition of elder abuse

Answer 15

“…single or repeated acts, or lack of appropriate action, occurring within a relationship where there is an expectation of trust, which causes harm or distress of an older person”

Question 16

Cultural and Socioeconomic Factors

Answer 16

• Frail, weak and dependent
• Erosion of bond: no family connections anymore
• Restructuring
• Distribution of power
• Migration
• Paternalistic societies

Question 17

Difference between assault and battery. Must report them!

Answer 17

Assault: uttering threats
Battery: touching against an elder’s will

** this is okay if they are certified or incompetent

Question 18

types of abuse

Answer 18

1. physical
2. emotional
3. sexual
4. financial
5. neglect

Question 19

what is psychological abuse? biggest type

Answer 19

1. Attempts to dehumanize or intimidate older adults
2. Verbal or non-verbal
3. Reduces sense of self-worth or dignity
4. Threatens psychological and emotional integrity

Question 20

what is physical abuse?

Answer 20

1. Non-accidental use of physical force to coerce or to inflict bodily harm
2. Physical discomfort, pain or injury
3. Injury does not have to be experienced ** ie. being pushed may not leave a mark

Question 21

What is financial abuse?

Answer 21

1. Financial manipulation or exploitation
2. Includes theft, fraud, forgery or extortion
3. Often accompanied by other forms of abuse (psychological, physical, denial of rights)
4. Perpetrator usually a trusted person in senior’s life

Question 22

what is neglect?

Answer 22

Failing to care for or meet the needs of dependent older adults
ACTIVE
- Intentional withholding of basic necessities
PASSIVE
- Not providing basic necessities because of lack of experience, information, or ability. Can be physical, psychological or financial

Question 23

what is sexual abuse?

Answer 23

1. Sexual behavior directed towards and older adult without their full acknowledgement
2. Include sexual assault, sexual harassment, and rape
3. Purpose to exert power and control or to demean
   person
4. Includes both physical and psychological
   components

Question 24

risk factors of abuse

Answer 24

1. Vulnerability
2. Gender
3. Psychosocial Factors
4. Caregiver Factors
5. Dependency
6. Past History of Abuse
7. Environmental and Systemic Factors

Question 25

Consequences of elder abuse

Answer 25

- Compounds the effects of marginalization (already marginalized, makes it worse) - Damage self-worth and dignity and increase their social isolation - Affects those around them - Physical Injuries

Question 26

Characteristics of perpetrator

Answer 26

- Substance Abuse - Psychiatric Disorder - History of family violence - Dependency on the older adult - Poor social network - Stress

Question 27

characteristics of a victim

Answer 27

- Social Isolation - Chronic Illness - Functional Limitations - Cognitive Impairment - Sharing living arrangements with perpetrator - Female gender

Question 28

why are elders at risk for legal concerns?

Answer 28

- Vulnerability - Frailty - Exposure to risks - Age related changes - Family caregiving - Resources for seniors in their community

Question 29

capacity vs competency

Answer 29

Capacity: you may lack competence but you can still perform your ADLs, still capable. Competency: Degree of mental ability that is required to make decisions

Question 30

Living decisions

Answer 30

culture plays a role in this decision | your personal decision on how you want your life to end

Question 31

factors influencing end of life decisions

Answer 31

```  Culture  Family members values and beliefs  Economics  Generational differences  Values and beliefs regarding age, illness and death ```

Question 32

Legal issues, why are they at risk for vulnerability

Answer 32

- live with more chronic illnesses which can impair cognition (communication & judgment) - are often living with changed economic resources - often live alone and are “easy targets” for the unscrupulous.

Question 33

what is the nurses duty

Answer 33

```  Malpractice/Unprofessional Conduct  CARNA – Nursing Practice Standards  Health Professions Act  Confidentiality  Code of Ethics  Documentation ```

Question 34

competency

Answer 34

 Capacity to make decisions |  Guardianship vs. Trusteeship

Question 35

informed consent

Answer 35

 Procedures  Invasion of Privacy Photos Medical records for study

Question 36

know chart!

Answer 36

..

Question 37

whats the difference between Enduring power of attorney and trustesship

Answer 37

EPOA- made someone your power of attorney when youre of sound mind Trusteeship: government and court makes decisions on what happens

Question 38

personal directives

Answer 38

 Survives mental infirmity/physical disability (unlike a POA)  Must describe the limits of the authorities (financial, property, health care, etc)  Must be in writing and usually made with a lawyer

Question 39

what is the nurses roles in personal directives

Answer 39

 Supporting client decision making |  Interpreting and following through with the clients wishes

Question 40

rights of the older adults

Answer 40

 Residents have the right to be free of unnecessary physical or chemical restraints.  Residents have the right to participate in care planning meetings.  When a resident experiences any deterioration in health, or when a physician wishes to change the resident's treatment, the facility must inform  the resident  the resident's physician  The resident’s legal representative or interested family member

Question 41

what is advanced care planning

Answer 41

Advance care planning is a process by which people can think about their values about future healthcare choices; explore medical information that is relevant to their health concerns; communicate wishes and values to their loved ones, their agent/representative and their healthcare team, and record those choices A Voice at the end of life