Mr. Parker is an 88-year-old resident of your LTC home with end-stage Alzheimer’s. He is wheelchair bound and spends most of his days sleeping in his wheelchair near a window facing the garden. He needs to be spoon fed but has recently started to refuse to eat. Mr. Parker has three children, one of whom is very involved in the care of her father. The team approaches the daughter about her father refusing to eat, and feels that his refusal is legitimate. Thus, they propose changing the plan of care to palliation. The daughter absolutely refuses, claiming that “you cannot kill my father, I want everything done to keep him living!” • What are some of the ethical issues in this case? • Do we know whether the resident is capable to make his own health care decisions? • Are there any known wishes from Mr. Parker? What would he want? What are his values? • Is his daughter the substitute decision-maker? Can she, in this role, demand treatment and expect that you comply?
Making healthcare decisions at the end of life care is the primary ethical issue bound with Mr.Parker. Parker's daughter does not wish for palliative care. But she is not involved in the primary care of the patient and so she is not in the state to take the right decision for the well-being of the patient. Additionally, the patient also not in the state of taking the right choice of his own treatment. He doesn't have a proper caregiver who involved wholly in the care decisions. Parker's wishes and his values should be included in the care decision process. Living will and advanced directives should be checked before taking the final decision. If it is not, then the son who involved in the care of the father can take the decision in spite of his father. The health care providers should explain the patient and his family about his condition and his need for palliative care which helps to improve the quality of life. Discuss with the family about the positive and negative outcomes of the patient in order to take the right decision.
Mr. Parker is an 88-year-old resident of your LTC home with end-stage Alzheimer’s. He is wheelchair bound and spends mos...
Mr. Lightning Strike Nara is a 35-year-old half Asian and Half Lakota Native male. He is in a Med-Surg unit receiving comfort care. He is dying of pancreatic cancer. Though his father was Japanese Mr. Nara identifies more with his Lakota Native American mother. His father died in an airplane crash when Mr. Nara was 5 years old. He was brought up in a reservation in North Dakota by his mother. Mr. Nara is married to a Lakota Native American...
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Mr. Heron is a client of your agency. He lives in a retirement home but uses home-support services from your agency two mornings a week. You have been visiting Mr. Heron for a month now. Although he is forgetful, he is a precise person who has definite preferences as to how things should be done. Four times out of the eight times you have visited Mr. Heron, he has met you at the elevator near his room. Sometimes he is...
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