Question

Read the Case Study and answer the following questions

An 87-year-old female resident has lived in your nursing home for three years. She was initially placed there by Adult Protective Services after her two daughters were determined to be stealing her medicines. She has end-stage Alzheimer's disease, is noncommunicative, and requires total feeding assistance. A living will is on file, indicating the resident's wish for no artificial means of prolonging her life, and she is also under the care of a local hospice agency. One of her daughters now has power of attorney. The daughter approaches you with a copy of her mother's membership certificate in the Hemlock Society, which advocates assisted suicide. (Assisted suicide is not legal in your state.) She also brings you a book published by the Hemlock Society. She claims that total feeding assistance is an artificial means of prolonging life and violates her mother's wishes. She asks that you stop the feeding and allow nature to take its course. The nursing staff reports that the resident eats relatively well. Her weight is stable, although she is assessed as being at high risk for pressure ulcers and weight loss. CNAs can tell you her favorite foods, based on facial expressions. She seems to especially like strawberry milkshakes; she smiles, smacks her lips, and sucks on the straw vigorously to the last drop. The ethics committee will be meeting with the daughters, hospice agency representatives, and the nursing home's attorney. You use the ten-step model by Pekel and Wallace (2015) to evaluate your options.

1. In your opinion, what is the biggest challenge with this situation for the leader of this facility?
2. If you were the decision maker, the Administrator, that will ultimately be held responsible by regulatory agencies for any decisions made and the ultimate outcome of this situation, what actions do you think you would you take and why? Who would you consult? What actions would you not take and why? Be sure to consider how your own personal beliefs and life experiences have potential to impact your actions, decisions, facility policies and interaction with residents/families.

Answer 1

The biggest challenge here is to educate the
daughterabout the basic requirements or eligibility
ota patient tor assisted suicide though there is
living will stating no artiiicial means to prolong

lite Here the patient though not responding
verbally is able to react to the type of teeds through
facial grlmace which is an act of accepting the
treatment willingly.

Some of the aciicrls which could be taken in place
of a administrator are

- Getting help trom the ethics committee to clarity
the daughters request is acceptable or not

. Gathering intorrnation trom the primary care
provider in regards to the patient status.tnis gives a
clear image otthe condition otthe patient about
the prognosis

. Counseling to the daughter in handling critical
situations

. The personal pellets and lite experiences can
impact the actions in the following ways

. Being sensitive, while making decision can
hinder the appropriate decision which can
benetit the patient and the family members

. Expecting the daughterto raise a legal notice
for permitting assisted suicide

. The eltherdecision can impact the tamiiy.This
will make the tamily members to go through a
stage of griefto overcome the situation.