Question

Describe one ethical issue related to access to services related to people who are aging in America. How might access to long-term health or other services improve for the elderly in the future? PLEASE PROVIDE SOURCES textbook used- healthcare ethics: critical issues for the 21st century. chapter 5 ethics and aging in america

Answer 1

#. Some of the ethical issues related to access to services related to people who are aging in America :-

1. Autonomy

-personal freedom to direct ones own life as long as it does not infringe on the rights of others

-capable of rational thought and is able to recognize the need for problem solving

-able to search for alternatives and select a solution that allows for personal freedom

-loss of autonomy/independence is a very real fear for older adults

-if safety is threatened then the older person must be referred to appreciate community services

-decisional autonomy: refers to the ability and freedom to make decisions without external influence

-executional autonomy: ability to implement decisions

2. Competency

-refers to the ability to fulfill one's role and handle one's affair in a responsible manner

-all adults are assumed to be competent

-all adults who have not been declared incompetent by a judge have the legal right to make their own decisions about medical treatment and health

-when questions arise about the persons ability to make health care decisions a legally appointted surrogate decision maker is designated

-a petition can be filed to determine whether the person is competent

3. Guardianship

-assigned as either partial or full if the person is incompetent or incapable of making decisions on his or her own behalf

Partial: incompetent person continues to make limited decisions

Full: person loses all rights to make decisions

-guardianship typically remains in place until the patient dies

-can be avoided if the person makes his/her wishes known in an comprehensive and legally binding manner (i.e. appointment of a surrogate decision maker before questions about competency arise)

4. Decision making capacity

-requires ability to understand risks versus benefits and apply personal values

-ability to understand, make and be responsible for the consequences of health care decisions

-determined by HCP and relates to a single decision rather than a global determination of the ability of one to manage their own affairs

-likely to have treatment preferences strongly based on religious values

-decisions are strongly influenced by needs, values, cultural factors, habits and emotions

-people with dementia want to remain involved in decisions about their care for as long as possible

-nurses must identify and address factors that influence cognitive functioning

Person must be able to...

-understand & process info that is relevant to decisions about diagnosis, prognosis, & treatment options

-weight the relative risks/benefits and outcomes

-apply personal values to the situation

-arrive at a decision that is consistent over time

-communicate that decision to others

5. Executive Control Functions:

-cognitive skills involved in successfully planning and carrying out goal oriented behavior such as self-care taks

-impaired by conditions such as dementia, stroke, major depression, parkinson's disease, traumatic brain injury and any condition affecting frontal lobe functioning.

#. An integrated, client-oriented system of care composed of both services and integrating mechanisms that guides and tracks clients over time through a comprehensive array of health,mental health, and social services spanning all levels of intensity ofcare.

Continuum of care is

•Client-oriented

•Comprehensive

•Integrated

With the access to long term health or other services ,it improves the elderly health because of following ways :-

o Response to changing needs

o Uniquely American nature

o Dedication to caregivers

o Increased focus on customer service

o Development of innovative types of care

- Aging in place

- Multilevel facilities

- Adult day care