Issues Regarding Elderly Patients
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This paper by Curtin (1995) discusses a case study of unethical treatment of an elderly woman living in a retirement community. The woman and her husband, both 89, were married for 40 years, were very close, and financially well-off. They were living in the facility when the husband suffered a heart attack and was hospitalized. He was recommended for bypass surgery, after which he was not doing well and remained in intensive care. The woman continued living at the facility, traveling alone each day to the hospital to visit her husband by taxi or bus, since she no longer drove. She was told by a doctor that her husband might not survive, and she responded by saying that if he died, she would commit suicide by jumping out of the window. A nurse at the facility overheard this and reported it to her superiors. They called in a psychiatrist who declared the woman perfectly sane, but recommended a suicide watch. Against her wishes and with her adamant protests, the facility hired two certified nursing assistants (CNAs) to be with her round-the-clock while she was in the assisted-living community, at the couple's expense. She refused to let these people in, and refused to pay for them. The woman has a daughter from her first marriage, but they do not get along and when the facility wanted the daughter to take over power of attorney of the couple's money, the woman rejected the idea. The facility then went to court and managed to get a judge to give them power of attorn
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ssessment Instrument Minimum Data Set (MDS) within two weeks of nursing home admission. Resident characteristics associated with the use of a feeding tube included in the study were: age; sex; race or ethnicity; marital status; advanced directives (DNR, living will, and durable power of attorney for healthcare); diagnosis of Alzheimer's disease, stroke, or cancer; and deterioration within the past 90 days of ability to perform activities of daily living. Facility characteristics were obtained from the MDS. Facility variables were size; urban vs rural location; fiscal characteristics and ownership; profit status; and whether Medicaid was the primary payer.
The study found that the use of a feeding tube was more likely if the resident was of a younger age; of a nonwhite race; male; divorced; lacked an advanced directive; had a recent decline in functional status; and had no diagnosis of Alzheimer's disease. Facility variables favoring use of a feeding tube were for profit status; in an urban setting; having more than 100 beds; and lacking a special dementia unit. Feeding tubes were also more likely among residents in facilities with a smaller number of residents with DNR orders, a higher prevalence of nonwhite residents, an
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Approximate Word count = 1784
Approximate Pages = 7 (250 words per page)
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