Nursing Home Ethics

Univ. of Rochester, NY. Reprint discusses ethical issues arising in nursing homes with dementia patients. Presents real-life cases to illustrate ethical issues and discusses how to solve problems, keeping in mind the needs and interests of all concerned. Also provides ways of dealing with nursing home residents and their families. Softcover. Previous edition listed AP week 2004-1.

Foreword

ix

Introduction

xi

Acknowledgments

xx

Chapter 1: Living With Dementia

1

(28)

Overview

1

(1)

"It was such an unexpected thing."

2

(3)

"It came to the point where we needed a diagnosis."

5

(5)

"She fought me tooth and nail."

10

(6)

"It was traumatic for her and for us."

16

(2)

"There was no way we could let her live alone."

18

(2)

"I don't think they watched her very well."

20

(2)

"We decided to move in with her."

22

(1)

"I wanted to make everything right and you just can't."

23

(1)

"I felt like I'd be betraying him."

24

(2)

"It's brought us close together."

26

(2)

Postscript

28

(1)

Chapter 2: The Nursing Home Experience

29

(30)

Overview

29

(1)

"I remember thinking, 'This just is happening too fast.' "

29

(4)

"I have to be her advocate."

33

(4)

"I want to go home."

37

(1)

Care Concerns — "That's not my idea . . . but I would never say anything."

38

(4)

Social Concerns — "Days are slow and not very interesting."

42

(2)

Environmental Concerns — "Sharing a room was very hard."

44

(10)

Nursing Homes and Long Term Care — "It's the way society is today."

54

(5)

Chapter 3: Ethics in Action

59

(41)

Overview

59

(1)

What Counts as an Ethical Matter

60

(2)

Application of Ethics in Practice

62

(5)

Contextual Considerations

67

(2)

Organizational Subcultures

69

(2)

Universal Moral Concerns

71

(3)

Frameworks for Assessing Resident-Focused Issues

74

(26)

Chapter 4: Case Examples

100

(71)

Overview

100

(1)

Case Examples

101

(70)

My Favorite Things

109

(3)

Breaking Bad News

112

(3)

I'm Scared of Him

115

(4)

It Feels Just Like Jail

119

(5)

Night and Day

124

(8)

As I Remember Him

132

(3)

Timing is Everything

135

(7)

Don't Get Around Much Anymore

142

(3)

A Moving Experience

145

(6)

I'm Ready to Go Home

151

(5)

Please, Just One More Bite

156

(8)

Get Me Out Of Here

164

(7)

Appendix: Nursing Home Ethics Committee Q & A

171

(26)

Sample Case Review Record

193

(2)

Sample Resources

195

(2)

References

197

(12)

Index

209

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