Doing the right thing for elderly residents in senior care isn’t always as cut and dry as I would like. As a matter of fact, I sometimes struggle with decisions that are made by senior care professionals or family members. Most things are done in the resident’s “best interests”, but who knows more about one’s best interest than the resident him- or her-self? What about residents diagnosed with Alzheimer’s disease or another dementing illness? Do we assume that somewhere inside their minds and hearts, there is still a human being who wants to live the way he or she wants to live? One day, who will make decisions for you?
Traditional Medical Ethics Don’t Work in Senior Care
A traditional view of ethics involves a heavy focus on autonomy, and while this may work for younger and middle aged people, for older individuals who lack the capacity to make their own decisions, autonomy way not work so well. Not too long ago, a critical turn in ethics came to senior care. There is a new ethical approach to that does not focus as much on autonomy. It takes emotions and relationships seriously and makes them a basis for moral decision-making and quality of life.
(NOTE: Interested in learning more about Ethics in health care? Checkout my Ethics CEUs on CEU Academy and try a FREE CEU today!)
Historically, medical ethics stem from autonomy, beneficence, non-malfeasance, and justice. Medical ethics focus on patient competency and self-determination. But, what of long-term care residents who are not competent and cannot determine their own care? It was during the 1980s that the proxy decision-maker was created, and most likely, for this reason. This was helpful, some will argue, but it also blurred the line between autonomy and competency. Does the inability to make a decision negate one’s right to do so? Is there a point in our lives where choice no longer matters?
What Do Seniors Worry About?
When it comes down to daily decisions that are to be made, most residents in long-term living worry less about treatments or termination of care and more about privacy, visitors, phone calls, activities and food. They most likely wish to live in habitual ways which allow them to preserve a sense of self despite the many losses they face. Health care professionals play a critical role in helping residents not only live a quality life, but they assist in preserving identity and worth. This is where the new ethics comes into play. It is not autonomy that is so important, but the relationship and human emotions that are more greatly valued. This new way of thinking is called Relational Ethics and it is a major shift from the more traditional medical model of ethics. And, many would argue, a better fit for senior care.
Make a Commitment
Senior care is far different from the medical care provided in hospitals or clinics. It is a hybrid of residential setting and nursing care that goes on 24/7. While medical ethics are pillars of good care, they simply do not fit the senior care model. A better way to provide quality of life and care can be guided by Relational Ethics. What is more important, the ability to make a sound, rational decision, or simply to be loved and respected?
Final Words on Ethics in Senior Care
I hope that you have found this short article helpful and will think more about what is really important in long-term care. But, it is one thing to know, and another to practice what you know. Therefore, I ask you to make a commitment to help preserve the identities of seniors and focus more on a person-centered relationship with them. Regardless of their physical or mental condition, they have emotions and feelings. It has been said that people will not remember the words you use, but rather how you made them feel.
(NOTE: Interested in learning more about Ethics in health care? Checkout my Ethics CEUs on CEU Academy and try a FREE CEU today!)