Care For The Elderly - Introduction & Principles

Care for the Elderly and the Chronically Ill Pelino, Ma. Sharlene Perez, Jan Ray Perez, Joel Pineda, Czarina Pineda, John Michael Joseph

CARE FOR THE ELDERLY

Why the Elderly? • They are sick more often • They suffer more from being in the end stage of various chronic progressive degenerative diseases • They are most likely to lack the capacity to make critical decisions Ethical Issues in the Care of the Elderly by Leslie Knowlton. GERIATRIC TIMES. March/April 2002. Vol. III. Issue 2

Principles of Medical Ethics • Beneficence and Non-maleficence • Cost-benefit analysis of medical treatment for older patients is much more difficult • Harm is more likely and benefit is less certain • E.g. Patient dies from pulmonary complication during a knee replacement surgery

Principles of Medical Ethics • Beneficence and Non-maleficence • Before elective surgery or any other medical intervention, benefits and risks, must be thoroughly assessed and discussed with the patient and relatives

Principles of Medical Ethics • Autonomy • Patients must be informed, fully understand and have time to consider all treatment and testing options • Some patients may have impaired comprehension or memory

Principles of Medical Ethics • Autonomy • Vehicles for expressing autonomy if they lose capacity to make decisions • Written advance directives • Designating a health care proxy • Accepting from witnesses “previously stated clear and convincing evidence stated verbally” by the patient

Principles of Medical Ethics • Justice • Approach on giving health care with limited budgets • Utilitarian approach • Idealistic approach

Principles of Medical Ethics • Justice • Utilitarian approach • Health care resources should be allocated to do the most good for largest number of people • Problem: in the elderly, success of intervention is less likely and they do not constitute the bulk of the population

Principles of Medical Ethics • Justice • Idealistic approach • Give help to people who need it most • Problem: the elderly will disproportionately need more health care funds than younger people

Principles of Medical Ethics • Respect for the sanctity of human life • Euthanasia