Client M is 65 years old with a history of mild to moderate dementia, short and
ID: 125859 • Letter: C
Question
Client M is 65 years old with a history of mild to moderate dementia, short and long term memory problems, anxiety disoorder, depressive manic disorder, regular diet with thin fluids no swallowing difficulities. Client M was admitted 6 months ago from another LTC home to be closer to family. Since admission client M refuses all PSW care for personal hygiene, refuses to shower or bath and refuses to come to the main dinning room for meals and wants to be serve meals in personal room. Client M is independent with ADL needing reminders, cueing, encouragement and set up help only. The facilty's policy no meals served to clients in personal room and clients must have a minimum of 2 baths or showers weekly in keeping with the Health Ministry's guideines. Describe and explain the ethical issues and give rationale for your answer according.
Explanation / Answer
Ethical dilemmas
The period of uncertainty:the people may have difficulties to carry out simple task it can be due to confusion or sometimes it's denial that is not ready or willingness to carry out the task
Some people are embarrassed as they tend to forget mere things like name of their children which make them revert themselves away from society . Negative experience of dementia is also an issue
Ethical issue during prices of identifying the condition
To refuse or to pursue a diagnosis
Whether to initiate relatives regarding the health disorder for the procedure
Wether should inform the patient with diagnosis
Ethical issues shortly after diagnosis
Whether to inform other people and impact of doing so
Whethet to take part in advance care
Whether to.address sensitive issue
Reasons for hope ,risk
Ethical issues during the process if living with dementia
Determine how support is needed
Balancing concerns about safety and risk with autonomy
How to react in situations where being honesty seems pointless
Ethical issues linked to caring for / receiving care
The need to manage risk
Impact of increased care need on relationship
Determing who should provide care
The use of restrainsand deceptionfecesion making when the patient lack capacity managing difficult care situation
Ethical issues at the time of possible move into residential care
When the person with dentist objects to or lack the capacity o consent to residential care but care at home is no longer possib le
When there is discrepancy between former and current wishes or promise of people with dementia
When people with dementia create new relation with carers
Ethical issues when providing care to ensure dignified end of life
Determing and interpreting wishes where they may be conflict between the person with dementia would have wanted and societal influence
Deciding on someone behalf of dementia
Dealing with difficulties accessing palliative care
Being involved in decisions about withholding and withdrawing investigation and treatment
Dealing with feeling that the person with dementia has changed so radically that they are no longer the same person
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