Decision Making
Self-determination
Free choice of one's own state or will without outside influence
Advanced care planning definition
wishes regarding potential incapacity and end-of-life care
Physical
The physical force that results in the threat of bodily injury, physical pain, or impairment. Includes striking, pushing, shaking, pinching, burning, physical restraints, force-feeding, and physical punishment.
Discrimination
The illegal culture or social behavior such as that which is demeaning, belittling, or withholding the full rights to a person
Ombudsmen
Responsible for acting as advocates for vulnerable residents in institutions
Informed Consent
ethical principle of self-determination or autonomy
Power of Attorney
•person (agent) who is legally appointed to act on behalf of another in ways that are specifically indicated in a legal document.
•General POA- business
•POA for health care- medical decisions for person when unable to do so for themselves
•*POA is the least restrictive measure for persons with impaired capacity- all rights through court- chosen by individual
Sexual
Nonconsensual sexual contact of any kind including persons not able to give consent- unwanted touch, forced nudity, sexually explicit photography...
Abandonment
The desertion of a person after assuming the responsibility of providing care or assistance
Advocate
Someone who defends, pleads, or acts on behalf of another; fights for someone who cannot fight for them selves
Beneficence
Do good
Durable Power of Attorney
Responsible for making medical decisions for the person when they are no longer able- continues after the person can no longer speak for themselves
Chosen by the individual and not a court
Psychological
The infliction of anguish, pain, or distress through verbal and non-verbal acts.
Threats, intimidation, harassment, belittling in from of others, forced isolation
Undue Influence
One person uses his or her role and power to exploit the trust, dependency, and fear to gain psychological control over the weaker person's decision making, usually for financial gain
List 3 ways to prevent Elder Mistreatment
Box 31.18
Paternalism
patients are expected to put blind trust in the doctor to make decisions that "he" thought was best for the patient
Health care proxy
•Health Care Proxy- chosen through “hierarchy” when person does not have capacity to make decisions and has not documented their preference (POA)
•substituted judgement”- decisions made on basis of what persons would have wanted
Medical
Unwanted medical treatments or procedures, venipunctures, urinary catheters, chemical restraints for convenience, failure to provide medical care
Neglect
A form of treatment resulting from the failure of action by a caregiver; mistreatment that is an omission; passive neglect; can be self-neglect
List 5 Examples of Undue Influence
Box 31.13
Decisional capacity
a person can understand a problem, the risks and benefits, the alternative options, and the consequences of a decision
Guardians and Conservators
Individuals, agencies, or corporations that have been appointed to take care, custody, and control of the incapacitated person
Financial
Illegal or improper use of another's funds, properties, or assets
Mandatory Reporting
•All nurses are required to report suspicions of abuse to state- Adult Protective Services (APS)
•All reports are investigated
•Belief that vulnerable person either has been or is likely to be abused, neglected, or exploited
•First reports are initially to supervisor and facility social worker- follow the organization's policy
Incapacity
Choices that are inconsistent with the preferences, expectations or values of the healthcare system. Lacks the ability to understand the problem at hand, the choice made, and its consequences.
It doesn't necessarily mean the patient has refused care, but has the right to refuse treatment (unless immediate danger to self or others)