Physical, mental, or social change in the life of an elderly
person may result in a loss of self-sufficiency. Deciding how to
compensate for the change -- a process that often involves family
members, friends, or health professionals -- frequently leads to
consideration of long-term care. Most of the existing literature on
ethics and decision making, however, focuses on acute care and does
not necessarily apply to issues involved in choosing long-term
care.
This book offers the first conceptual and ethical framework for
thinking about long-term care decision making in gerontologic and
geriatric practice. It is also the first to examine these issues at
the level of decision-making by elders, family members, and
professionals and to consider the broad range of options -- from
receiving care at home to entering a nursing home. The discussion
ranges from the philosophical, historical, and societal to the
sometimes painfully specific and personal. Topics include the
current system of long-term care in the United States and how it
evolved; value considerations facing professionals involved with
home care and care plans; the basic concepts of autonomy and
independence; the affect on long-term-care of changing
intrafamilial relationships and responsibilities; and a preventive
ethics approach to long-term care decision making. The chapters
make effective use of case histories and offer a strong sense of
how individual human lives are affected by these issues.
"This collection of essays is a forum for clinicians, ethicists,
and policy specialists to address the social and ethical
implications of both the basic and the high-technology aspects of
caring for very ill or very dependent patients in their homes... It
should also be brought to the attention of the health policy
analysts and politicians who believe cheaper care at home will
solve our health care crisis." -- The New England Journal of
Medicine
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