Biomaterial Database

Nursing home placement and the demented patient. A case presentation and ethical analysis. 1986

D E Meier, and C K Cassel

The decision to seek nursing home placement will be faced with increasing frequency as the population over age 65 continues to grow. Although this is a difficult juncture under any circumstances, the ethical issues accompanying such a move for persons of diminished competence are unusually complex and require involvement of many concerned parties. In a typical case presentation, the social context informing these decisions is described, including bias against the aged, perceptions of scarce resources in health care, and the problematic role of the courts. The perspectives and moral obligations of the patient, family, and health professionals are discussed and contrasted to clarify the sometimes conflicting roles and needs of those three parties. A stepwise process of decision making before nursing home placement is offered in an effort to choose the least restrictive alternative for the patient while respecting the needs of concerned persons.

UI	MeSH Term	Description	Entries
D008297	Male		Males
D008875	Middle Aged	An adult aged 45 - 64 years.	Middle Age
D009735	Nursing Homes	Facilities which provide nursing supervision and limited medical care to persons who do not require hospitalization.	Homes, Nursing,Nursing Home
D010361	Patients	Individuals participating in the health care system for the purpose of receiving therapeutic, diagnostic, or preventive procedures.	Clients,Client,Patient
D003657	Decision Making	The process of making a selective intellectual judgment when presented with several complex alternatives consisting of several variables, and usually defining a course of action or an idea.	Credit Assignment,Assignment, Credit,Assignments, Credit,Credit Assignments
D003704	Dementia	An acquired organic mental disorder with loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning. The dysfunction is multifaceted and involves memory, behavior, personality, judgment, attention, spatial relations, language, abstract thought, and other executive functions. The intellectual decline is usually progressive, and initially spares the level of consciousness.	Senile Paranoid Dementia,Amentia,Familial Dementia,Amentias,Dementia, Familial,Dementias,Dementias, Familial,Dementias, Senile Paranoid,Familial Dementias,Paranoid Dementia, Senile,Paranoid Dementias, Senile,Senile Paranoid Dementias
D004995	Ethics, Professional	The principles of proper conduct concerning the rights and duties of the professional, relations with patients or consumers and fellow practitioners, as well as actions of the professional and interpersonal relations with patient or consumer families. (From Stedman, 25th ed)	Professional Ethics,Ethic, Professional,Professional Ethic
D005190	Family	A social group consisting of parents or parent substitutes and children.	Family Life Cycles,Family Members,Family Life Cycle,Family Research,Filiation,Kinship Networks,Relatives,Families,Family Member,Kinship Network,Life Cycle, Family,Life Cycles, Family,Network, Kinship,Networks, Kinship,Research, Family
D006280	Health Workforce	The availability of HEALTH PERSONNEL. It includes the demand and recruitment of both professional and allied health personnel, their present and future supply and distribution, and their assignment and utilization.	Health Manpower,Health Occupations Manpower,Manpower, Health,Manpower, Health Occupations,Workforce, Health
D006699	Home Care Services	Community health and NURSING SERVICES providing coordinated multiple services to the patient at the patient's homes. These home-care services are provided by a visiting nurse, home health agencies, HOSPITALS, or organized community groups using professional staff for care delivery. It differs from HOME NURSING which is provided by non-professionals.	Domiciliary Care,Home Health Care,Care Services, Home,Home Care,Services, Home Care,Care, Domiciliary,Care, Home,Home Care Service,Service, Home Care