There are more than 1.4 million senior citizens living in nursing homes. Elderly residents are a particularly vulnerable population, with mental or physical incapacitation leaving them more susceptible to abuse and neglect. The National Center on Elder Abuse (NCEA) has classified seven different types of elder abuse, including physical abuse, sexual abuse, emotional or psychological abuse, financial or material exploitation, neglect, abandonment, and self-neglect.
Physical abuse is the use of physical force that may result in bodily injury, physical pain, or impairment. Physical abuse may include but is not limited to such acts of violence as striking, hitting, beating, pushing, shoving, shaking, slapping, kicking, pinching, and burning (NCEA, 2020).
Sexual abuse is defined as non-consensual sexual contact of any kind with an elderly person. Sexual contact with any person incapable of giving consent is also considered sexual abuse. It includes, but is not limited to, unwanted touching, all types of sexual assault, or battery, such as rape.
Emotional or psychological abuse is defined as the infliction of anguish, pain, or distress through verbal or nonverbal acts. Emotional/psychological abuse includes but is not limited to verbal assaults, insults, threats, intimidation, humiliation, and harassment.
Financial or material exploitation is defined as the illegal or improper use of an elder’s funds, property, or assets. Examples include, but are not limited to, cashing an elderly person’s checks without authorization or permission, forging an older person’s signature, misusing or stealing an older person’s money or possessions, and coercing or deceiving an older person into signing any document (NCEA, 2020).
Neglect is defined as the refusal or failure to fulfill any part of a person’s obligations or duties to an elder. Neglect may also include the failure of a person who has fiduciary responsibilities to provide care for an elder for example pay for necessary home care services or the failure on the part of an in-home service provider to provide the necessary care.
Abandonment is defined as the desertion of an elderly person by an individual who has assumed responsibility for providing care for an elder, or by a person with physical custody of an elder.
Self-neglect is characterized as the behavior of an elderly person that threatens his/her health or safety. Self-neglect generally manifests itself in an older person as a refusal or failure to provide himself/herself with adequate food, water, clothing, shelter, personal hygiene, medication when indicated, and safety precautions (NCEA, 2020).
Ethical Dilemmas and Considerations on Euthanasia, Suicide, and Assisted Suicide
Ethics in nursing do not appear sporadically when a decision regarding a law needs to be made, they are the ever-present guide to nursing practice. Every interaction with people, be they patients or colleagues is guided by ethics. Therefore, they have an important place in euthanasia, suicide, and assisted suicide (Wright, 2020).
The first step towards dealing with an ethical issue is identifying the moral or ethical conflict. In the case of euthanasia, suicide, and assisted suicide, one ethical conflict is that between the principles of autonomy, the right of the ill individual to practice self-determination and take action that he or she deems best for him or herself, and non-maleficence, the act of doing no harm.
An individual suffering from a terminal or incurable illness may wish to act autonomously and request euthanasia but, Wright (2020) proposes that the sacredness of our existence does not allow the act of euthanasia to be presented as ethical nursing practice. However, the answer is not so clear. They say that if the individual is deemed medically competent and is fully aware of the proposed consequences then their autonomy should be respected.
National Center on Elder Abuse (2020). Types of abuse. https://ncea.acl.gov/Suspect-Abuse/Abuse-Types.aspx (Links to an external site.)
Wright, A., (2020). Ethical considerations and implications for euthanasia and assisted suicide in New Zealand. https://www.nursingjournal.co.nz/volume-four-1-2017/ethical-considerations-and-implications-for-euthanasia-and-assisted-suicide-in-new-zealand/ (Links to an external site.) ReplyReply to Comment
According to the National Center of Elder Abuse (NCEA), one in ten Americans aged sixty and above suffers from at least two forms of elder abuse. The different forms of elder abuse include physical abuse, which is an intentional use of force against an older person’s wishes. It is characterized by broken bones, bruises, burns, joint dislocation, sprains, and tooth loss. Sexual elder abuse is the second most common form of elder abuse. It is unwanted or forced sexual association with older adults. It is associated with genital or anus bleeding, bruised inner thighs or genitals, panic attacks, injuries in the pelvic region, and emotional and social withdrawal. The list also includes emotional and psychological elder abuse. It inflicts fear, mental agony, and distress to the respective adult. It takes several forms, including isolation, intimidation, terrorizing, insults, and threats. The most common signs of psychological abuse in adults include depression and withdrawal, isolation from family and friends, weakened self-esteem, and frequent attempts to hurt those around them.Stichler (2013) also argues that elder neglect is considered a form of abuse, according to NCEA. It occurs when the caregiver fails to prevent the elders from meeting their basic needs or preventing harm. Failure to provide the elders adequately with necessary daily activities, clothing, medical care, hydration, nutrition, and protection from damage are forms of elder neglect. The list also includes elder abandonment, which is often linked with neglect. When caretakers leave the elders in nursing homes, hospitals, or facility centers without an official arrangement on their care is a form of abandonment.In most cases, elders abandoned in healthcare centers might seem confused, scared, or lost. They may also appear depressed, lonely, dehydrated, and malnourished. The last two types of elder abuse, according to NCEA, include financial elder abuse and elder self-neglect. Financial elder abuse is linked to the improper, illegal, or unauthorized use of older people’s resources. Some of the warning signs of financial elder abuse include a pattern of missing property or belongings, elders facilitating discussions with mere documentation, and elders with no idea of their economic conditions. Elder self-neglect occurs when elders are weak enough to withdraw from meeting their daily needs.Practical Approaches for Ethical Dilemmas and Considerations in Healthcare Some of the ethical dilemmas and considerations in healthcare include cases linked to suicide, euthanasia, and assisted suicide. One of the primary approaches includes comparing the issue at hand to the specific rules in the Codes of Ethics (Stichler, 2013). In the long run, the health professionals would have analyzed the problem at hand with the Codes of Ethics and come up with a useful course of action relative to the issue presented with each patient. It is also vital to identify the party in power and control over the situation at hand. These steps are crucial as nurses will identify the resource relative to ideas, information, or clarification at hand.U.S. Department of Health & Human Services and Centers for Disease Control and Prevention (2014) states that addressing ethical dilemmas comes with breaking down the situation into competent parts. It provides room for identifying the issue at hand and generating the critical steps necessary to solve the issue. Healthcare professionals will identify and describe the possible question accurately and develop relevant ethical dilemmas and considerations. Ethical dilemmas and concerns in healthcare linked in activities above are easily found in the medical bodies’ legal sources such as legal codes and statues of practice.
ReferencesStichler, J. F. (2013). Healthy work environments for the ageing nursing workforce. Journal of Nursing Management, 21(7), 956–963. https://doi.org/10.1111/jonm.12174 (Links to an external site.)U.S. Department of Health & Human Services and Centers for Disease Control and Prevention. (2014). The State of Aging & Health in America 2013 [E-book]. CreateSpace Independent Publishing Platform. https://www.cdc.gov/aging/pdf/state-aging-health-in-america-2013.pdf (Links to an external site.)Elder Abuse, discussion board week 1.doc