Discusses the interests of various affected parties, such as clients, families, neighbors, agencies, aides, and caregivers, in the provision of home health care. Because of the real moral claims of these parties, accommodation, which requires mediation between patient interests, others' interests, and the reality of available services, should be the desired goal. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Capacity assessment is a growing area of practice in geriatrics. In this pilot study we illustrate the potential relationship between clinician variables and capacity ratings. Twelve older adults with mild dementia or schizophrenia were rated by six clinicians from diverse disciplinary backgrounds. Capacity ratings were associated with clinician values regarding patient involvement in medical decisions, clinician-patient mismatches on such values, and emotional reactions to patients. Expanding our understanding of the impact of clinician variables on capacity ratings may enhance the reliability and validity of capacity assessments and help to promote autonomy when appropriate.
By viewing the dining room as a ritualized site, the authors explain the function and meaning this space holds for residents of assisted living facilities. The authors' findings encompass three themes: time and the way daily life within assisted living is ordered by mealtimes; choice, one of assisted living's values, and its expression and encouragement in the dining room; and social interaction, a consequence of gathering everyone in one place three times a day. The daily meal as ritual is meaningful because it provides order and purpose, and functions to communicate crucial information about social mores and setting-specific social expectations.
Examines autonomy issues relating to guardianship, the appointment of a substitute or surrogate decision maker for persons who may be labeled as disabled, incapacitated, or incompetent. Competency is a key concern in the decision to appoint a guardian. Guardianships may be used to impinge on the rights of older individuals to make health care decisions that go against medical advice or common acceptance. The participation of impaired adults in decision making under guardianship depends on an interacting set of value systems and the willingness of protectors to include them. The motivations of decision makers and an analysis of the underlying value systems are necessary preconditions for choosing guardianship as a protective intervention. (PsycINFO Database Record (c) 2012 APA, all rights reserved)