In few places in American society are adults so dependent on others as in nursing homes. Minimizing this dependency and promoting autonomy has become a major focus of policy and ethics in gerontology. Yet most of these discussions are divorced from the day-to-day reality of long-term care and are implicitly based on concepts of autonomy derived from acute medical care settings. Promoting autonomy in long-term care, however, is a complex task which requires close attention to everyday routines and a fundamental rethinking of the meaning of autonomy. This timely work is based on an observational study of two different types of settings which provide long-term care for the elderly. The authors offer detailed descriptions of the organizational patterns and routine practices that erode autonomy of the elderly. Their observations lead to a substantial rethinking of what the concept of autonomy means in long-term care. The book concludes with suggestions on how the autonomy of elderly individuals in long-term care institutions might be promoted.

In recent years, the triumph of autonomy has made paternalist interventions increasingly problematic. The value of a patient's right to self-determination and the practice of informed consent are considered supremely important in present-day health care ethics. In general, the idea of 'doctor knows best' has become more and more suspicious. This has left us with a situation in which paternalist medicine seems difficult to reconcile with respect for patient autonomy. This book offers a thorough reflection on the relationship between autonomy and paternalism, and argues that, from both theoretical and practical angles, the tension between these concepts is not as acute as it might seem. In long-term care, psychiatry, and care for the severely handicapped, the principle of respect for autonomy is particularly ill-suited. This, however, does not mean that such respect is totally irrelevant, but that it should take a different shape. Good care in those cases requires us to transcend the sharp dichotomy between autonomy and paternalism. In Autonomy and Paternalism: Reflections on the Theory and Practice of Health Care various acclaimed authors present their views on this interesting and extremely relevant debate.

Since publication of the last series volume focusing on emerging systems, long term care has continued to evolve. This present volume brings to the forefront issues related to populations of varying age groups that have been neglected or under-reported. The chapters focus on populations or groups of professionals that are integral to long term care as recipients of services or as care providers. The authors present evidence to foster the creation of new paradigms of care and inform policy makers of the need for innovation. Topics examined include: Pediatric Skilled Nursing Facilities Mental Health Services Management of AIDS Patients Chronic Illness and Disability in the Prison Setting Sexuality in long Term Care Decision Making for Vulnerable Populations in the Nursing Home

Among the issues confronting America is long-term care for frail, older persons and others with chronic conditions and functional limitations that limit their ability to care for themselves. Improving the Quality of Long-Term Care takes a comprehensive look at the quality of care and quality of life in long-term care, including nursing homes, home health agencies, residential care facilities, family members and a variety of others. This book describes the current state of long-term care, identifying problem areas and offering recommendations for federal and state policymakers. Who uses long-term care? How have the characteristics of this population changed over time? What paths do people follow in long term care? The committee provides the latest information on these and other key questions. This book explores strengths and limitations of available data and research literature especially for settings other than nursing homes, on methods to measure, oversee, and improve the quality of long-term care. The committee makes recommendations on setting and enforcing standards of care, strengthening the caregiving workforce, reimbursement issues, and expanding the knowledge base to guide organizational and individual caregivers in improving the quality of care.

Binstock Ethical Issues in Long-Term Care Nancy Neveloff Dubler American Culture and Long-Term Care Otto von Mering Forecasting the Future of Long-Term Care Dennis L. Kodner

Learn how to work with people who are in need of long-term care to achieve a higher quality of life A person living with a disAbling condition has issues and challenges much different from others. Pastoral Care with Young and Midlife Adults in Long-Term Care puts a needed spotlight on various disAbling conditions needing long-term care; the issues facing people who are disAbled individually and collectively; theology available to address concerns; insights into individual spirituality; and practical recommendations for pastoral care staff. Focusing specifically on adults between the ages of 18 to 64 rather than those over that age, this source examines ways to effectively work with those who have disAbling conditions achieve a higher quality of life. Pastoral Care with Young and Midlife Adults in Long-Term Care discusses in-depth the issues which face people with physical or mental disAbling conditions. These include; the fragmentation of family life; health care issues; expenses; rights for people which varying disAbling conditions; labeling; suffering; ethics; sense of self; and coping with the adjustments of needing long-term care. The book contains a bibliography of source material; a glossary; and an annotated list of movies and videos that illuminate pastoral care issues and offer perspectives on death, dying, and grieving. Some issues covered in Pastoral Care with Young and Midlife Adults in Long-Term Care include: disAbling conditions health care of women health care of men economics of disAbility the impact of disAbling conditions upon the family long-term care rights and ethics for people with disAbling conditions language suffering grief acceptance spirituality and faith the faith journey ethics readjustment and more Pastoral Care with Young and Midlife Adults in Long-Term Care is an insightful, important book for pastoral care professionals, counselors, educators, health professionals, psychologists, and anyone with a disAbling condition.

New Edition Available 5/1/2013 Building on the wisdom and forward thinking of authors John Monagle and David Thomasa, this thorough revision of Health Care Ethics: Critical Issues for the 21st Century brings the reader up-to-date on the most important issues in biomedical ethics today.

This thorough revision of health care ethics brings the reader up to date on the most important issues in biomedical ethics today.

This collection of original essays opens up a novel area of inquiry: the distinctively ethical dimension of women's experiences of aging. Fifteen distinguished contributors here explore assumptions, experiences, practices, and public policies that affect women's well-being and dignity in later life. The book brings to the study of women's aging a reflective dimension missing from the empirical work that has predominated to date. Ethical studies of aging have so far failed to emphasize gender. And feminist ethics has neglected older women, even when emphasizing other dimensions of 'difference.' Finally work on aging in all fields has focused on the elderly, while this volume sees aging as an extended process of negotiating personal and social change.

This volume assesses the importance of autonomy to quality of life in long-term care facilities. First addressing conceptual issues, the editors then pose such questions as: What is autonomy and what does it mean in the context of physically and/or cognitively impaired elders? What is the effect of nursing home financing and federal regulations? How does the traditional medical model, which casts residents as "patients", affect autonomy? How does the physical environment make a difference? The contributors then go on to describe six successful models of care that provide a more meaningful quality of life through promoting autonomy. Contributors include Robert and Rosalie Kane, Keren Brown Wilson, and Bart Collopy.