Enhancing Autonomy in Long-term Care


Book Description

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.




The Erosion of Autonomy in Long-Term Care


Book Description

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 a detailed description of the organizational patterns that erode autonomy of the elderly. Their observations lead to a substantial rethinking of what the concept of autonomy means in these settings. The book concludes with concrete suggestions on methods to increase the autonomy of elderly individuals in long-term care institutions.




Autonomy and Long-term Care


Book Description

The realities and misconceptions of long-term care and the challenges it presents for the ethics of autonomy are analyzed in this perceptive work. While defending the concept of autonomy, the author argues that the standard view of autonomy as non-interference and independence has only a limited applicability for long-term care. He explains that autonomy should be understood as a comprehensiveness that defines the overall course of a person's life rather than as a way of responding to an isolated situation. Agich distinguishes actual and ideal autonomy and argues that actual autonomy is better revealed in the everyday experiences of long-term care than in dramatic, conflict-ridden paradigm situations such as decisions to institutionalize, to initiate aggressive treatments, or to withhold or to withdraw life-sustaining treatments. Through a phenomenological analysis of long-term care, he develops an ethical framework for it by showing how autonomy is actually manifest in certain structural features of the social world of long-term care. Throughout this timely work, the rich sociological and anthropological literature on aging and long-term care is referenced and the practical ethical questions of promoting and enhancing the exercise of autonomy are addressed.







Enhancing Autonomy in Long-term Care


Book Description

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.




Quality of Life and Well-Being for Residents in Long-Term Care Communities


Book Description

This book explores key factors long-term care recipients have identified as impacting their quality of life and offers programmatic and policy recommendations to enhance well-being within long-term care communities. Leadership and staff who work in nursing homes and other residential care communities serve as gatekeepers to resident well-being, often without recognizing how residents’ quality of life is impacted by their decision-making. This book takes a life domain approach to build on research-based studies that document key drivers of care recipients’ quality of life, including relationships, autonomy and respect, activities and meals, environment, and care. Using a framework that enhances understanding of resident quality of life, it outlines practical, programmatic, and policy suggestions for long-term care stakeholders, such as administrators, managers, front-line staff, family members, and policy-makers, whose directives and actions impact the lived experience of long-term care residents. As such, this book serves as a roadmap for leaders and managers of long-term care communities, along with policymakers who regulate health and human services, to best structure care environments to maximize quality of life and well-being for long-term care recipients.







The Erosion of Autonomy in Long-term Care


Book Description

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.




Ethics, Law, and Aging Review, Volume 9


Book Description

This volume explores the concept of safety as applied in the long term care context. Chapters examine the way in which the quest for safety may work either synergistically or adversely upon other worthy social goals. Among the initiatives considered are promoting the decision-making autonomy of patients/clients and their surrogates, enhancing the quality of care and quality of life available to long term care residents, and providing fair compensation for injured victims when serious harm occurs. Questions addressed that are of concern to legal and ethical theorists, social science researchers, and patient/client advocates include: To what extent do litigation and/or regulation accomplish the safety and other legitimate objectives of public policy in the long term care arena? Do the costs of various approaches outweigh the benefits in promoting safety and other goals? How do litigation and regulation compare with alternative approaches to achieving the same goals, in terms of an acceptable cost/benefit balance?




Dependence and Autonomy in Old Age


Book Description

Respecting the autonomy of disabled people is an important ethical issue for providers of long-term care. In this influential book, George Agich abandons comfortable abstractions to reveal the concrete threats to personal autonomy in this setting, where ethical conflict, dilemma and tragedy are inescapable. He argues that liberal accounts of autonomy and individual rights are insufficient, and offers an account of autonomy that matches the realities of long-term care. The book therefore offers a framework for carers to develop an ethic of long-term care within the complex environment in which many dependent and aged people find themselves. Previously published as Autonomy and Long-term Care, this revised edition, in paperback for the first time, takes account of recent work and develops the author's views of what autonomy means in the real world. It will have wide appeal among bioethicists and health care professionals.