Nursing Home Ethics: Everyday Issues Affecting Residents with Dementia

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Powers provides a comprehensive and thoughtful examination of the ethical issues that arise in long-term care. The first two chapters set the stage by exploring the pre-nursing home experiences of families living with dementia and, in contrast, how residents and family members experience life in the nursing home. The following chapters contain detailed hypothetical cases that include questions, possible actions, and insightful commentary to illustrate practical approaches to understanding ethical everyday issues affecting nursing home residents. The book also contains a useful Appendix focusing on creating a Nursing Home Ethics Committee.
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Editorial Reviews

Doody's Review Service
Reviewer: Donna Marie Minner, BSN, RN (University of Missouri-Columbia)
Description: This is a comprehensive yet very readable guide to the day-to-day ethics of dementia care. Information is presented in a way that makes the reader "feel" the needs of the individual. Case studies used at the end of the book will be useful and enlightening for teaching care providers, family members, or other interested parties how to use an empathetic approach in problem solving for persons they care for.
Purpose: The author would like this book to further the perspective that care for people with dementia is a daily exercise in ethics. The author brings to light the importance of a person-centered approach. This approach means understanding persons with dementia, their families, and nursing home staff members as unique individuals. With many nursing homes and their staff members struggling with difficult and sometimes confusing care issues, this book has the potential to place ethical care in an understandable light.
Audience: According to the author, this book is written primarily for professional nursing home staff and educators, but may be helpful for family members and other interested individuals. I found the book easy to read and logically written. Case studies used to illustrate concepts in chapter 4 are written at a general reading level so that they may be used to aid in teaching all levels of staff. The case studies are written with pros and cons for possible interventions, and are presented in a thought provoking, nonjudgmental way. The author's many years in nursing home practice and research with nursing home culture shines through the many illustrative stories, quotes, and presentation of discussions.
Features: This book takes the reader from the viewpoint of the person with dementia as far as what living with dementia can be like, through the nursing home experience in the eyes of residents and families, and finally to the use of ethics as a practical approach to understanding the everyday issues of care for the person with dementia. The last chapter puts forth 12 hypothetical cases in dialogue format with discussion with questions and potential actions and responding commentary. This book will be an excellent addition to any nursing home to be used in the teaching and coaching of staff. As a nurse consultant with a specialty in care of persons with dementia, I had a difficult time putting it down. I will use it often as a reference and a teaching aid. The illustrative stories, quotes, and case studies add greatly to the value of this book and make the concepts come alive.
Assessment: This is a wonderful new addition to any library of resources on care of persons with dementia. It is well written, thought provoking, easy to understand, and will appeal to a variety of individuals with an interest in the field of dementia care. It should be used as a teaching aid for all levels of nursing home staff members and should be offered to families as well.

5 Stars! from Doody
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Product Details

  • ISBN-13: 9780826102706
  • Publisher: Springer Publishing Company, Incorporated
  • Publication date: 6/14/2006
  • Edition description: New Edition
  • Pages: 240
  • Product dimensions: 6.34 (w) x 9.08 (h) x 0.51 (d)

Meet the Author

Bethel Ann Powers, RN, PhD, is an Associate Professor and Associate Director of the Center for Clinical Research on Aging at the University of Rochester School of Nursing. Dr. Powers received a BS degree in nursing from Alderson-Broaddus College in West Virginia and an MS in nursing as well as MA and PhD degrees in anthropology from the University of Rochester. She has received the Distinguished Nurse Researcher Award from The Foundation of the New York State Nurses Association (NYSNA) and the NYSNA Council on Nursing Research and an Excellence in Nursing Research Award from Epsilon Xi Chapter, Sigma Theta Tau International, Nursing Honor Society; and she is a Fellow of the Society for Applied Anthropology and The Gerontological Society of America.

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Table of Contents

Chapter 1 Living With Dementia 1
Overview 1
"It was such an unexpected thing." 2
"It came to the point where we needed a diagnosis." 5
"She fought me tooth and nail." 10
"It was traumatic for her and for us." 16
"There was no way we could let her live alone." 18
"I don't think they watched her very well." 20
"We decided to move in with her." 22
"I wanted to make everything right and you just can't." 23
"I felt like I'd be betraying him." 24
"It's brought us close together." 26
Postscript 28
Chapter 2 The Nursing Home Experience 29
Overview 29
"I remember thinking, 'This just is happening too fast.'" 29
"I have to be her advocate." 33
"I want to go home." 37
Care Concerns - "That's not my idea ... but I would never say anything." 38
Social Concerns - "Days are slow and not very interesting." 42
Environmental Concerns - "Sharing a room was very hard." 44
Nursing Homes and Long Term Care - "It's the way society is today." 54
Chapter 3 Ethics in Action 59
Overview 59
What Counts as an Ethical Matter 60
Application of Ethics in Practice 62
Contextual Considerations 67
Organizational Subcultures 69
Universal Moral Concerns 71
Frameworks for Assessing Resident-Focused Issues 74
Chapter 4 Case Examples 100
Overview 100
Case Examples 101
My Favorite Things 109
Breaking Bad News 112
I'm Scared of Him 115
It Feels Just Like Jail 119
Night and Day 124
As I Remember Him 132
Timing is Everything 135
Don't Get Around Much Anymore 142
A Moving Experience 145
I'm Ready to Go Home 151
Please, Just One More Bite 156
Get Me Out Of Here 164
Nursing Home Ethics Committee Q & A 171
Sample Case Review Record 193
Sample Resources 195
References 197
Index 209
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