Legal issues of elderly and example

 Decision-making capacity
This implies the ability to understand the nature and consequences of different options, to make a
choice among those options, and to communicate that choice. Clinicians commonly care for elderly
persons who have conditions (eg, dementia) that impair decision-making capacity. However, patients
must have decision-making capacity to be autonomous and participate in informed con sent. Decision-
making capacity includes the ability to communicate a choice, understand the nature and consequences of
the choice, manipulate rationally the information necessary to make the choice, and reason consistently
with previously expressed values and goals. Depending on the diagnosis affecting a person’s judgment
and insight, an individual who is unable to make their own healthcare decisions at a particular point in
time may be able to regain their ability to make their own decisions again in the future. For example, an
individual who may be undergoing an episode of confusion due to delirium or loss of interest due to
depression may be able to improve after effective treatment and make healthcare decisions in the future.

 Competency
A legal determination by a judge as to mental disability or incapacity; whether a person is legally
fit and qualified to give testimony or execute legal documents. For example, gathering insight or
interviewing the elderly patient and friends and relatives of the patient can provide substantial
information when mental competency is in question.

 Informed consent
This is a legal doctrine requiring the disclosure of information about a proposed treatment before
obtaining consent for its performance. Informed consent involves providing factual information,
including the benefits and burdens of an action, and determining a person’s understanding of that
information. For example, informed consent does not mean that an individual can or should dictate their
care alone. If an individual asks for tests or treatments that the healthcare providers consider useless or
harmful, the healthcare team has a duty to use their skills for the individual’s benefit and not to harm
them. In case of a disagreement between an individual and/or their caregivers and the healthcare
team, meetings can be scheduled to discuss concerns.

 Refusal of treatment
Older adults with decision-making capacity have the right to refuse treatment, even if such refusal
hastens or results in their death. Competent adults can refuse care even if the care would likely save or
prolong the patient’s life.1 As Mahowald notes, “Respect for patient autonomy trumps beneficence and
non maleficence”. The patient may refuse to be informed about their medical condition and make a
decision. An example would be the statement, “I don’t want to hear anything from you. I’m not going to
the hospital.”They may be informed and then refuse to make a decision. “Wow, that sounds bad either
way. Do what you think is best.”Or they may refuse both parts. “My daughter is a paramedic. Talk to her
about it”. However, the right to refuse doesn’t exist in an ethical or legal vacuum, it’s found with the duty
to provide care.

 Power of Attorney
 A competent adult, called “the principal,” signs a document that grants a trusted individual the
authority to make decisions on their behalf if the principal is unable to. The person designated to act in
the principal’s best interest is called “the agent.” It’s the agent’s job to make sure the principal in this case
their aging parent or loved one is well cared for.

 Advanced-care directive or living will

 This provides specific instructions about the particular kinds of treatments / interventions an
individual would or would not want to prolong or sustain life. The document gives a trusted friend, family
member, or professional the medical power of attorney to carry out your health care treatment and wishes
at the end of life. This lets your loved one say in advance what kind of medical care they would like to get
and if they want life-support procedures.