ETHICO-LEGAL CONSIDERATIONS IN THE CARE OF

OLDER ADULTS
Members:
Johnley Atun
Denverth Ortacio
Rea Llana
BSN-3A
 Introduction
• As our society continues to age, the care of older adults has become an increasingly
significant and complex issue. Providing ethical and legal considerations in the care of
older adults is not only a moral imperative but also a critical aspect of healthcare
practice and policy. This discussion delves into the intricate intersection of ethics and
legality within the realm of elderly care, exploring the challenges, dilemmas, and
responsibilities that healthcare professionals, caregivers, and policymakers face when
caring for older adults. From issues of autonomy and informed consent to questions
surrounding end-of-life decisions and healthcare resource allocation, the ethico-legal
landscape of elderly care is multifaceted and continually evolving. By examining these
considerations, we can better navigate the complex ethical and legal terrain to ensure
that the dignity, rights, and well-being of our aging population are upheld and
protected.
 Objectives
• Understand the core ethical principles that guide elderly care.
• Recognize the legal framework governing the care of older adults.
• Identify common challenges and dilemmas in this field.
• Discuss best practices for maintaining high-quality care while
adhering to ethical principles and legal requirements.
• Equip individuals with the knowledge and skills needed to make
informed, patient-centered decisions respecting older adults'
autonomy.
ETHICS
• Ethics refers to the study and practice of principles and values that
guide human behavior and decision-making, particularly in
determining what is morally right or wrong. It involves examining and
applying concepts like fairness, honesty, integrity, and empathy to
make ethical judgments and choices in various situations and
contexts. Ethics serves as a framework for individuals and societies to
navigate complex moral dilemmas and maintain a sense of moral
responsibility.
• Ethics in the care of older adults, often referred to as "elder care
ethics" or "geriatric ethics," involves the application of moral
principles and values to guide the treatment, support, and well-being
of elderly individuals.
Ethical Principles in Care
of the Older Adults
Autonomy • Beneficence
-Respecting the elderly • Acting in the best
person's right to make interests of the elderly
decisions about their person to promote
own life, health, and their well-being and
care, as long as they are provide them with the
mentally competent to best possible care. For
do so. instance, a caregiver
should ensure that a
senior receives
appropriate medical
treatment and social
support to enhance
their quality of life.
Justice
Treating elderly
individuals fairly and
equitably, without
discrimination or bias.
Veracity
Being truthful and honest with
elderly individuals and their
families. For instance, providing
accurate information about their
health condition, treatment
options, and expected outcomes
so that they can make informed
decisions.
Confidentiality
It is the right of an individual to
not have personally identifiable
information disclosed to others
without that individual's express
informed consent.
Respect for dignity
Recognizing and valuing
the inherent worth and
dignity of every elderly
person, regardless of their
physical or cognitive
limitations. This includes
providing personal care
with sensitivity and
maintaining their privacy
and self-esteem.
 Informed Consent
Cultural Sensitivity
Ensuring that the elderly person
Acknowledging and respecting the
or their legal representative fully
cultural and religious beliefs and
understands the risks, benefits,
practices of the elderly person.
and alternatives of medical
procedures or care options before
giving consent. This allows them
to make decisions that align with
their values and preferences.
Ethical Delimma
Caring for older adults comes with various challenges and ethical
dilemmas due to the complex nature of their needs and the potential
conflicts that can arise.
Some of the key challenges and ethical
dilemmas in the care of older adults:
1. Autonomy vs. Safety: 2. End-of-Life Decisions:
- Respecting an older adult's - Making decisions about end-of-
autonomy and their right to make life care, including the withdrawal
decisions about their care, even or withholding of life-sustaining
when those decisions may not treatments, can be emotionally
align with what caregivers or challenging for both the older
healthcare providers believe is in adult and their caregivers.
their best interest. - Ethical Dilemma: Ensuring that
decisions align with the older
adult's wishes while also adhering
to legal and ethical standards for
end-of-life care.
3. Resource Allocation: 4. Family Conflicts:
- Limited healthcare - Family dynamics can
resources, such as organ lead to conflicts and
transplants or specialized disagreements regarding
treatments, may the care and decision-
necessitate difficult making for an older adult.
decisions about who - Ethical Dilemma:
receives care. Balancing the interests
- Ethical Dilemma: and opinions of various
Distributing resources family members with the
fairly while considering best interests of the older
factors like age, adult and their autonomy.
prognosis, and the
potential for benefiting
 6. Quality of Life:
5. Capacity and Consent:
- Striving to enhance the
- Assessing an older quality of life for older
adult's capacity to make adults, even when faced
decisions about their with chronic illnesses,
care, especially in cases disabilities, or pain.
of cognitive impairment - Ethical Dilemma:
or dementia. Deciding on appropriate
- Ethical Dilemma: interventions and
Determining when and treatments to balance
how to involve surrogate relief of suffering with the
decision-makers and preservation of dignity
respecting the older and well-being.
adult's wishes when
 8. Resource
7. Elder Abuse and Constraints:
Neglect:
- Working within
- Detecting and healthcare systems with
preventing elder abuse, limited resources, which
which can be physical, can impact the quality
emotional, financial, or and availability of care.
neglectful.
- Ethical Dilemma:
- Ethical Dilemma: Prioritizing care and
Reporting and addressing advocating for older
abuse while respecting adults in resource-
the older adult's constrained
autonomy and privacy. environments.
9. Cultural and Ethical 10. Palliative and
Diversity: Comfort Care:
- Providing culturally - Ensuring that older
sensitive care that adults receive adequate
respects the diverse pain management and
beliefs and values of palliative care.
older adults and their - Ethical Dilemma:
families. Balancing the use of
- Ethical Dilemma: medications for pain
Navigating situations relief with concerns
where cultural or about potential side
religious beliefs may effects or addiction.
conflict with standard
medical or ethical
Navigating Legal Aspects of End-
of-Life Care for Older Adults
Advance Directives
Older adults can create advance directives, such as living wills or
durable powers of attorney for healthcare, to specify their preferences
for medical treatment and appoint someone to make healthcare
decisions on their behalf if they become incapacitated.
Do-Not-Resuscitate (DNR) Orders

Older adults can choose to have a DNR order, which instructs

healthcare providers not to perform cardiopulmonary resuscitation
(CPR) if their heart stops or they stop breathing.
 Hospice Care
Hospice care is often a legal option for terminally ill older adults. It
focuses on providing comfort and quality of life rather than curative
treatment.
Guardianship

In cases where older adults are unable to make decisions for

themselves and have not designated a healthcare proxy, the court may
appoint a legal guardian to make healthcare decisions on their behalf.
 Legal Requirements for Withdrawing
Treatment
Laws may vary by jurisdiction, but generally, healthcare providers must
follow legal and ethical guidelines when withdrawing or withholding
life-sustaining treatment, ensuring it aligns with the patient's wishes or
best interests.
 Physician-Assisted Suicide and Euthanasia
Laws regarding physician-assisted suicide and euthanasia vary widely
by country and state. Some places allow these practices under strict
legal frameworks, while others prohibit them entirely.
 Informed Consent
Medical providers must obtain informed consent from the older adult
or their designated healthcare proxy before initiating any significant
medical procedures or treatments.
Legal Challenges
Disputes can arise among family members or between healthcare
providers and family regarding end-of-life decisions. Legal processes
may be required to resolve such disputes.
Signs of Elder Abuse and Neglect
•Physical abuse
Unexplained injuries, bruises, or broken bones.
Emotional abuse Sudden changes in behavior,
withdrawal, or depression.
•Financial abuse
Unexplained withdrawals, missing money or
possessions.
•Neglect
Poor hygiene, malnutrition, or untreated medical
conditions.
•Verbal abuse
Belittling, threats, or intimidation.
•Caregiver stress
Signs of burnout or frustration in the caregiver.
•Changes in living conditions
Unsafe or unsanitary living conditions.
•Lack of necessary medical care
Untreated illnesses or chronic conditions.
•Fear or anxiety
The elder may appear fearful or anxious around
certain individuals.
Legal obligations to report and
prevent abuse of older adults
Mandatory Reporting Laws
Many jurisdictions have laws requiring certain
professionals, such as healthcare workers and social
workers, to report suspected elder abuse to
authorities.
Adult Protective Services (APS)
APS agencies are often responsible for receiving and
investigating reports of elder abuse. Reporting abuse
to APS is a legal requirement in many places.
Long-Term Care Ombudsman Programs
These programs advocate for residents in nursing
homes and other long-term care facilities and can
investigate and address abuse allegations.
Guardianship Laws
Courts can appoint legal guardians to protect the
rights and well-being of older adults who are unable
to advocate for themselves.
Healthcare Provider Obligations
Healthcare professionals may be legally required to
report signs of abuse or neglect they observe in their
patients.
No-Contact Orders
Courts can issue orders to prevent alleged abusers
from contacting or approaching older adults who are
at risk.
Elder Abuse Prevention Programs
Some areas have laws supporting community-based
programs aimed at preventing elder abuse through
education, awareness, and support services.
Best Practices in Geriatric Care:
Ensuring Quality Healthcare for
Older Adults
Patient-Centered Care Communication
Tailor care plans to individual Use clear and simple language,
needs, considering their medical and ensure that older adults
history, preferences, and goals. understand their diagnoses,
medications, and treatment plans.
Encourage questions.
Respect and Dignity Medication Management
Treat older adults with
respect, preserving their Review medications
dignity and autonomy. regularly, avoiding
Involve them in decision- polypharmacy (excessive
making when possible.
medication use) and
Comprehensive
Assessment addressing potential
Conduct thorough interactions or side
assessments, taking into effects.
account physical, mental,
and social aspects of
health. Screen for common
geriatric issues like
cognitive impairment and
falls.
Fall Prevention Chronic Disease
Assess and address fall Management
risks, which are common Manage chronic
among older adults. This conditions effectively,
includes home safety ensuring that
evaluations and medications and
recommending interventions align with
appropriate the goals of care.
interventions. Mental Health Support
Nutrition and Exercise Recognize and address
Promote a balanced diet mental health issues,
and regular physical such as depression and
activity, tailored to the anxiety, which can be
individual's capabilities underdiagnosed in older
Caregiver Support
Recognize the role of
caregivers and provide
resources and support to
them.
Geriatric Specialization
Healthcare providers
with geriatric training can
offer specialized care and
insights into the unique
needs of older adults.
Continuity of Care
Promote coordination
among healthcare
providers and ensure that
transitions between care
settings are smooth.
Cultural Sensitivity
Be sensitive to cultural
differences and
preferences in care.
Pain Management
Adequately assess and
manage pain, considering
the potential for
underreporting in older
adults.
Regular Follow-up Prevention of Elder
Schedule regular follow- Abuse
up appointments to Be vigilant for signs of
monitor progress and elder abuse and take
adjust care plans as appropriate actions if
needed. suspected.
Technology Integration
Embrace technology to
enhance care delivery,
such as telehealth
options for older adults
who may have difficulty
with in-person visits.
THANK YOU!!