Subject(s)
Brain Injuries/complications , Personality Disorders/etiology , Personality , Adolescent , Adult , Aged , Brain Injuries/psychology , Female , Humans , Male , Middle Aged , Personality Assessment , Severity of Illness IndexSubject(s)
Brain Injuries/complications , Depressive Disorder, Major/therapy , Mental Disorders/etiology , Mental Disorders/therapy , Psychotherapy/methods , Selective Serotonin Reuptake Inhibitors/therapeutic use , Adult , Amantadine/therapeutic use , Clinical Protocols , Cognition Disorders/etiology , Cognition Disorders/therapy , Cognitive Behavioral Therapy , Combined Modality Therapy , Depressive Disorder, Major/etiology , Humans , Male , Sertraline/therapeutic useSubject(s)
Bipolar Disorder/diagnosis , Brain Injury, Chronic/psychology , Depressive Disorder, Major/diagnosis , Frontal Lobe/injuries , Personality Disorders/diagnosis , Bipolar Disorder/psychology , Depressive Disorder, Major/psychology , Diagnosis, Differential , Encephalomalacia/diagnosis , Encephalomalacia/psychology , Follow-Up Studies , Frontal Lobe/pathology , Humans , Male , Middle Aged , Personality Disorders/psychologyABSTRACT
Unique and challenging ethical difficulties arise during mobile psychiatric treatment of elderly patients. This article outlines and analyzes five of these challenges that have been encountered during nearly 20 years of experience with the Psychogeriatric Assessment and Treatment in City Housing Program in Baltimore, Maryland. The ethical challenges reviewed are: establishing the treatment contract versus the right to refuse treatment, protecting confidentiality versus patient protection, protecting autonomy versus asserting beneficence, treatment termination versus open-ended treatment, and cost versus benefit of care. Ethical challenges with homebound elderly patients are unique because of patient characteristics as well as features of the treatment environment.
