ABSTRACT
When elderly persons become cognitively impaired, decision-making and case management can be intensely frustrating for health care providers who must make provisions for both short-term and long-term care. Numerous barriers pose challenges to the case managers in addition to those that occur when health care terminology does not fit easily into the legal vocabulary of the judge who makes the ultimate decision naming a guardian or conservator. Ongoing research by the authors has been involved in identifying criteria to determine incompetency by both formal and informal caregivers of cognitively impaired elderly. A scale, currently consisting of 10 criteria, has been developed and continues to be refined by the authors.
Subject(s)
Cognition Disorders/diagnosis , Geriatric Assessment , Psychiatric Status Rating Scales , Aged , Geriatric Psychiatry , Humans , Managed Care Programs , Mental Competency , Patient Care TeamSubject(s)
Geriatric Assessment , Memory Disorders/diagnosis , Memory, Short-Term , Mental Competency , Aged , Humans , Nursing AssessmentABSTRACT
The increased number of elderly persons who will become cognitively impaired in the near future is a cause for concern to all in the health care professions. Even though the final determination of incapacity and incompetency is a legal decision, input from health care professionals is weighed heavily by courts. Health professionals can have influence at the clinical level and also at the level of influencing social policy. Nurses rely on input from the assessments of informal caregivers. This research was conducted to determine guardians' perceptions of important criteria on the Incompetency Assessment Scale. Eleven guardians, a majority of whom were daughters of the elderly wards, perceived 9 of the 22 criteria on the IAS as important or very important to the question of incompetency. All nine criteria are found in Minnesota's statutory definition of incompetency, and also appear in the first two levels of the Maslow hierarchy of needs. Further research is recommended to develop a weighting or clustering of criteria to more accurately ascertain the way that incompetency judgments are made by guardians and other caregivers.
Subject(s)
Cognition Disorders/psychology , Legal Guardians/psychology , Mental Competency , Mental Status Schedule , Social Perception , Adolescent , Adult , Aged , Aged, 80 and over , Caregivers/psychology , Child , Child, Preschool , Female , Human Rights , Humans , Infant , Male , Middle Aged , Models, PsychologicalABSTRACT
The purpose of this article is to discuss issues that decision makers must consider when confronted with the dilemma of a cognitively impaired older person for whom they are responsible either informally (as family) or formally (as health care professionals). The article examines (1) the decision-making dilemmas faced by caregivers of older persons, (2) coordination necessary among decision makers, (3) legal criteria for incompetency, and (4) caregiver stress. The need for clarification of incompetency criteria for improved coordination among caregivers is suggested.
Subject(s)
Cognition Disorders , Decision Making , Home Nursing/legislation & jurisprudence , Legal Guardians , Patient Care Planning/legislation & jurisprudence , Aged , Family , Humans , Professional-Family Relations , Stress, Psychological , United StatesABSTRACT
With increasing evidence that life-style is an important influence on health, three nursing faculty members at the University of Minnesota implemented a learning project to enable students to assess, plan, and evaluate their own life-styles. The goal was to have the students attempt to make positive changes. As part of a "health concepts" nursing course, students became much more aware of social, economic, environmental, and cultural factors that either enhanced or detracted from their ability to achieve their ideal life-styles. The students responded favorably to this assignment because of the potential benefits of investing in themselves while pursuing the rigorous program leading to a nursing degree.
Subject(s)
Health Education/methods , Life Style , Self Care , Students, Nursing , Education, Nursing, Baccalaureate , Female , Health Education/standards , Health Status Indicators , Humans , Male , Nursing Assessment , Patient Care Planning , Program Evaluation , Quality of Life , Risk FactorsSubject(s)
Health Education/standards , Health Promotion , Adult , Aged , Educational Measurement , Evaluation Studies as Topic , Female , Humans , Life Style , Male , Middle Aged , Surveys and Questionnaires , United StatesABSTRACT
The role of the professional nurse in participation with other members of the health care team is exciting and demanding. The professional student at various levels could benefit from the experience in this ambulatory setting to aquire skills and explore the concept of promoting health as well as care of illness. Minnesota has been a forerunner in the passage of legislation which informs the citizens as to the expectations they can hold in relation to their health care. A majority of these rights pertain to the informational needs of persons seeking health care. To comply with the law, the health care providers must be cognizant of the law and acquire skills as students to enable the client to be active and intelligent participants in their health care team, in either acceptance or refusal of care. The opportunity and challenges are obvious. How will we as nursing educators assist our students as practitioners of tomorrow to meet them?
