Aspectos Éticos en el Cuidado de las Demencias / Ethical Aspects in the Care of Dementias

En los últimos años se ha venido produciendo un incremento de la población anciana con algún tipo de demencia. La demencia es un tipo de dolencia que se caracteriza por generar una dependencia progresiva que suscita numerosas preguntas éticas. La demanda creciente de su atención integral pone a prueba la estabilidad de la familia, las instituciones y los servicios sociosanitarios. Y la magnitud de su impacto se recrudece aún más cuando se aprecia la extrema vulnerabilidad que llegan a presentar las personas con demencia. La enfermera cuida de forma profesional a la persona con demencia y a su familia en todos los ámbitos asistenciales. Por todo ello, se hace necesario que las enfermeras asuman plena-mente la responsabilidad de garantizar y preservar las máximas de libertad, dignidad y autoestima. Asimismo, deben velar por la integridad, además de por la seguridad jurídica las personas atendidas en servicios y centros geriátricos, así como en sus domicilios. Para ello, es imprescindible que manejen adecuadamente los cono-cimientos que le faciliten el correcto abordaje de los dilemas éticos que con más frecuencia podemos observar en la asistencia de estas personas y sus familiares. Dada la complejidad que rodea dicha atención, es preciso contemplar las mejores acciones de forma ética y legal. Teniendo en cuenta que las dificultades en la asistencia difícilmente se pueden resolver aplicando, sola-mente, el sentido común, apelamos al compromiso de la enfermera para aplicar los principios básicos de la bioética: no maleficencia, justicia, beneficencia y autonomía de la persona enferma

In recent years there has been an in-crease in the elderly population with some type of dementia. Dementia is a kind of disease that is characterized by generating a progressive dependence, raising numerous ethical questions. The growing demand for its integral attention tests the stability of the family, institutions and social health services. And the magnitude of its impact is further exacerbated when the extreme vulnerability of people with dementia is appreciated. The nurse takes care professionally of the person with dementia and their family in all care settings. For all these reasons, it is necessary for nurses to fully assume the responsibility of guaranteeing and preserving the maxims of freedom, dignity and self-esteem. Likewise, they must ensure the integrity, in addition to the legal security of the people served in services and nursing homes, as well as in their homes. For this, it is essential that they adequately handle the knowledge that facilitates the correct approach to the ethical dilemmas that we can most frequently observe in the assistance of these people and their families. Given the complexity surrounding such attention, it is necessary to contemplate the best ethically and legally actions. Bearing in mind that difficulties in care can hardly be solved by applying only common sense, we appeal to the commitment of the nurse to apply the basic principles of bioethics: non maleficence, justice, beneficence and autonomy of the patient

[Ethical and Legal Aspects That Consider in the Medical History of the Elderly]. / Aspectos ético-jurídicos que considerar en la historia clínica de la persona mayor.

Nurses regularly use the patient's clinical history and we interact through it with multi and interdisciplinary team with the purpose of providing comprehensive care to the elderly. We make professional use of personal patient information with this interaction, as well we generate the nursing care plan and nursing records. We also perform comprehensive geriatric assessment and other specific registers aimed at elderly care, which have a clear impact on patient health care. The progress and regulatory complexity on the use of medical history, new strategies of the relationship in the context of care, based on bioethics, as well as the active role of nurses in the creation of information, makes necessary to review the ethical and legal issues surrounding this document, in this case, in elderly patients.

[The Right to Information in the Older Person]. / El derecho a la información en la persona mayor.

Population aging is and will be a reality that should be paid attention to, not only because of the progressive increase in their share, but also because of the growing numbers of people living in dependency and, by extension, human and technical qualification as it is required by the nurse who takes care of them. Patients in Spain have gone from being passive recipients of health care to be a key part of the healthcare system, with health professionals being increasingly aware of this situation. The development of legislation on autonomy and rights of people contributed to that sick people are being better informed, and can participate in their health process. Nurses act on the basis of both the Spanish Legislation and the Code of Ethics of the Spanish Nursing, where key guidelines for ethical and legal performance of nurse are compiled. Nurses provide information on health status on a daily basis and as a consequence have to face major ethical dilemmas very often. As a general premise flight ends should be clear. Ends, such as the malfeasance produced the so-called information obstinacy (report a negative diagnosis or prognosis to a patient who does not want to know), as the conspiracy of silence in front of a patient who wants to be informed. Therefore, communication on the state of health of a person, in most cases, makes it easier so you can take appropriate measures to ensure the success of treatment and care or acceptance of their situation.