Presentation is loading. Please wait.

Presentation is loading. Please wait.

Older Adults Legal & Ethical Basis for Practice Settings for Psychiatric Care Chapters 25, 26, 27.

Similar presentations

Presentation on theme: "Older Adults Legal & Ethical Basis for Practice Settings for Psychiatric Care Chapters 25, 26, 27."— Presentation transcript:

1 Older Adults Legal & Ethical Basis for Practice Settings for Psychiatric Care Chapters 25, 26, 27

2 Increased proportion of older adults has altered the socioeconomic condition in America & transformed health care By 2030, 23% US pop, will be > 65 yrs age Ageism: bias against individual due to age Assessment and communication strategies  Geropsychiatric nurses work with older adults and are knowledgeable about meds, normal aging and chronic disease Elderspeak  Adults speaking to elders as though they are children Chapter 25: Older adults

3 Psychiatric disorders in older adults Older adults with mental disorders are inappropriately diagnosed and receive inadequate treatment Depression; most common disorder in >65 yrs  Antidepressant therapy: emphasis is on avoidance side effects rather than efficacy  Psychotherapy: individual or group therapy Suicide: highest of any age group  Assessment for suicide risk  Right to die Alcoholism and substance abuse AIDS and AIDS related dementia

4 Use of Restraints: ethical, legal & safety concern  Physical restraints: manual methods or mechanical devices  Chemical restraints: drugs to inhibit behavior or movement Omnibus Budget Reconciliation Act (OBRA)  Declares each nursing home pt has the right to be free from unnecessary drugs or physical restraints Control of Decision Making Process  Patient Self Determination Act  Advance Directive/ Living Will  Directive to Physician  Durable Power of Attorney for Health Care  Nursing Role in Decision Making Process Legal and ethical issues affecting the older adult

5 Chapter 26: Legal and ethical basis for practice Ethical dilemma: results when there is a conflict between 2 or more courses of action both favorable and unfavorable outcomes Legal and Ethical Concepts  Ethics: study of philosophical beliefs about what is right and wrong in society  Bioethics: ethical questions arise in healthcare, 5 basic principles Beneficence Autonomy Justice Fidelity Veracity  Mental Health Laws Civil rights: pts with mental illness have same rights

6 Due process in civil commitment Admission to hospital  Voluntary admission  Involuntary admission 3 different commitment procedures: judicial determination, administrative determination and agency determination  Emergency involuntary hospitalization  Observational involuntary hospitalization  Long term commitment  Involuntary outpatient commitment Discharge from hospital  Conditional release  Unconditional release  AMA Admissions and discharge procedures

7 Right to treatment Right to refuse treatment Right to informed consent Rights surrounding involuntary commitment & psychiatric advance directives Rights regarding restraint and seclusion Patient Confidentiality  Ethical Considerations  Legal Considerations: HIPPA Patients employers Rights after death Patient Privilege and HIV Exceptions to Rule Child and Elder abuse reporting statutes Patients rights under the law

8 Torts are category of civil law applies to health care Tort is civil wrong for which money damages may be collected by injured party from the wrongdoer  Common Liability Issues Protection of patients -#1 priority  Violence  Negligence/malpractice: act or omission of act that breaches the duty of care and results in or is responsible for persons injuries Tort law applied to psychiatric settings

9 Standards of care established by ANA Guidelines for Nurses who suspect negligence Duty to report and intervene Unethical and Illegal practices Documentation of care  Purpose of medical records  Facility use of medical records  Medical records as evidence  Nursing guidelines for computerized charting Forensic Nursing Determination of standard of care

10 Chapter 27: Settings for psychiatric care 46% of population will be diagnosed with mental health disorder over lifetime 80% will seek treatment but the delay can take years Current treatment includes inpatient and outpatient  Outpatient Care; PCPs are 1 st choice, psychiatric care, CMHC, psych home care, IOP’s PHP  Inpatient Care; 24 hr nursing care in safe setting  Therapeutic milieu- positive holistic setting

11 Treatment settings State Acute Care General Hosp & Private Psych Acute Care Pediatric Psych Care Geriatric Psych Care VA Forensic Psych Care Alcohol and Drug Abuse Treatment Self-help Options Mental Health Parity Law (1996); illegal to limit annual or lifetime mental health benefits unless they do so for medical care


13 Thank you!

Download ppt "Older Adults Legal & Ethical Basis for Practice Settings for Psychiatric Care Chapters 25, 26, 27."

Similar presentations

Ads by Google