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Pages:
5 pages/≈1375 words
Sources:
2 Sources
Style:
APA
Subject:
Health, Medicine, Nursing
Type:
Case Study
Language:
English (U.S.)
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MS Word
Date:
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$ 21.6
Topic:

Ethical Challenge to the Professional Caregivers and to Their Agencies

Case Study Instructions:

Read the following case study and submit a 1500 – 2000-word paper that addresses the case study and the questions at the end of the case study.
Mr. B. is an 83-year-old male referred to home health services following a hospital admission for congestive heart failure. His payor source is Medicare (traditional). He lives alone and indicates he does not have sufficient financial resources to afford private-pay in home supportive care. His daughter, who lives in the neighboring county about 30 miles away, has offered her father to move in with her – he has refused and she is not “forcing the issue”. Mr. B. is also not open to discussing moving to an assisted living environment.
This is his third hospital admission for the same problem over the last 12 months and his second admission to a home health agency. He was discharged from the previous home health agency 6 weeks ago. Physician orders are for the home health agency to provide skilled nursing for assessment of his cardiac condition and to teach him about his care and medication regime. Physical therapy has been ordered to establish a home exercise program. Home health aide services have been ordered 3 times a week to assist Mr. B. with his personal care needs.
By the end of the third week of service, it is clear to the RN Case Manager that Mr. B. is not making progress to the established goals. She reports during case conference that he is not a good candidate for teaching because of intermittent confusion and forgetfulness. According to the nurse, no matter what she has tried to teach him and regardless of the aids she has used, Mr. B. continues to take is medication incorrectly. She states, “I know he needs services, but I am not sure that he is in the right environment. I am concerned about Mr. B. – I am not sure why his daughter won’t just step up and put her foot down.”
The physical therapist reports at case conference that the “client lacks motivation”. The home exercise program has been established with Mr. B.; however, he does not complete the exercises between therapy visits.
An improvement in his personal hygiene has been noted with the Home Health Aide (HHA) services. The HHA has also been successful in decluttering his living space. The HHA reports that she is concerned that he is not eating regular meals.
This situation offers an ethical challenge to the professional caregivers and to the agency for which they work.
Discuss how you would handle this ethical dilemma. Address the following questions as a part of your response:
What are your concerns about this case?
How does the RN Case Manager meet her ethical responsibilities to the patient and to the organization?
What is the best plan of action to ensure the client’s safety and well-being?
What are realistic outcomes and goals for this client?
Who will provide the ongoing care needs required by this client?

Case Study Sample Content Preview:

Case 6
Student’s Name
Institution
Course
Date
Case 6
Home health services facilitate an effective transition from the hospital and into the home. The goals of home healthcare are to ensure that patients can function with greater independence and to improve their well-being so that they are not hospitalized. However, these goals can be difficult to achieve, especially when the patient is unable to follow instructions from home healthcare professionals. The transfer of care responsibility to home healthcare professionals increases the complexity of care and contributes to ethical challenges (Heggestad et al., 2020). Home healthcare professionals need to address the ethical challenges they face to ensure that the patient is improving in areas such as medication adherence, personal hygiene, and physical activity. This paper discusses how home healthcare professionals can address ethical challenges while providing care to an elderly man who has been unable to make significant progress in meeting the set goals for his well-being.
Mr. B.’s case is a good example of the ethical challenges that home healthcare professionals encounter in the course of providing home health services to elderly patients. The patient does not want to move in with his daughter nor does he want to discuss assisted living facilities. The ethical issues presented in this case are patient autonomy as well as beneficence. The major areas of concern, in this case, are as below:
* Medication adherence- The patient is unable to correctly take his medication despite receiving education about the prescribed medication regimen. This has been attributed to his intermittent forgetfulness and confusion.
* Poor nutrition- The patient is not taking regular meals and this can contribute to his health deterioration.
* Limited physical activity- Despite having a well-established exercise program, the patient fails to complete his exercises. His physician’s orders included a home exercise program, which is appropriate for patients with congestive heart disease.
* Patient’s overall well-being- The patient’s non-compliance with medication, poor nutrition, and poor physical engagement affects how soon he can achieve his health goals.
The RN has to be ethically responsible to the agency that has employed her. This includes not deviating from what is best for the organization. The RN case manager has ethical responsibilities to the patient as well. Her responsibilities to the patients include advocacy, beneficence, and respect for autonomy (Sortedahl et al., 2018). As a patient’s advocate, she has to champion the needs of the patient and ensure the patient is receiving the right care and health services in the right environment. She also has to observe the ethical principle of beneficence as part of her responsibility to the patient. This means that she has to do what is best for the patient. This requires a balancing act between benefits and risks that certain courses of action present to the patient. Finally, the RN case manager has to respect the patient’s autonomy. The patient has a right to self-determination (Sortedahl et al., 2018) and as such, his decision not to move in with his daughter or to conside...
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