Clinical situations in dementia care raise issues that require legal, moral and ethical decision making by health practitioners. Whilst the law may provide direction in the care of the person with dementia, the issue of competence to provide consent raises moral and ethical concerns. As you review a wide range of clinical exemplars you will find the recurring theme of �consent� and the capacity of the person with dementia to communicate and have respected his/her perspective and viewpoint require thoughtful reflection (online module 3).
(1) Choose one of the following clinical issues (1-5 below).
(2) In relation to that issue, reflect upon your knowledge of the practice context and plan for how you would manage the situation. You should answer the broad question (bolded) guided by the suggested itemised processes (a,b,c) using an essay format (including an introduction, body and conclusion). Your answer should be informed by relevant scholarly literature and research sources and supported by the use of practical examples from dementia care.
How would you manage your chosen clinical topic/ issue and ensure you cared for your client morally and ethically, acknowledging standards of practice for your profession?
In your answer to the above question, review how you would:
a. manage processes of determining capacity and ensuring informed consent
b. communicate in a manner that positively positions the person with dementia in your care
c. enhance clinical decision-making partnerships to negate the undesirable impact of discrimination and stigmatisation.
Select one (1):
1. Issues of consent. The administration of medication and the challenge of the client who refuses to take the prescribed medicine.
2. Issues of withdrawal of treatment. Select one topic from a range of treatment issues including: the withdrawal of nutrients and hydration, �not for resuscitation� procedures and the complexities of clinical decision making associated with the cessation of �active� treatment and the commencement of palliative approaches in severe dementia cases.
3. Issues of restraint (physical and chemical). The use of restraint as a strategy for managing what is perceived by some health care practitioners to be unsafe clinical situations.
4. Complex dementia care cases. Select one topic from: disclosing the dementia diagnosis, privacy, surveillance and safety, the ethics of undertaking research in a dementia clinical setting.
5. This topic involves discussion that critically examines attempts to dispel myths and generate guidance for health care practitioners in sensitively, ethically and legally managing the sexual rights of older people with dementia.
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