The Elderly With Dementia And Their Autonomy

Argumentative Essay – The Elderly with dementia and their Autonomy Student’s Name Institution Course Date Ageism and autonomy have in the recent past elicited never-ending debates, especially in the Western countries. My essay seeks to explain how and why the elderly with dementia can maintain their autonomy. Ageism, which is defined as stereotyping and discriminating an individual due to their age (in our case the elderly), has been on the rise over the years. Although age can decapitate one's ability to make independent, however, rational decisions that comes along with patients’ autonomy lie in the fact that capacity is what matters in making a specific decision, in this case competency is what matters not age. A clinician can determine the ability of a patient to make specific decisions through conducting a functional assessment. Competency is a legal determination made in court by a Judge. Patients with dementia cannot be assumed to have lost their functionality without evaluation by a clinician. This evaluation is then used to determine whether they can lead normal lives, makes a will or is able to give an informed consent. Some patients with moderate or severe dementia show some level of understanding and even indicate their choices. The key decision making components when doing a capacity evaluation include understanding, communicating a choice, appreciation, and reason. Varying situations will influence if the evaluation will the assessment will be formal or informal with open-ended questions. The analysis is situational specific. The clinician spending time with the patients and the family will help in gaining more information; there are two thoughts on autonomy the individualistic and the relational (Walter et al 2014). Individualistic argues that what matters is the decision-making capacity and the content of what is communicated is irrelevant, while relational suggests that if one can the complete procedural requirement they are as autonomous (Walter et al 2014). . Respecting patient autonomy in health care is a primary concern to caregivers, patients, clinicians, and bioethicists. In western democracies where personal autonomy is held in high regard in all domains from social to political, it is understood that it is important that individual live lives that are essential to their choice. This promoted in the legal, political and moral spheres. Autonomy, in this case, is rooted in a liberal ideology that for one to be considered autonomous, they must be self-governing. The decisions they make are supposed to have been deliberated on not coerced. Universally, patients have the right to make decisions about their health in a clinical context; autonomy is understood to imply a patient's ability to make decisions concerning their health with the patient authority replacing the doctor "knows" best approach. Decisions made by the patients should, however, reflect their values and hence their mind should be functional enough to make logical decisions. This is a major challenge in most nursing homes as many of their residents are inflicted with dementia. In this case, caregivers rely on instructions given by the patient when they were still functionally fit. If there is no instruction, the legally approved person responsible for the patient will make the decision guided by the known values of the patient (Scobie, 2016). Respecting of the patient's autonomy in healthcare settings consist of knowledgeable consent, whereby either the patient or relative of the demented patient is handed all the important information before making decisions. These decisions are supposed to be made without any coercion. Informed refusal is also part of informed consent as it contains respect for the patient's will. However, this procedure with time has been reduced to collecting signatures and little attention given to the patient's wishes (Paqueet al, 2017). In nursing homes, holding on to personal autonomy becomes a challenge. When a demented patient becomes ill, they show great dependence. In most cases, our values and wishes to be replaced with what is thought to be best for their health. This occurs as the nurses perceive that with their experience they know what is best for their health more than the patient. Himself/her...