Only within the past decade or so have medical ethicists, healthcare
policy analysts, and politicians devoted significant time and energy to
the myriad issues and problems facing the elderly. Careful
consideration has revealed multiple concerns over the treatment of the
elderly by families, healthcare providers, government agencies, and
facility administrators and staff. One particularly troublesome area of
concern involves nursing home placement and care. Dramatic stories
sometimes rise to the level of national attention and scrutiny. We hear
and read accounts of elder abuse by nursing home staff, indifference by
nursing home administrators, disagreements over whether to initiate or
withdraw a particular life-sustaining treatment, pain management
protocols, physician-assisted suicide, and the issuing and honoring of
DNR orders. But then these stories, as well as the ethical and policy
debates they engender, are soon forgotten by the general public.
Stories often not heard at all involve the everyday, mundane problems
and dilemmas faced by nursing home residents. These problems include
roommate selection, waiting lists, privacy surrounding grooming and
sexual relations, scheduling of meals and sleeping, confidentiality of
medical conditions, freedom to walk around the facility or take trips
outside the facility, and use of mechanical and chemical restraints. In
one sense, these issues are more problematic and more intractable than
those represented in dramatic but fleeting news accounts. What is
gradually becoming obvious to many is that the problems faced by the
elderly in long-term care—whether these problems are remarkable
or mundane, rare or frequent—deserve sustained, careful
attention.
Time to return to work following workplace violence among direct healthcare and social workers
