Concerned About Client Decision-Making Capacity? Considerations for Practice

2005 ◽  
Vol 6 (2) ◽  
pp. 50-55 ◽  
Author(s):  
Kathy Black ◽  
Hana Osman
Keyword(s):  
Decision Making ◽  
Cognitive Impairments ◽  
Age Groups ◽  
Well Being ◽  
Case Managers ◽  
Ethical Aspects ◽  
Older Americans ◽  
Factors Affecting ◽  
Decision Making Capacity ◽  
Potential Safety

Many more people are reaching old age than ever before, and older people are increasingly living longer. As the nation experiences this unprecedented growth of older Americans, geriatric case managers are likely to encounter many clients at very advanced ages. Concomitantly, practitioners will confront elders with questionable decision-making capacity, as dementia and other cognitive impairments are more common among the older age groups. These clients pose potential safety and well-being concerns and may be vulnerable to exploitation, neglect, and abuse in their homes. Case managers’ responses to such client scenarios may range from little involvement, by acquiescing to the client’s right to make autonomous decisions, to resorting to legal action, which may lead to a substantial loss of rights for the elder. This article provides considerations for practice with elders presenting with questionable decision-making capacity and precarious living situations. The distinction between capacity and competency is presented and factors affecting decision making are discussed. Ethical aspects are addressed and the process of assessing capacity is reviewed to enhance case managers’ practices in this area.

scholarly journals The factors affecting response rate in survey on well-being among people with foreign origin

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
E Lilja ◽  
A Seppänen ◽  
H Kuusio
Keyword(s):  
Online Survey ◽  
Response Rate ◽  
Age Groups ◽  
Response Rates ◽  
Well Being ◽  
Migrant Population ◽  
Population Surveys ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Face To Face

Abstract Background Previous population surveys among people with foreign background (PFB) in Finland have had successful response rates (62%-66%) when using mainly face-to-face interviews. A cross-sectional population survey (FinMONIK) explored more cost-efficient ways to collect the data on PFB. Methods The data collection was conducted in Finland between May 2018 and January 2019. The random sample consisted of 12 877 (after removing over-coverage) 18-64-year-olds stratified by region. First, a letter containing a link to the online survey with 18 different language options was sent to the participants. After two reminders, the questionnaire was sent twice on paper to the non-respondents. Finally, supplementary phone interviews were carried out by multi-lingual interviewers. All the participants were able to enter in a draw to win gift cards. Results The response rate (RR) for the online survey was 34%. RR was highest for those who had lived in Finland 5 years or less (43%) and lowest among the divorced (23%) and Estonians (27%). The paper questionnaire was mostly preferred by older age groups, increasing the RR of 40-64 year-olds from 31% to 48%. Telephone interviews increased the RR by five percent points, thus making the final RR for the survey 53%. Persons born in the EU and North-America responded the most frequently (58%) whereas RR was lowest amongst the Sub-Saharan African origin migrants (47%). RR was particularly low (42%) for those who had moved to Finland at ages 0-6. Conclusions In surveys conducted amongst PFB, relatively good response rates can be obtained by using alternate methods for gathering data instead of costly and time-consuming face-to-face interview. Age and marital status seemed to affect the preference of survey format. The overall RR varied by country of origin. Key messages A good response rate can be obtained without face-to-face interviews in migrant population surveys. Migrant population surveys can be conducted more efficiently by combining a variety of methods.

scholarly journals Possible Factors Affecting Pre-School Children's Irregular Posture Formation

2020 ◽  
Vol 3 (118) ◽  
pp. 19-24
Author(s):  
Laura Daniusevičiūtė-Brazaitė ◽  
Rūta Beistarytė
Keyword(s):  
Physical Activity ◽  
Financial Burden ◽  
Age Groups ◽  
Well Being ◽  
Study Data ◽  
The Body ◽  
Body Parts ◽  
Factors Affecting ◽  
Interactive Games ◽  
Posture Assessment

Background. A review of the health and physical activity of children and teenagers in Lithuania over the last twenty years has shown that many aspects of pupil physical capacity have deteriorated between 1992 and 2012 (Venckunas, Emeljanovas, Mieziene, & Volbekiene, 2017). Also research has shown that musculoskeletal disorders were most commonly found in children aged 4 to 6 years (Daniusevičiutė-Brazaitė & Grėbliauskienė, 2019). Therefore, if these negative trends continue, the growing health problems will pose a greater threat to human well-being and become a serious financial burden for the state and society. Currently technologies are an integral part of everyday life, so the need for interactive games or animated programs cannot be doubted. Research (Lobel, Engels, Stone, Burk, & Granic, 2017) has shown that the use of play-based intervention for children significantly improves fine and visual motor performance. Hence, it is important to identify the possible factors affecting pre-school children’s irregular posture formation. Methods. The study included 377 preschool children from 4 to 6 years old. Three evaluations were performed in the study: posture (using W. K. Hoeger posture assessment methodology), abdominal and back muscle endurance, and balance (Arcinavičius,, Kesminas, & Milčarek, 2004). Results. Assessing the results of the shoulder position of 5-year-old children, results showed that only 16% had good shoulder posture, satisfactory – 74%, bad – 10%. Age was found to have no effect on posture assessment results. According to the study, balance, back, and abdominal functional capacity were better in 6-year-old children. Conclusion. After analyzing 4-year old children group torso, abdomen, lower spine and legs, we can see that a higher percentage of children had a satisfactory posture in the aforementioned body parts. According to the posture results, the most abnormal part of the body was the abdomen. The study data showed that 6-year-old subjects’ balance, lower spine and abdominal performance were better compared to other age groups. Keywords: preschool child, physical activity, posture.

scholarly journals Progressive decline of decision-making performances during multiple sclerosis

2009 ◽  
Vol 15 (2) ◽  
pp. 291-295 ◽  
Author(s):  
SAMANTA SIMIONI ◽  
CHRISTIANE RUFFIEUX ◽  
JOERG KLEEBERG ◽  
LAURE BRUGGIMANN ◽  
RENAUD A. DU PASQUIER ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Decision Making ◽  
Health Status ◽  
Iowa Gambling Task ◽  
Perceived Health ◽  
Well Being ◽  
Perceived Health Status ◽  
Progressive Decline ◽  
Decision Making Capacity ◽  
Disability Status

AbstractThe purpose of this study was to evaluate longitudinally, using the Iowa Gambling Task (IGT), the dynamics of decision-making capacity at a two-year interval (median: 2.1 years) in a group of patients with multiple sclerosis (MS) (n = 70) and minor neurological disability [Expanded Disability Status Scale (EDSS) ≤ 2.5 at baseline]. Cognition (memory, executive functions, attention), behavior, handicap, and perceived health status were also investigated. Standardized change scores [(score at retest-score at baseline)/standard deviation of baseline score] were computed. Results showed that IGT performances decreased from baseline to retest (from 0.3, SD = 0.4 to 0.1, SD = 0.3, p = .005). MS patients who worsened in the IGT were more likely to show a decreased perceived health status and emotional well-being (SEP-59; p = .05 for both). Relapsing rate, disability progression, cognitive, and behavioral changes were not associated with decreased IGT performances. In conclusion, decline in decision making can appear as an isolated deficit in MS. (JINS, 2009, 15, 291–295.)

scholarly journals Social portrait of patients of the cardio-rehabilitation unit of a large cardio-surgical center

2020 ◽  
Vol 64 (3) ◽  
pp. 124-131
Author(s):  
Aleksandr V. Zubko ◽  
Tamara P. Sabgayda ◽  
Elena V. Zemlyanova ◽  
Angilina G. Filatova ◽  
Tea T. Kakuchaya ◽  
...  
Keyword(s):  
Family Relations ◽  
Age Groups ◽  
Well Being ◽  
Overweight And Obesity ◽  
Behavioral Characteristics ◽  
Protective Behavior ◽  
Rehabilitation Unit ◽  
Chi Square ◽  
Factors Affecting ◽  
The Social

Background. The social portrait of patients often helps to define preventive measures for specific diseases in patients of different social and age groups. Need in cardio-surgery is substantiated not only by inborn but also by acquired diseases of heart, in most cases - ischaemic heart disease. The development of cardiovascular diseases is affected by multiple factors including lifestyle. Objective. To analyze the social and behavioral characteristics of cardio-surgical patients. Materials and methods. The authors analyzed the results of a survey of 93 patients in the rehabilitation unit of V.I. Burakovsky Research Institute of Cardiosurgery in 2019. The adapted questionnaire for identifying factors affecting population health was used. The respondents were divided into 3 age groups: 12 patients were under 40 years (mean age of 30.1, 75.0% men); 50 patients - 40-65 years (mean age of 56.4, 76.0% men); 30 patients - 65+ years (mean age of 70.3, 50.0% men). To analyze differences Chi-square and Fisher exact tests were applied. Results. Educational level is increasing with age. Financial well-being was estimated as poverty by one-third of respondents in all groups. 5.4% are dissatisfied with their family relations. The feeling of loneliness is often experienced by 4.3% of respondents. About one-half of respondents mentioned they do not care about their health and 18.5% of the don’t know their diseases to be treated using cardio-surgery. More than half of respondents are uneasy about their future uncertainty. Discussion. The respondent’s’ social status differs in age groups. The social and behavioral characteristics of patients of the cardio-rehabilitation unit allow them to create an integrated social portrait. Conclusions. Patients of cardio-rehabilitation units are characterized by higher educational levels and employment, better financial conditions. Among them, there were few lonely persons, but many sedentary ones. Such patients are characterized by a non-responsible attitude to their health, higher frequency of smoking, overweight, and obesity. Age-specific differences are related to physical fitness but nor to attitude to health neither to self-protective behavior.

scholarly journals Factors Affecting Students Decision Making In Accommodation Process of University

2019 ◽  
Vol 8 (2S9) ◽  
pp. 842-847
Keyword(s):  
Decision Making ◽  
University Students ◽  
Reaction Rate ◽  
Well Being ◽  
T Test ◽  
Factors Affecting ◽  
The World ◽  
Accommodation Process

The hostels accommodation assumes a critical job in the hotel business all through the world and even in a few areas in Malaysia. Be that as it may, in numerous spots in Malaysian hostels have yet to be presented. They can possibly offer spending lodging accommodation, yet inns and motels remain the most prevalent types of cabin. A center gathering was utilized to pick up understanding into students' impression of hostels and helped in the advancement of a composed study. It was sent to a haphazardly chosen test of 215 university students. There was a reaction rate of 8% (n=401). Respondents thought about hostels and were ready to remain in them. Therefore, a factor investigation was led on 31 attributes of hostels that may be imperative to hostel clients and it was confirmed that these things could be decreased to three factors: Safety and Amenities (α=.92), Area and Socializing (α=.91), and Accommodations (α=.60).In fact, well-being and Amenities had the most elevated mean scores for individual things in the factor while Accommodations had the least. The various straight relapse was utilized to decide whether the three factors would foresee university students ‘plan to remain in a hostel. The relapse demonstrate was huge (p≤.000) and every one of the three factors were noteworthy. The model had a R Square of .31. A t-test was utilized to decide whether guys and females contrasted in goal to remain in a hostel, Protection issue, Room Sharing, Security, Cleanliness Issue and Freedom. However, females had higher mean scores for Room Sharing than guys. This examination demonstrated that undergrads would remain in a hostel. The hostel proprietors/administrators what's more, hostel associations can utilize this data to more readily showcase their hostel and it will help them to figure out which luxuries they should need to meet client requests. Research ought to be led with a bigger and all the more geologically various example to decide whether the results can be summed up past university students. Nonetheless, research with genuine hostel clients will help to decide qualities they believe are essential and to contrast results and this examination.

A Study of Factors Affecting Residential Property Buying Decisions Post Covid-19 Pandemic

2020 ◽  
Vol 16 (02) ◽  
pp. 41-49
Author(s):  
Tushar Jindal ◽  
T. P. Singh ◽  
Nitesh Rohilla ◽  
Anupam Saxena
Keyword(s):  
Decision Making ◽  
Research Paper ◽  
Residential Property ◽  
Daily Routine ◽  
Herd Behavior ◽  
High Involvement ◽  
Factors Affecting ◽  
Factors Analysis ◽  
Decision Making Capacity ◽  
Prospective Buyer

More than 90% of people make their most expensive purchase when they buy a residential property. This expensive purchase takes much time to decide what, where, when, why and how to buy. Many factors are involved to answer all the questions to make the accurate decision. These factors impact the decision-making capacity of the buyers. Factors like demographics, physiographic, motivational, aspirational, tendency of herd behavior all impacts the decision-making capacity. In comparison to common purchases which involves less effort like our daily routine purchase takes less amount of time and money to make the accurate decision, Residential property buying requires high involvement in terms of time, effort and money with lot of factors analysis which can effects the buying decision of prospective buyer. This research paper aims to analyze all those factors which are going to impact the decision making capacity of residential property buyer, especially in post Covid 19 situation, what all factors are going to become crucial for buyer while buying property? and what relevance they hold in respect of each other? The paper aims to help both developer and buyer to tick all those boxes which are going to satisfy requirements of both. Also, while considering these factors it will be easy for developer to channelize sales and prospective buyers will get what they really want.

scholarly journals Overriding Adolescent Refusals of Treatment

2021 ◽  
Vol 20 (3) ◽  
Author(s):  
Anthony Skelton ◽  
Lisa Forsberg ◽  
Isra Black
Keyword(s):  
Decision Making ◽  
Medical Treatment ◽  
Well Being ◽  
Differential Treatment ◽  
Parental Responsibility ◽  
Decision Making Capacity ◽  
The Asymmetry

Adolescents are routinely treated differently to adults, even when they possess similar capacities. In this article, we explore the justification for one case of differential treatment of adolescents. We attempt to make philosophical sense of the concurrent consents doctrine in law: adolescents found to have decision-making capacity have the power to consent to—and thereby, all else being equal, permit—their own medical treatment, but they lack the power always to refuse treatment and so render it impermissible. Other parties, that is, individuals who exercise parental responsibility or a court, retain the authority to consent on an adolescent’s behalf. We explore four defences of the doctrine. We reject two attempts to defend the asymmetry in the power to consent to and refuse medical treatment by reference to transitional paternalism. We then consider and reject a stage of life justification. Finally, we articulate a justification based on the distinctiveness of adolescent well-being.

Ethical issues in palliative care research

2021 ◽  
pp. 1312-1317
Author(s):  
Tyler Tate ◽  
David Casarett
Keyword(s):  
Decision Making ◽  
Palliative Care ◽  
End Of Life ◽  
Ethical Issues ◽  
Research Participation ◽  
Ethical Aspects ◽  
Care Research ◽  
Qualitative And Quantitative ◽  
Decision Making Capacity ◽  
Potential Benefits

Recent growth in palliative care research has created a heterogeneous field that encompasses both qualitative and quantitative techniques, and descriptive as well as interventional studies. Despite the valuable knowledge that has been produced by this research, and the promise of future important advances, its progress has been impeded by a persistent uncertainty about the ethics of these studies. For instance, there have been concerns raised about whether patients near the end of life should ever be asked to participate in research, although others have objected to this extreme position. Nevertheless, the combination of ethical and practical issues can create substantial barriers to palliative care research. This chapter discusses five ethical aspects of palliative care research that investigators and clinicians should consider in designing and conducting palliative care research. These include (1) the study’s potential benefits to future patients, (2) the study’s potential benefits to subjects, (3) the study’s risks to subjects, (4) subjects’ decision-making capacity, and (5) the voluntariness of subjects’ choices about research participation.

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