scholarly journals Disparities and ethical considerations for children with tracheostomies during the COVID-19 pandemic

2020 ◽  
Vol 13 (3) ◽  
pp. 371-376
Author(s):  
Lulia A. Kana ◽  
Andrew G. Shuman ◽  
Jennifer Helman ◽  
Kelly Krawcke ◽  
David J. Brown
Keyword(s):  
Chronic Illness ◽  
Long Term Care ◽  
Rehabilitation Services ◽  
Ethical Considerations ◽  
Term Care ◽  
Healthcare Resources ◽  
Marginalized Communities ◽  
Ethical Concerns ◽  
Ethical Discourse

The COVID-19 pandemic is exacerbating longstanding challenges facing children with tracheostomies and their families. Myriad ethical concerns arising in the long-term care of children with tracheostomies during the COVID-19 pandemic revolve around inadequate access to care, healthcare resources, and rehabilitation services. Marginalized communities such as those from Black and Hispanic origins face disproportionate chronic illness because of racial and other underlying disparities. In this paper, we describe how these disparities also present challenges to children who are technology-dependent, such as those with tracheostomies and discuss the emerging ethical discourse regarding healthcare and resource access for this population during the pandemic.

Commentary: The Broader Context of Long-Term Care Ethics

2016 ◽  
Vol 25 (3) ◽  
pp. 554-556
Author(s):  
Jason Lesandrini ◽  
Carol O’Connell
Keyword(s):  
Care Setting ◽  
Long Term Care ◽  
Ethical Issues ◽  
Term Care ◽  
Ethical Concerns ◽  
Healthcare Settings ◽  
Care Facilities ◽  
Ethics Program ◽  
Made In

Ethical issues in long-term care settings, although having received attention in the literature, have not in our opinion received the appropriate level they require. Thus, we applaud the Cambridge Quarterly for publishing this case. We can attest to the significance of ethical issues arising in long-term care facilities, as Mr. Hope’s case is all too familiar to those practicing in these settings. What is unique about this case is that an actual ethics consult was made in a long-term care setting. We have seen very little in the published literature on the use of ethics structures in long-term care populations. Our experience is that these healthcare settings are ripe for ethical concerns and that providers, patients, families, and staff need/desire ethics resources to actively and preventively address ethical concerns. The popular press has begun to recognize the ethical issues involved in long-term care settings and the need for ethics structures. Recently, in California a nurse refused to initiate CPR for an elderly patient in a senior residence. In that case, the nurse was quoted as saying that the facility had a policy that nurses were not to start CPR for elderly patients.1 Although this case is not exactly the same as that of Mr. Hope, it highlights the need for developing robust ethics program infrastructures in long-term care settings that work toward addressing ethical issues through policy, education, and active consultation.

scholarly journals Dignity in long-term care

2016 ◽  
Vol 24 (6) ◽  
pp. 744-751 ◽  
Author(s):  
Jennifer Kane ◽  
Kay de Vries
Keyword(s):  
Long Term Care ◽  
Aged Care ◽  
Research Literature ◽  
Ethical Considerations ◽  
Term Care ◽  
Care Environment ◽  
The United Kingdom ◽  
Care Facilities ◽  
Common Thread

Background: The concept of dignity is recognised as a fundamental right in many countries. It is embedded into law, human rights legislation and is often visible in organisations’ philosophy of care, particularly in aged care. Yet, many authors describe difficulties in defining dignity and how it can be preserved for people living in long term care. Objectives: In this article, Nordenfelt’s ‘four notions of dignity’ are considered, drawing on research literature addressing the different perspectives of those who receive, observe or deliver care in the context of the long-term care environment. Methods: A review of the literature was undertaken using the terms ‘nursing homes’, ‘residential care’ or ‘long-term care’. The terms were combined and the term ‘human dignity’ was added. A total of 29 articles met the inclusion criteria from the United Kingdom (14), United States (2), Australia (1), Sweden (3), Hong Kong (2), Norway (3), Nordic (1), Taiwan (1), Netherlands (1). Ethical Considerations: Every effort has been made to ensure an unbiased search of the literature with the intention of an accurate interpretation of findings. Discussion: The four notions of dignity outlined by Nordenfelt provide a comprehensive description of the concept of dignity which can be linked to the experiences of people living in long-term care today and provide a useful means of contextualising the experiences of older people, their families and significant others and also of staff in long-term care facilities. Of particular interest are the similarities of perspectives of dignity between these groups. The preservation of dignity implies that dignity is a quality inherent in us all. This links directly to the exploration and conclusions drawn from the literature review. Conversely, promoting dignity implies that dignity is something that can be influenced by others and external factors. Hence, there are a number of implications for practice. Conclusion: We suggest that two of Nordenfelt’s notions, ‘dignity of identity’ and ‘dignity of Menschenwüde’, are a common thread for residents, family members and staff when conceptualising dignity within long-term care environments.

Healthcare in Rural Manitoba: Resources and Related Issues of Access

1989 ◽  
Vol 2 (2) ◽  
pp. 6-11
Author(s):  
John M. Horne
Keyword(s):  
Rural Communities ◽  
Geographic Distribution ◽  
Long Term Care ◽  
Efficient Allocation ◽  
Allocation Of Resources ◽  
Term Care ◽  
Healthcare Resources ◽  
Hospital Medical ◽  
Publicly Insured

This paper reviews the existing allocation of healthcare resources to and within rural Manitoba. The geographic distribution of hospital, medical and long-term care resources is described and discussed in relation to widely held perceptions of continuing problems in access to publicly insured care among residents of rural communities. Opportunities for more effective and efficient allocation of resources are identified, including various arrangements for sharing both facilities and personnel between communities.

Ethical Considerations in the Conduct of Electronic Surveillance Research

2006 ◽  
Vol 34 (3) ◽  
pp. 611-619 ◽  
Author(s):  
Ashok J. Bharucha ◽  
Alex John London ◽  
David Barnard ◽  
Howard Wactlar ◽  
Mary Amanda Dew ◽  
...  
Keyword(s):  
Assisted Living ◽  
Long Term Care ◽  
The United States ◽  
Assisted Living Facilities ◽  
Ethical Considerations ◽  
Term Care ◽  
Baby Boomer Generation ◽  
Demographic Shifts

Nearly 2.5 million Americans currently reside in nursing homes and assisted living facilities in the United States, accounting for approximately five percent of persons sixty-five and older. The aging of the “Baby Boomer” generation is expected to lead to an exponential growth in the need for some form of long-term care (LTC) for this segment of the population within the next twenty-five years. In light of these sobering demographic shifts, there is an urgency to address the profound concerns that exist about the quality-of-care (QoC) and quality-of-life (QoL) of this frailest segment of our population.

scholarly journals Keperawatan Pasien Berpenyakit Kronis

2014 ◽  
Vol 1 (2) ◽  
pp. 45-50
Author(s):  
Elly Nurachmah
Keyword(s):  
Chronic Illness ◽  
Health Care Providers ◽  
Nursing Practice ◽  
Long Term Care ◽  
Care Providers ◽  
Term Care ◽  
Caring Behavior ◽  
Pathological Alteration ◽  
Factors Influencing

Keperawatan merupakan falsafah mendasar praktik keperawatan. Dikembangkan oleh Watson (1985), keperawatan terdiri atas 10 faktor karatif yang menganjurkan perawat memberikan asuhan keperawatan paripurna kepada para pasien  sehubung dengan kondisi penyakit mereka, termasuk pasien berpenyakit kronis. Penyakit kronis ialah penyakit yang karena cirri-cirinya membutuhkan perawatan jangka panjang. Biasanya disebabkan oleh perubhan patologi yang “irreversible” dimana mengarahkan kemampuan seseorang karena kegagalan fungsi tubuh. Penyakit kronis menciptakan banyak masalah tidak hanya pada individu dan keluarga tetapi juga pada pemberi pelayanan kesehatan termasuk perawat. Mereka harus “hidup” dengan pasien dari hari ke hari dan mengatasinya. Mereka berada pada status kematian yang datangnya tidak dapat diperkirakan dengan tepat. Perawat merasa putus asa terhadap prognosa penyakit menyebabkan mereka sulit merawat pasien berpenyakit kronis. Hal ini juga merupakan salah satu alasan mengapa perawat tidak mampu memperlihatkan perilaku merawat seperti yang dikatakan Watson. Artikel ini mencoba menguraikan teori merawat berdasarkan kasih sayang, factor yang mempengaruhi perawat dalam merawat, dan alasan pemberian perawatan pada pasien berpenyakit kronis dengan menggunakan sikap merawat yang tepat. Caring is a fundamental philosophy of nursing practice. It was developed by Watson (1985). It consist of ten carrative factors that allow nurses to provide a comprehensive nursing care to patients regardless of their condition of illness including patients with chronic illness. Chronic illness is a variety of illness that because of its characteristic needs long term care. It is usually caused by non-reversible pathological alteration that lead to incapacity of a person due to impairment of body function. Chronic illness has created many problems not only for individuals and families but also for health care providers including nurses. They have to “live” with the patient day to day and cope with it. Following the chronicity of disease, death will come unpredictably. Nurses feel a sense of hopelessness with regard to the prognosis that make them difficult to care for individuals with chronic illness. This is also one of the reasons why nurses are unable to demonstrate caring behavior as stated by Watson. This article attempts to describe about theory of caring, factors influencing nurses caring behavior, and reasons to provide care to patients with chronic illness using appropriate caring behavior.

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