The Ethical Challenge of Providing Healthcare for the Elderly

Neurodegenerative diseases (NDs) represent one of the most important public health problems and concerns, as they are a growing cause of mortality and morbidity worldwide, particularly in the elderly. Despite remarkable breakthroughs in our understanding of NDs, there has been little success in developing effective therapies. The use of natural products may offer great potential opportunities in the prevention and therapy of NDs; however, many clinical concerns have arisen regarding their use, mainly focusing on the lack of scientific support or evidence for their efficacy and patient safety. These clinical uncertainties raise critical questions from a bioethical and legal point of view, as considerations relating to patient decisional autonomy, patient safety, and beneficial or non-beneficial care may need to be addressed. This paper does not intend to advocate for or against the use of natural products, but to analyze the ethical framework of their use, with particular attention paid to the principles of biomedical ethics. In conclusion, the notable message that emerges is that natural products may represent a great promise for the treatment of many NDs, even if many unknown issues regarding the efficacy and safety of many natural products still remain.

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The Ethical Challenge of Providing Healthcare for the Elderly

Cambridge Quarterly of Healthcare Ethics ◽

10.1017/s096318010000582x ◽

1995 ◽

Vol 4 (2) ◽

pp. 148-162 ◽

Cited By ~ 5

Author(s):

David C. Thomasma

Keyword(s):

Fast Rate ◽

The Elderly ◽

Ethical Challenge ◽

Care For The Elderly ◽

The World ◽

Near Future

Populations around the world are aging at a very fast rate, so much so that care for the elderly will soon rupture even the most carefully planned, enlightened care provisions societies can offer. The demographics in advanced countries demonstrate this dilemma, even without projections based on antiaging medications that may be possible in the near future, and a healthier lifestyle that has preoccupied the yuppies for about 10 years.

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Informed Consent and the Elderly: An Ethical Challenge for Critical Care Nursing

Critical Care Nursing Clinics of North America ◽

10.1016/s0899-5885(18)30806-2 ◽

1990 ◽

Vol 2 (3) ◽

pp. 461-471 ◽

Cited By ~ 5

Author(s):

David A. Buehler

Keyword(s):

Critical Care ◽

Informed Consent ◽

The Elderly ◽

Ethical Challenge ◽

Critical Care Nursing ◽

Care Nursing

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Cell surface changes during aging of human bladder epithelium examined by lectin probes and SEM

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100162429 ◽

1990 ◽

Vol 48 (3) ◽

pp. 966-967

Author(s):

J. Jacob ◽

M.F.M. Ismail

Keyword(s):

The Elderly ◽

Ultrastructural Changes ◽

Pokeweed Mitogen ◽

Asymmetric Structure ◽

Luminal Surface ◽

Bladder Epithelium ◽

Aldehyde Groups ◽

Cell Surface Changes ◽

Phosphate Buffered Saline ◽

Surface Changes

Ultrastructural changes have been shown to occur in the urinary bladder epithelium (urothelium) during the life span of humans. With increasing age, the luminal surface becomes more flexible and develops simple microvilli-like processes. Furthermore, the specialised asymmetric structure of the luminal plasma membrane is relatively more prominent in the young than in the elderly. The nature of the changes at the luminal surface is now explored by lectin-mediated adsorption visualised by scanning electron microscopy (SEM).Samples of young adult (21-31 y old) and elderly (58-82 y old) urothelia were fixed in buffered 2% glutaraldehyde for 10 m and washed with phosphate buffered saline (PBS) containing Ca++ and Mg++ at room temperature. They were incubated overnight at 4°C in 0.1 M ammonium chloride in PBS to block any remaining aldehyde groups. The samples were then allowed to stand in PBS at 37°C for 2 h before incubation at 37°C for 30 m with lectins. The lectins used were concanavalin A (Con A), wheat germ agglutinin (WGA), phytohaemagglutinin (PHA) and pokeweed mitogen (PWM) at a concentration of 500 mg/ml in PBS at pH 7.A.

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The effect of dental geriatric curricula on attitudes toward the elderly

Journal of Dental Education ◽

10.1002/j.0022-0337.1988.52.9.tb02232.x ◽

1988 ◽

Vol 52 (9) ◽

pp. 516-518 ◽

Cited By ~ 2

Author(s):

J Mann ◽

TJ Bomberg ◽

JM Holtzman ◽

DB Berkey

Keyword(s):

The Elderly

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Speech-Language Pathologists' Attitudes Toward Aging and the Elderly

Contemporary Issues in Communication Science and Disorders ◽

10.1044/cicsd_30_f_146 ◽

2003 ◽

Vol 30 (Fall) ◽

pp. 146-155 ◽

Cited By ~ 5

Author(s):

Jeff Searl ◽

Rodney M. Gabel

Keyword(s):

The Elderly ◽

Speech Language Pathologists ◽

Attitudes Toward Aging

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Pharmacology Issues Related to Dementia Syndrome of Depression in Elderly Residents of Long-Term Care Settings

Perspectives on Neurophysiology and Neurogenic Speech and Language Disorders ◽

10.1044/nnsld25.2.61 ◽

2015 ◽

Vol 25 (2) ◽

pp. 61-69

Author(s):

Angel L. Ball ◽

Adina S. Gray

Keyword(s):

Depressive Symptoms ◽

The Elderly ◽

Environmental Communication ◽

Pharmacological Intervention ◽

Team Approach ◽

Discussion Paper ◽

Term Care ◽

Anticholinergic Medications ◽

Inappropriate Treatment ◽

Dementia Syndrome

Pharmacological intervention for depressive symptoms in institutionalized elderly is higher than the population average. Among the patients on such medications are those with a puzzling mix of symptoms, diagnosed as “dementia syndrome of depression,” formerly termed “pseudodementia”. Cognitive-communicative changes, potentially due to medications, complicate the diagnosis even further. This discussion paper reviews the history of the terminology of “pseudodementia,” and examines the pharmacology given as treatment for depressive symptoms in the elderly population that can affect cognition and communication. Clinicians can reduce the risk of misdiagnosis or inappropriate treatment by having an awareness of potential side effects, including decreased attention, memory, and reasoning capacities, particularly due to some anticholinergic medications. A team approach to care should include a cohesive effort directed at caution against over-medication, informed management of polypharmacology, enhancement of environmental/communication supports and quality of life, and recognizing the typical nature of some depressive signs in elderly institutionalized individuals.

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