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Ethics of Working with Older Adults

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As professionals in the aging services sector, it is important to recognize the ethical issues that could arise when working with older adults. There are multiple areas in which ethical issues can emerge, including complex family dynamics, addressing end-of-life wishes, preserving dignity and respect, promoting independence, and keeping the individual safe. It is also important for professionals to understand ethical principles and how they can be applied in their daily work.

Ethics are a system of moral values and can also be described as a set of principles of conscientious conduct. For those that work with older adults, this essentially means doing the right thing and honoring the individual’s decision. This is not always easy but there are well known ethical principles that help to guide professionals and they can be applied to various fields. The ethical principles include autonomy, justice, beneficence, non-maleficence, and fidelity. The definitions of these terms are outlined below.

Ethical principles:

  • Autonomy: the right of a person to determine his or her own destiny
  • Justice: seeks the sharing of benefits and burdens based on fairness and equality
  • Beneficence: to do good on behalf of the individual rather than healthcare professionals
  • Non-maleficence: to protect the individual’s safety and not cause harm
  • Fidelity: involves loyalty, faithfulness and honoring commitments

The use of ethical principles is driven by formal and informal dimensions of the culture in which the professional works. Formal dimensions of culture are driven by polices and procedures. They are written and planned out, such as a client or patient bill of rights. Informal dimensions of culture are driven by the way people actually do things. They are unwritten and more spontaneous and include things such as storytelling, observing the behavior of others and “water-cooler talk.”

The reason ethics are so important when working with older adults is because there are various attributes of advancing age that can make older adults vulnerable.

Vulnerable Attributes of Advancing Age:

  • Isolation and loneliness
  • Health status
  • Physical decline
  • Personal losses
  • Cognitive impairment
  • Economic and social challenges
  • Social supports
  • Financial security/socioeconomic status
  • Employment history and education
  • Environmental factors
  • Institutionalization
  • Less likely to report abuse

Knowing these factors and applying ethical principles can assist senior care professionals in understanding how to reduce the risk of harm, how to advocate for the older adult and how to report issues to the proper authorities when necessary. It is also important for family caregivers to know and understand these attributes so they can plan ahead for their loved one’s needs and avoid some of the common ethical issues that could occur.

Common Ethical Issues:

  • Ageism
  • Capacity and competency
  • Informed consent
  • Confidentiality
  • Professional boundaries
  • Elder abuse and neglect
  • Dignity of risk
  • Bias and discrimination
  • Dementia
  • Personal privacy
  • Grievances or complaints

The goal is to avoid ethical issues and the best way to do so is to take proactive steps to reduce the risks. The following are key tips to consider reducing the risk of harm to older adults and uphold ethical principles.

Tips for Professionals to Uphold Ethical Principles:

  • Inquire about your organization’s ethical practices
  • Review your profession’s code of ethics
  • Refresh on patient/client/resident bill of rights
  • Stay up-to-date on local and national laws and regulations for your profession and industry
  • Engage in ethical decision making
  • Report any abuse or neglect

Tips for Family Caregivers to Uphold Ethical Principles:

  • Learn the signs of abuse
  • Educate loved one about fraud prevention
  • Plan ahead and discuss loved one’s wishes (consider everyday and long-term needs)
  • Get important documents in place (power of attorney for health care and finance)
  • Seek professional help (consider an elder law attorney)

If ethical issues do arise, it is helpful to engage in an ethical decision-making model. To learn more about ethical decision making models and the ethics of working with older adults, watch this webinar and even earn a free continuing education (CE) credit*. For more caregiving resources visit www.caregiverstress.com.

*CE credits are only available for 60 days following the live webinar event.

Last revised: August 6, 2020

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