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ETHICAL ISSUES IN PROVIDING CARE FOR THE ELDERLY BY HEALTH PROFESSIONALS




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Professional ethics is particularly important in medicine, especially when  in the performance of professional duties higher moral values are concerned — human life, health, freedom, dignity, personal inviolability. The ethical issues related to the elderly are:

— Keeping the elderly people’s dignity

— Respect for the elderly

— Quality of life

— How contemporary theories of morality influence the care for the elderly

— Growing old gracefully

— Assisted living

Those providing health care to elderly people need to carry out extensive work to exchange ideas and experiences as a way to ethically providing care and protection by promoting ethical thinking in order to improve the planning and delivery of care for elderly people; ensuring a greater understanding of the way in which enrich our understanding and awareness of the ethical problems of the elderly.The professionals providing health care in geriatrics should have: extensive theoretical and conceptual knowledge and understanding of theories of morality and their relationship with the elderly people and their care.

Knowledge and understanding through contemporary debate, through critical analysis of ethical issues, through insight and evidence drawn from the care for the elderly.

They should assist in solving ethical problems in their work with the elderly.

The knowledge and awareness to provide the necessary basis for originality in developing and applying ethical principles in the context of their professional role, and by conducting empirical research.

Integrating knowledge of theories of morality associated with elderly people to inform and guide former’s professional role.

They should be able to reflect on a wide range of disciplinary, scientific and professional issues as well as social, cultural and ethnic responsibilities that are required for making a judgment.

Knowledge of theories of morality associated with elderly people and knowledge and logical reasoning set in these theories, in order to communicate  them to specialized and non-specialized audiences in a clear and unequivocal manner. In professional situations they should be able to act in a way that takes into account the complex ethical issues that arise when caring for elderly people.

They should be able to ensure protection for the elderly by promoting ethical thinking in order to improve the planning and delivery of care for the latter.

Growing old gracefully — is the foundation of moral  and ethical aspects related to the elderly people’s  quality of life, with particular emphasis on the importance of healthy aging, health promotion and health education among the aging population. Health promotion and health education can support healthy aging. The social significance of the sexual characteristics of the bodies in the aging process and concepts such as sex and sexuality in old age, the importance of personal ties, issues of quality of life, dignity and respect, compassionate care, decisions about end of life and family dynamics are particularly important roles in providing quality health care.

Those working with old people should be able to critically analyze the social sense of the physical, psychological and sexual health of older people; reflect on perceptions about gender characteristics of the bodies of old age; discuss the relevance of health promotion among elderly people; discuss issues that may alter or improve the ability of elderly people to be involved in the promotion and maintenance of health; critically think about the ways in which health education can support healthy aging; engage elderly people into developing strategies to help the latter maintain good health; create links with external organizations that represent the views of elderly people to encourage health promotion.

Another important aspect is assisted living in the practice of insurance and use of aids in working with older people. “Rehabilitation in the period of ageing is defined as a continual and complex effort for revitalization of the individual to his habitual functional and social position or maintenance and increase in the residual function.” [4]

Geriatrics should not be confused with the concept of palliative care, which aims to help people in the last stages of an incurable illness to die in a dignified way. Geriatrics in turn is called to help the elderly and very old people lead a better life. There increases with age the risk of diabetes, atherosclerosis, arthritis, hypertension, cancer and other processes of disability. Amenities and facilities for the elderly should be everywhere around them.

At home — there they must have appropriate furniture for them:

— In the kitchen  — cupboards in the kitchen should be located lower, there should be present light or sound signaling appliance in case a plugged in kitchen appliance is forgotten;

 — Dining-room — the dining tables hould be comfortable and positioned so as to be easily accessible;

  • Living room – the furniture should be comfortable, affordable and capable of easy cleaning

 — Bathrooms space should be larger so that to enable elderly people’s motion in a wheelchair, walker or crutches freely;

— The dishes at home should be of unbreakable material.

— Their access to the yard should be unhindered.

To provide access to public places and buildings it is necessary:

— pavements to be bevelled at zebra crossings

-traffic lights should be provided with a light and sound signal

— lanes in parks and gardens should be free of bumps and obstacles that would seriously hamper the movement of the elderly

— In front of public buildings there should be placed ramps or in case there are no ramps there should be no steps at the entrance of the building.

Special aids when for one reason or another the elderly people have walking difficulties special aids are necessary to facilitate and improve their way of life. Depending on what disease they suffer or on account of  old age itself there should be offered a wide variety of such subsidiary means, such as:

  • Wheelchair
  • Wheelchair for bathroom
  • Ortokar
  • Walker
  • Hearing aid

Aids that are used for comfort and convenience in geriatrics:

  • Serving trays
  • Sink railing
  • Standing support for reading books
  • Channel ramp
  • Chicago rolling armchair
  • Luxurious bed/chair table
  • Rollators
  • Easy-to-view digital watch
  • Economy ramp for wheelchairs
  • Trolley Lift
  • Folding chair
  • Foldable ramp for thresholds
  • Frisco Space Saver
  • Telescopic portable ramp
  • Magnifying glass 8 times / 3 times
  • Orlando rolling armchair
  • Riviera lift for bathtub
  • Folding ramp
  • Richmon Electric Adjustable Bed
  • Ramp for travelling
  • Ultra lightweight wheelchair for travelling 2
  • Ultra-lightweight aluminum walker

Depending on the disease the needs for special aids for the elderly are different. “Regular exercises have a considerable role for the prevention of diseasebut their effects for preservation of the available motive functions are also significant.”[5] In diseases of neurological nature (Parkinson’s, multiple sclerosis, stroke, etc.) or diseases of the musculoskeletal system (degenerative, trauma, osteoporosis, etc.), there should be made-to-measure special aids.

In problems with vision and hearing other made –to-measure special aids are necessary. It is important to know that people at this age must maintain good locotomitive conditions. Professional care providers for elderly people need to acquire advanced specialized knowledge and understanding of aging and address the challenges that elderly people face in the delivery of health care rehabilitation, support their independent life in view of the possibilities offered by utilities. With aging the needs and abilities of people change. The role of the specialist is to acquire knowledge and skills to keep the dignity and quality of life of older people intact. The new generation of highly competent professionals must be able:

— To ensure the quality of life in old age

— To discover and meet the specific needs of elderly people

— To help the elderly by ensuring a safe and comfortable life

—  To improve links between different generations

— To better communication among older people

Literature

  1. Draganova, M., S. Panayotova. The importance of ethics for provision of quality health care”. Ethics in Bulgarian Health 2007
  2. Health Law. SG. 70/2004.
  3. Health Insurance Act. SG. 70/1998
  4. Mihaylova – Alakidi V. The rehabilitation approach in geriatrics In: Contemporary dimensions of the problems of successful ageing. EX-PRESS Publishing House , Gabrovo, 2011, p.52-57.
  5. Mihaylova V., I. Bivolarski I, M Baltov, E. Raikov, A. Alakidi, «The role of targeted physical activity through the use of complex pas LFK elderly persons.» Journal of Eurasian Union of Scientists (ESU), Medical Science, Collection of scientific works, Moscow, Russia, №2 ( 11), part 4, ISSN 2575-7999, 129-134, 2015 International Code of Medical
  6. Popova  S. «Personality and Health», Sofia 1993
  7. 7. Professional ethics code. SG No.79 / 2000
  8. 9. Vodenitcharov Ts., S. Popova. «Medical Ethics» Sofia DAK 2003
  9. 10. http://www.meyra.bg/
  10. 11. http://www.daya-bg.com/
  11. 12. http://sgr.hit.bg/fir.html
    ETHICAL ISSUES IN PROVIDING CARE FOR THE ELDERLY BY HEALTH PROFESSIONALS
    The article analyzes issues related to the quality of life of elderly people, with particular emphasis on dignity and respect. Some ethical issues concerning elderly people and their social rehabilitation are also considered.
    Written by: Bozhkova Maria Krasteva
    Published by: БАСАРАНОВИЧ ЕКАТЕРИНА
    Date Published: 12/23/2016
    Edition: euroasian-science.ru_25-26.03.2016_3(24)
    Available in: Ebook