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SAFE & DEPENDENT or UNSAFE & INDEPENDENT: The Ethical Challenge of Providing Services To the Mentally Competent Consumer Experiencing Physical Decline Jennifer J. Strayer, LMSW Laura Remmel, RN
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SAFE & DEPENDENT or UNSAFE & INDEPENDENT: The Ethical Challenge of Providing Services To the Mentally Competent Consumer Experiencing Physical Decline.

Dec 28, 2015

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Page 1: SAFE & DEPENDENT or UNSAFE & INDEPENDENT: The Ethical Challenge of Providing Services To the Mentally Competent Consumer Experiencing Physical Decline.

SAFE & DEPENDENTor

UNSAFE & INDEPENDENT:The Ethical Challenge of Providing

Services To the Mentally Competent Consumer Experiencing Physical Decline

Jennifer J. Strayer, LMSWLaura Remmel, RN

Page 2: SAFE & DEPENDENT or UNSAFE & INDEPENDENT: The Ethical Challenge of Providing Services To the Mentally Competent Consumer Experiencing Physical Decline.

GENERAL OVERVIEW

Introductions of Presenters

The Home Health Care Team and Patient Safety

The Consumer’s Perspective

The Role of the Social Worker

Page 3: SAFE & DEPENDENT or UNSAFE & INDEPENDENT: The Ethical Challenge of Providing Services To the Mentally Competent Consumer Experiencing Physical Decline.

GENERAL OVERVIEW

The Role of the Nurse

The Role of Adult Protective Services

Improving the System

Discussion with the Audience

Page 4: SAFE & DEPENDENT or UNSAFE & INDEPENDENT: The Ethical Challenge of Providing Services To the Mentally Competent Consumer Experiencing Physical Decline.

The Home Health Care Team and Consumer Safety

Function and purpose of home health care

Team members (SN, PT, OT, ST, MSW, Personal care aides)

Services provided

Addressing concerns of consumer safety Assessment of physical functioning/home safety Assessment of mental competence

Page 5: SAFE & DEPENDENT or UNSAFE & INDEPENDENT: The Ethical Challenge of Providing Services To the Mentally Competent Consumer Experiencing Physical Decline.

THE CONSUMER’S PERSPECTIVE

The consumer’s personal experience: How does he/she feel? What does he/she want?

Remaining at home: The decisional balance Unsafe & Independent Safe & Dependent

Page 6: SAFE & DEPENDENT or UNSAFE & INDEPENDENT: The Ethical Challenge of Providing Services To the Mentally Competent Consumer Experiencing Physical Decline.

THE CONSUMER’S PERSPECTIVE

Available options and resources

Family / support networks

Decision-making

System navigation, service/program access

Long term care planning:

Page 7: SAFE & DEPENDENT or UNSAFE & INDEPENDENT: The Ethical Challenge of Providing Services To the Mentally Competent Consumer Experiencing Physical Decline.

THE SOCIAL WORKER’S PERSPECTIVE

The role of the social worker in consumer safety

The social worker’s experience: Case examples

Personal reactions to field work

Page 8: SAFE & DEPENDENT or UNSAFE & INDEPENDENT: The Ethical Challenge of Providing Services To the Mentally Competent Consumer Experiencing Physical Decline.

THE SOCIAL WORKER’S PERSPECTIVE

NASW (National Association of Social Workers) Code of Ethics 1.02 - Self-determination 1.07(c) – Privacy and

Confidentiality

Page 9: SAFE & DEPENDENT or UNSAFE & INDEPENDENT: The Ethical Challenge of Providing Services To the Mentally Competent Consumer Experiencing Physical Decline.

THE NURSE’S PERSPECTIVE

The role of the nurse in consumer safety

The nurse’s experience: Case examples

Personal reactions to field work

Page 10: SAFE & DEPENDENT or UNSAFE & INDEPENDENT: The Ethical Challenge of Providing Services To the Mentally Competent Consumer Experiencing Physical Decline.

THE NURSE’S PERSPECTIVE

American Nurses Association – Code of Ethics for Nurses 1.4 – Self-determination 3.2 – Confidentiality

Page 11: SAFE & DEPENDENT or UNSAFE & INDEPENDENT: The Ethical Challenge of Providing Services To the Mentally Competent Consumer Experiencing Physical Decline.

ETHICAL DILEMMA

Professional obligation to consumer Self-determination and Confidentiality

vs. Personal safety

To report or not to report: Making the decision to refer to Adult Protective Services (APS) Interdisciplinary

discussion/consultation Potential repercussions

Page 12: SAFE & DEPENDENT or UNSAFE & INDEPENDENT: The Ethical Challenge of Providing Services To the Mentally Competent Consumer Experiencing Physical Decline.

THE ROLE OF ADULT PROTECTIVE SERVICES

Adult and Long-Term Care Facility Resident Maltreatment Act

Arkansas Adult Protective Services (APS) statistical information

Procedure for making an referral for APS investigation

Page 13: SAFE & DEPENDENT or UNSAFE & INDEPENDENT: The Ethical Challenge of Providing Services To the Mentally Competent Consumer Experiencing Physical Decline.

ADULT PROTECTIVE SERVICES PERSPECTIVE

The role of the APS case worker in consumer safety

The APS case worker’s experience: Case examples

Personal reactions to field work

Page 14: SAFE & DEPENDENT or UNSAFE & INDEPENDENT: The Ethical Challenge of Providing Services To the Mentally Competent Consumer Experiencing Physical Decline.

Improving the System

Why?

Improve quality of life

Personal interest (this could one day be you or someone you love)

Decrease healthcare costs

Page 15: SAFE & DEPENDENT or UNSAFE & INDEPENDENT: The Ethical Challenge of Providing Services To the Mentally Competent Consumer Experiencing Physical Decline.

Improving the System

How?

Revising current programs and processes

Collaboration between State agencies, community service providers, and consumers

Page 16: SAFE & DEPENDENT or UNSAFE & INDEPENDENT: The Ethical Challenge of Providing Services To the Mentally Competent Consumer Experiencing Physical Decline.

DISCUSSION WITH THE AUDIENCE

Questions for the presenters?

Ideas for improving the system

Your professional perspective

Page 17: SAFE & DEPENDENT or UNSAFE & INDEPENDENT: The Ethical Challenge of Providing Services To the Mentally Competent Consumer Experiencing Physical Decline.

CONTACT INFORMATIONJennifer J. Strayer, LMSW

Medical Social Worker IIBaptist Home Health Network11900 Colonel Glenn Rd, Ste. 2000Little Rock, AR 72210-2820Office  501-202-7480Email  [email protected]

Laura Remmel, RN Baptist Home Health Network 11900 Colonel Glenn Rd, Ste. 2000

Little Rock, AR 72210-2820Office  501-202-7480Email [email protected]