Ethics for dementia case study

[yoyogirl]

Hiya All
I am currently working on an assignment for university and it is on the nursing and medical ethics of a patient with dementia.

The pretend situation is that "Frank" is 81 and was recently admitted to hospital with urine infection that lead to him becoming confused, agitated and was showing all the signs of dementia. However hsi infection is now better, however he is showing signs of dementia and has muscle weakness from laying in bed for 3 weeks and not moving.
The hospital wish to discharge him to a nursing home, however his son Carl wants him at home with his wife who also has dementia. His son can look after him despite living 30 miles away with his wife and will stay in his propetty. However his wife is concerned over finances (him stopping work) and not being able to see her husband.

I have looked into theory of the situation and have the information in front of me on my portal however I can't seem to link the theory to the situation. i have emailed tutor and i am awaiting her phone call tomorrow.
can anyone help me out.

[Pomegranate]

Physiology, OT. Does Frank have capacity under MCA to decide to stay at home? If so then you have to allow him to. DOLS says least restrictive treatment option etc, even if he doesn't have capacity, so social services and OT etc would need to look at least restrictive means for him to remain at home. The discussion between his wife and his son is a personal matter. You can't get involved with that.

[Amaryllis]

If it's early signs, book him in for further testing, but he is allowed to make choices for himself.

If he is not capable of making those choices, a guardian of some type needs to be appointed for him.

As for the wife, can she sign for him? How competent is she?

Get social work involved (for the decision making capacity), get PT/OT involved (muscle weakness), and get the patient (if he can make the choice) to sign for medical folks to talk with the son (to head off HIPAA violations). If the patient can't make choices, and his wife is too far gone to make choices, identify next-of-kin, which should be the son.

Basically, for choices, depending on how competent everyone is it should be: Patient --> wife --> son.

Sometimes the best choice is the nursing home. Sometimes it's not. Generally when I hear that someone will just stay home with someone who is demented, I give it six months, tops. It's an incredible strain and most people don't quite get it. Even if son will stay with his parents, make sure they have services at home to keep in touch so he doesn't drown.

[HopeRises]

I definitely feel like if your unsure you need to ask your lecturer and do some research. It's all good asking here but, I feel like you need to work it out yourself by doing your reading/research around it.