Ethical conflicts in long-term care of the aged: nutritional problems and the patient-care worker relationship.
The patient-care worker relationship was analysed by observation and unstructured group discussion in four long-stay somatogeriatric wards at Saint Lars Hospital. Investigation centred on patients entering the terminal phase who could no longer be spoon-fed. The relationship was complicated and reciprocal, and failure by the care worker to interpret her role and the dying patient's behaviour correctly led to emotional conflict and double-binding, with resultant anxiety for both herself and the patient. Infusions and tube-feeding prescribed in such cases were given not for the patient's benefit but to relieve anxiety in care workers and relatives. Permitting the patient a natural, painless death from water deficiency may be preferable to prolonging pain and discomfort by intervening with infusion and tube-feeding.
D000368:Aged; D004992:Ethics, Medical; D005247:Feeding Behavior; D005260:Female; D005851:Geriatric Nursing / Q000379:methods; D006801:Humans; D008134:Long-Term Care / Q000523:psychology; D011369:Professional-Patient Relations; D013548:Sweden; D013727:Terminal Care / Q000523:psychology*