A case study of the death of an older woman in a nursing home: are nursing care practices in compliance with ethical guidelines?
This article presents a case study describing and analyzing ethical issues in the care during the last 11 weeks of life of a 101-year-old nursing home resident. The case presented here is part of a larger ongoing ethnographic study of death and dying in nursing homes. Two nursing care issues with ethical implications are discussed. First, the resident could not eat or drink independently, but she received no assistance with her meals. Second, she remained in a wheelchair for many hours and developed three pressure ulcers on her buttocks. Furthermore, she became tired when sitting in the wheelchair for long periods of time, fell out of the wheelchair, and subsequently was restrained "for her safety." Using selected principles from the International Council of Nurses and the American Nurses Association code for nurses, the resident's care is discussed and recommendations for improving the care of nursing home residents are presented.
Kayser-Jones
J
J
University of California, San Francisco, School of Nursing, Department of Physiological Nursing, 94143, USA.
D000058:Accidental Falls; D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000575:American Nurses' Association; D000884:Anthropology, Cultural; D002423:Cause of Death; D004993:Ethics, Nursing; D005260:Female; D005851:Geriatric Nursing / Q000331:legislation & jurisprudence / Q000592:standards*; D019983:Guideline Adherence / Q000331:legislation & jurisprudence / Q000592:standards*; D006801:Humans; D020380:Needs Assessment; D009735:Nursing Homes / Q000331:legislation & jurisprudence / Q000592:standards*; D015404:Nursing Methodology Research; D010344:Patient Advocacy / Q000331:legislation & jurisprudence; D017410:Practice Guidelines as Topic / Q000592:standards*; D003668:Pressure Ulcer / Q000209:etiology; D011787:Quality of Health Care; D013727:Terminal Care / Q000331:legislation & jurisprudence / Q000592:standards*; D017749:Total Quality Management; D014481:United States