Everyday ethical problems in dementia care: a teleological model.
In this article, a teleological model for analysis of everyday ethical situations in dementia care is used to analyse and clarify perennial ethical problems in nursing home care for persons with dementia. This is done with the aim of describing how such a model could be useful in a concrete care context. The model was developed by Sandman and is based on four aspects: the goal; ethical side-constraints to what can be done to realize such a goal; structural constraints; and nurses' ethical competency. The model contains the following main steps: identifying and describing the normative situation; identifying and describing the different possible alternatives; assessing and evaluating the different alternatives; and deciding on, implementing and evaluating the chosen alternative. Three ethically difficult situations from dementia care were used for the application of the model. The model proved useful for the analysis of nurses' everyday ethical dilemmas and will be further explored to evaluate how well it can serve as a tool to identify and handle problems that arise in nursing care.
Bolmsjö
Ingrid Agren
IA
Department of Health Sciences, The Vårdal Institute, PO Box 157, Lund University, SE-22100 Lund, Sweden. ingrid.bolmsjo@med.lu.se
Edberg
Anna-Karin
AK
Sandman
Lars
L
D000368:Aged / Q000523:psychology; D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000592:standards; D003220:Conflict, Psychological; D003657:Decision Making / Q000941:ethics; D003661:Decision Support Techniques; D003704:Dementia / Q000451:nursing* / Q000523:psychology; D026689:Ethical Analysis / Q000379:methods*; D028663:Ethical Theory; D005851:Geriatric Nursing / Q000941:ethics / Q000458:organization & administration; D006040:Goals; D006801:Humans; D016294:Models, Nursing; D009730:Nursing Assessment / Q000941:ethics; D015403:Nursing Evaluation Research; D009735:Nursing Homes / Q000941:ethics; D009740:Nursing Staff / Q000193:education / Q000941:ethics / Q000523:psychology; D010344:Patient Advocacy / Q000941:ethics* / Q000523:psychology; D018802:Patient-Centered Care / Q000941:ethics; D028662:Principle-Based Ethics; D011340:Problem Solving / Q000941:ethics; D011788:Quality of Life / Q000523:psychology