The major purpose of the qualitative study that will be presented was to expand our understanding of the ethical tension embedded in the decision making processes of social workers as they evaluate decisional capacity of elders experiencing some degree of cognitive impairment. Many of the ethical tensions experienced by social workers in home health care involve practice decisions concerning the degree of autonomy which social workers support in the frail elders they serve. Decisional capacity has also been held as an essential prerequisite for the support of autonomy in health care decision making. Situations complicated by ambiguity concerning the decisional capacity of elders are challenging for social workers. The research findings that will be presented are based on a qualitative study that explored social workers’ reflections on their practice evaluations and interventions that involved the evaluation of decisional capacity of community-dwelling elders. A convenience sample of seventeen home health care social workers Maine, New Hampshire and Vermont participated in the research project. An interview guide of open-ended questions was used for all interviews. All interviews and one group discussion were tape recorded and transcribed. Constant comparative analysis was employed to examine factors contributing to ethical tension experienced by the participants. A key finding is that ethical tension is associated with uncertainty concerning clinical decisions when mental health and health issues converge. Uncertainty concerning clinical decisions contributed to difficulty managing pressure experienced by participants in their role as a members of interdisciplinary teams.
Learning Objectives: As a result of this presentation, participants will be able to: 1) identify the ethical tension inherent in the evaluation of decisional capacity of community-dwelling frail elders, 2) recognize the interplay of psychological and physiological factors in the evaluation of decision capacity in community health settings, 3) recognize the role of clinical certainty in relation to making practice decisions congruent with professional values and 4) analyze how the separation of health and mental health in our system of care and education may contribute to disparities in health and lack of adequate care delivery
Keywords: Mental Health,
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.