Ethical Dilemmas in Discharge Planning for Older Adults Teaching Module

This PowerPoint teaching module covers the NASW Code of Ethics applicable to discharge planning, ethical decision making models, common ethical dilemmas, potential interventions, and community resources to facilitate discharge planning. Examples of ethical decisions with considerations and potential resolutions are described. These include considerations related to cognitive capacity, disagreement with the discharge between family members and health care team, conflicting ethical standards, refusal of services, spouse-partner unwillingness to have partner come home, unsafe living environments, and multiple failed discharge attempts. Resolving issues by using Mattison’s hierarchical ethical decision-making model are discussed.

Advanced Competencies Addressed In This Module:

• An understanding and directing the ways one’s own values and biases regarding aging impact professional practice and ethical work with older clients, their families, and the provision of aging health and mental health services
• Ability to intervene sensitively and according to professional ethics to assist older adults and families who have diverse cultural, spiritual, and ethnic values and beliefs, including:

a) different cultural perspectives, functional roles and contributions the elderly generation make in society
b) the areas of death & dying, hospice and palliative care, help-seeking, caregiving & family responsibility, physical & mental illness, and cognitive impairment

• Application of social work ethical principles to decisions on behalf of all older adult clients with special attention to those who have limited decisional capacity including:

a) complex situations in which self-determination and dignity are challenged or inconsistent with safety and legal concerns
b) reporting and intervening with those in danger to self or others

• Provision of comprehensive geriatric social work case management to link elders and their families to resources and services to assist them with multi-faceted problems and provide long-term care planning
• Demonstration of collaboration skills and leadership with other disciplines in geriatric interdisciplinary practice with older adults, their caregivers, and in a variety of service setting including public social services, adult protection, advocates, rehabilitation services, Adult Day Health Care, and Hospice/Palliative Care