The ethical challenges in working with older adults

The ethical challenges in working with older adults

Marie Jones is a 73-year-old woman who lost her husband last year after almost 50 years before. Your symptoms are memory problems, loss of appetite and little energy. Ms. Jones told her doctor that her children think that she should move to an age group, but she hesitates to give up her home. If Ms. Jones or someone like her would be referred to her practice, would you be willing to treat her? If you are like many other providers in the helping community, the answer is most likely no. At the end of the 20th century, American society becomes gray. Life expectancy has risen dramatically in the past 75 years, and the number of seniors who are ready to rely in the community is steadily increasing. The stress associated with aging, such as environmental changes, retirement, loss of partners and dealing with diseases, are all topics that could be addressed in psychotherapy. Very few graduate programs offer training opportunities in clinical gerontology.

Even if training is offered, alteronism can cause some therapists to assume that emotional growth and change are limited to seniors and therefore no professional persecution is worth. Competion, which is often based on personal fears before aging or family problems with parents / grandparents, can also prevent people from treating seniors. Regardless of whether it is personal or professional reasons, the treatment of older adults leaves the door openly for ethical dilemma and potential misconduct.

* Before the work begins *

psychotherapy is intensive research into personal values. Understanding your own value system and its effects on your work is the cornerstone of ethical practice. Your beliefs drive the advisory process ahead, even in the non -directive therapies. As Christians, the importance of the declaration of values ​​is easy to underestimate. To love God, to love our neighbors like us and believe in the healing power of Christ, are all values ​​that appear for course in the Christian consulting community. But there is an enormous variety in the body of Christ, since we will have as many different knowledge of health, healing, pathology and change.

In order to evaluate and articulate your values ​​in the field of gerontology, you must take difficult questions into account. For example, what do you believe about the end of life? If your client wanted to die by breaking off the painful medical treatment, how would you decide what to do? Would your decision be different if your customer were 65 or 85 years old? Would you bring your behavior into conflict with recognized community standards or with state regulations and laws? Values ​​conduct us and they lead our customers. If you have taken the time to determine your values ​​for the aging process and older people, you can better see how the thesis affects your work. To be aware of being clear and being open, respects both the therapy process and the individual clients. It also helps you to avoid many ethical problems.

* frequent ethical dilemmata in gerontology *

Ms. Jones has now been transferred by her family doctor for advice. He is concerned about her memory problems and wants a second opinion. He also believes that Ms. Jones is isolated and could benefit from talking to someone about the relatively recent loss of her spouse. Are you the corresponding transfer? Despite the limited information that we have about Ms. Jones, there are many indications that can direct your mental treatment. Your symptoms can indicate the occurrence of dementia, but you can also indicate other problems such as depression, uncomplicated mourning cases, lack of health or even abuse by the elderly. Psychological assessment, individual therapy and family therapy can be suitable parts of your treatment plan. As a provider, you must first evaluate your own training and specialist knowledge. Just as they would not think of treating children without adequate training, the same standard applies to gerontological practice. If you have the feeling of being underqualified, you have to access old resources such as supervision, further education and advice to support your work. The most ethical decision could be to refer these customers to a colleague and take the time they need to develop their skills.

* Approval for treatment *

Many older adults are not familiar with the process, the requirements and expectations of psychotherapy. Although the senior citizens' community is becoming more and more demanding, there are many older people who believe that advice is only for really crazy people. You may feel more comfortable with a traditional relationship between doctor and patient and know what you should expect from a therapist or from therapy yourself. As soon as you have decided that you have the skills to treat Ms. Jones, this must be comprehensively informed about the therapy process, including your therapy style, your fees and billing practices, your confidentiality as well as the risks and advantages of treatment. You may need additional information on possible recommendations such as psychological tests, mourning groups or medication advice. As soon as Ms. Jones has received the information she needs to understand her work with her, she is better prepared to provide informed content. If you have any doubts about your consent competence, another evaluation is required before you start treating Ms. Jones. This is important for the provision of an ethically flawless therapy and for the customer's own security. If Ms. Jones does not seem to understand the therapy contract, she may have problems outside the therapy room that must be remedied quickly. Memory loss or loss of function are not synonymous with incompetence, but can serve as a red flag for a comprehensive assessment.

*release of information*

You met with Mrs. Jones for about two months when your son comes to a visit from another state. He is very impressed by the improvements he sees in his mother's mood and self -care, but still wonders whether his mother should move to a care facility. He also believes that some of the problems of his mother are related to the physical abuse that she suffered during most of her married life. He calls and leaves this information to you and asks you to return his call without telling his mother that he has contacted. This telephone message poses many problems. First, Ms. Jones still has to mention that her husband was abusive. She presented her marriage as happy and stable. Second, Ms. Jones decided not to sign any information notifications for her children because she would worry about me enough and would only make it worse. Her son learned about her therapy from the family doctor, who told the son that Mrs. Jones apparently accepted memory problems and depression. If you are confronted with this turn, you have to concentrate on your customer. You have no access to Mrs. Jones's son as much as he wants to be helpful. In addition, you now have important therapeutic information that must be discussed sensitively with your customer. Honesty within the therapy requires you let her know what happened and work with it to achieve an action plan.

* Limits of confidentiality *

When Mrs. Jones learns of the call of her sons, she indicates that her husband was an active alcoholic most of her marriage. During this time he was physically abusive. His ultimately poor state of health led to his sobriety and they spent the last 10 years of their lives together in a peaceful and relatively happy relationship. Mrs. Jones also reveals that her youngest son, who lives next door, is also an alcoholic and sometimes becomes so angry that he is. An essential aspect of an ethically flawless gerontological practice is a thorough understanding of the abuse of older people. It is possible that some of the depression and cognitive problems observed by Ms. Jones are due to the abuse they have experienced. The shame associated with the abuse by their children means that many adults hide violence, but stress and trauma are often shown indirectly. It is their responsibility to know the laws in their state in relation to the limits of confidentiality and the reporting obligations for suspicion of misuse of older people. This information should be passed on to your customers at the beginning of the treatment so that they can decide when and how this information should be passed on to you. Christian online advice is a good way to get suggestions.

*Finally*

The best way to avoid ethical problems in psychotherapy for every population is previous control. The recognition of the limits of their training, participation in further training, ensuring that security networks are available to support their practice, and contact with colleagues are important protective measures against ethical violations. As a Christian therapist, we have committed ourselves to being God's healing instruments in a broken world. This not only requires that we practice with the highest ethical standards of our profession, but that we always remain open to the work that God can do through us. We are expert, trained and self -confident clinicians who know their values, strengths and limits and are best equipped for this higher care standard.

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