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Table of Contents
Contributors; 1: Geriatric Epidemiology; Introduction; Medical Implications of the Aging Population; Acute Versus Chronic Illness; Polypharmacy; Dementia; Surrogate Decision-Maker; Social Implications of the Aging Population; Health Literacy; Living Arrangements; Finances; References; 2: Evaluating Capacity for Safe and Independent Living Among Vulnerable Older Adults; Capacity for Safe and Independent Living; Two-Dimension Model of Autonomy and Capacity; The Functional Domains of Safe and Independent Living.
Practical Approach to the Assessment of Capacity for Safe and Independent Living MED-SAIL Instrument; Interventions to Support Capacity for Safe and Independent Living; References; 3: Surrogate Decision-Making and Advance Care Planning; Introduction; Advance Care Planning as a Process to Promote Patient Autonomy; Factors Influencing Surrogates' Decision-Making; Burden of Decision-Making for Others; Racial/Ethnic Disparities in EOL Decision-Making; Surrogate Decision-Making for "Unbefriended" Patients; Physician Orders for Life-Sustaining Treatment (POLST); References.
4: End-of-Life Care of Older Adults Introduction; What Is Palliative Care?; What Is Hospice Care?; Prognosticating for Older Adults; Requests for Hastened Death; Physician-Assisted Dying; Discontinuation of Treatments at the End of Life; Palliative Sedation; The Rule of Double Effect; Shared Decision-Making Process; References; Additional Recommended Reading; 5: Special Considerations in Older Surgical Patients; Introduction; Appropriateness of the Operation; Informed Consent; Do Not Resuscitate and Surgery; Barriers to Perioperative DNR; Recommendations.
Public Reporting of 30-Day Mortality Impact of Mortality Reporting; References; 6: Ethical Issues of Renal Replacement Therapy in the Elderly; Introduction; Management Considerations in Elderly Patients with ESRD; Comorbidities Impacting Management of ESRD; Outcomes in Elders with ESRD Treated with Dialysis Versus Conservative Management; Decision-Making; Considerations with Renal Replacement Therapy; Considerations with Conservative and Palliative Care; The Importance of Advance Care Planning; References; 7: Ethical Considerations for the Driver with Dementia; Introduction.
Ethical Issues Driving Situations; Clarifying Provider Responsibilities; Steps to Take; References; 8: Medical Futility; Introduction; History of Futility; Futility Versus Potentially Inappropriate Care; Strategies to Prevent Conflict; Advanced Care Planning; Communication Skills; Early Consultation; Aggressive Palliation; Approaching Conflict; Assess Urgency of Decision-Making; Surrogate Decision-Makers and Substituted Judgment; Follow Hospital Policy/State Law; Futility and Do-Not-Resuscitate Orders; Conscientious Objections; Case Discussion; References.
Practical Approach to the Assessment of Capacity for Safe and Independent Living MED-SAIL Instrument; Interventions to Support Capacity for Safe and Independent Living; References; 3: Surrogate Decision-Making and Advance Care Planning; Introduction; Advance Care Planning as a Process to Promote Patient Autonomy; Factors Influencing Surrogates' Decision-Making; Burden of Decision-Making for Others; Racial/Ethnic Disparities in EOL Decision-Making; Surrogate Decision-Making for "Unbefriended" Patients; Physician Orders for Life-Sustaining Treatment (POLST); References.
4: End-of-Life Care of Older Adults Introduction; What Is Palliative Care?; What Is Hospice Care?; Prognosticating for Older Adults; Requests for Hastened Death; Physician-Assisted Dying; Discontinuation of Treatments at the End of Life; Palliative Sedation; The Rule of Double Effect; Shared Decision-Making Process; References; Additional Recommended Reading; 5: Special Considerations in Older Surgical Patients; Introduction; Appropriateness of the Operation; Informed Consent; Do Not Resuscitate and Surgery; Barriers to Perioperative DNR; Recommendations.
Public Reporting of 30-Day Mortality Impact of Mortality Reporting; References; 6: Ethical Issues of Renal Replacement Therapy in the Elderly; Introduction; Management Considerations in Elderly Patients with ESRD; Comorbidities Impacting Management of ESRD; Outcomes in Elders with ESRD Treated with Dialysis Versus Conservative Management; Decision-Making; Considerations with Renal Replacement Therapy; Considerations with Conservative and Palliative Care; The Importance of Advance Care Planning; References; 7: Ethical Considerations for the Driver with Dementia; Introduction.
Ethical Issues Driving Situations; Clarifying Provider Responsibilities; Steps to Take; References; 8: Medical Futility; Introduction; History of Futility; Futility Versus Potentially Inappropriate Care; Strategies to Prevent Conflict; Advanced Care Planning; Communication Skills; Early Consultation; Aggressive Palliation; Approaching Conflict; Assess Urgency of Decision-Making; Surrogate Decision-Makers and Substituted Judgment; Follow Hospital Policy/State Law; Futility and Do-Not-Resuscitate Orders; Conscientious Objections; Case Discussion; References.