The erosion of autonomy in long-term care / Charles W. Lidz, Lynn Fischer, Robert M. Arnold.

Format:

Book

Author/Creator:

Lidz, Charles W., author.

Fischer, Lynn, 1956- author.

Arnold, Robert M., 1957- author.

Series:

Oxford scholarship online.

Oxford scholarship online

Language:

English

Subjects (All):

Nursing home residents--United States.

Nursing home residents.

Autonomy (Psychology) in old age.

Older people--Long-term care.

Older people.

Homes for the Aged--United States.

Interpersonal Relations.

Long-Term Care--in old age.

Nursing Homes--in old age--United States.

Patient Advocacy.

Medical Subjects:

Homes for the Aged--United States.

Interpersonal Relations.

Long-Term Care--in old age.

Nursing Homes--in old age--United States.

Patient Advocacy.

Physical Description:

1 online resource (210 p.)

Edition:

1st ed.

Place of Publication:

New York : Oxford University Press, 2023.

Language Note:

English

Summary:

In few places in American society are adults so dependent on others as in nursing homes. Minimizing this dependency and promoting autonomy has become a major focus of policy and ethics in gerontology. Yet most of these discussions are divorced from the day-to-day reality of long-term care and are implicitly based on concepts of autonomy derived from acute medical care settings. Promoting autonomy in long-term care, however, is a complex task which requires close attention to everyday routines and a fundamental rethinking of the meaning of autonomy.

Contents:

Intro

Contents

1. The Meaning of Autonomy in Long-Term Care

Different Concepts of Autonomy

Autonomy, Privacy, and Liberty

Conclusion

2. How Did We Get Here? A Brief History of the Nursing Home

The Colonial Period

The Rise of Institutions

The Jacksonian Approach

The Early Twentieth Century

Social Security and the Advent of Proprietary Homes

The Emerging Medical Model

The Growth of Regulation

The Regulatory Criteria at the Time of This Study

3. The Research Setting and Strategies

The Research Setting

Research Strategy-The Use of Participant Observational Techniques

Nonethnographic Data Collection

Informed Consent

Analysis

4. The Value Basis of Long-Term Care

Positive Staff Evaluations

Negative Staff Evaluations

Family Values

Residence Staff Values

5. Caring and Cared-for: Role Relationships in Long-Term Care

The Role Relationships of Patient and Physician

Role Relationships in Intermediate and Skilled Care

Family Roles

Role Relationships in the Residence

6. Restrictions

Preserving the Body

Compliance with Fiscal Policies

Maintenance of Institutional Routines

7. Activities and Schedules: The Routine of Daily Life

Temporal Autonomy

Schedules of Care

Scheduled Breaks in the Routine-Weekly Activities

Residence Routines and Schedules

8. Interaction Patterns and Autonomy

Staff-Patient Interaction Patterns

Staff-Resident Interactions

Patient/Patient Interactions

9. Privacy: Access to Space and Property

Spatial Rights

Privacy of Possessions

Information Privacy

Bodily Privacy

Residential Units

10. Physical Redirection and Restraint

Physical Redirection

Restraints

Conclusion.

11. Summary and Implications for Long-Term Care

Life on the Nursing Side-A "Total Institution"?

The Impact of Nursing Homes on Autonomy

Autonomy and Demented Patients

The OBRA Regulations: A Regulatory Solution?

Applying the Lessons of Residential Area to the Nursing Home

References

Index

A

B

C

D

E

F

G

H

I

J

K

L

M

N

O

P

Q

R

S

T

U

V

W

Z.

Notes:

Previously issued in print: 1992.

Includes bibliographical references (pages 183-186) and index.

Derived record based on print version record and publisher information.

ISBN:

0-19-770654-1

1-280-52610-6

9786610526109

0-19-974873-X

1-4294-0741-7

OCLC:

666963890