Geriatric mental health ethics: a casebook

197 Pages·2009·0.85 MB·English

by  Shane S. Bush

Geriatric Mental
Health Ethics
ShaneS.Bush,PhD,ABPP,ABPN,isthedirectorofLongIslandNeuropsychology,
P.C., and is a clinical assistant professor in the Department of Psychiatry and Be-
havioralScience,StateUniversityofNewYorkatStonyBrookSchoolofMedicine.
He is board certified in clinical neuropsychology and rehabilitation psychology by
theAmericanBoardofProfessionalPsychology,andisboardcertifiedinneuropsy-
chologybytheAmericanBoardofProfessionalNeuropsychology.Heisafellowof
theAmericanPsychologicalAssociation’sDivisionsofNeuropsychology,Rehabilita-
tionPsychology,andAdultDevelopmentandAgingandisafellowoftheNational
Academy of Neuropsychology. He is an editorial board member of The Clinical
Neuropsychologist, Applied Neuropsychology, Archives of Clinical Neuropsychol-
ogy,andJournalofHeadTraumaRehabilitation.Hehaspublishedfivebooksand
two special journal issues on ethical issues and one book on geriatric neuropsy-
chology.Hehasalsopublishedarticles,chapters,andpositionpapersonethicaland
professionalissues,andhaspresentedonprofessionalethicsatnationalconferences.
Geriatric Mental
Health Ethics
A Casebook
SHANE S. BUSH, PhD, ABPP, ABPN
Copyright©2009SpringerPublishingCompany,LLC
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LibraryofCongressCataloging-in-PublicationData
Bush,ShaneS.,1965–
Geriatricmentalhealthethics:acasebook/ShaneS.Bush.
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Includesbibliographicalreferencesandindex.
ISBN978-0-8261-0319-2(alk.paper)
1.Geriatricpsychiatry–Moralandethicalaspects–Casestudies. 2.Olderpeople
Casestudies–Mentalhealthservices–Moralandethicalaspects I.Title.
[DNLM:1.MentalHealthServices–ethics. 2.Aged. 3.Ethics,Professional.
4.HealthServicesfortheAged–ethics. 5.MentalDisorders–therapy.
WM30B9784g2009]
RC451.4.A5B842009
(cid:1)
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2008036376
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The author and the publisher of this Work have made every effort to use sources
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appropriate.
To the older adults in my personal and professional lives who have shared
their experiences and, through their present, have given me glimpses
into both the past and the future. I hope that I provided something of
value in return.
And
To Dana, Sarah, and Megan—always.
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Contents
ForewordbyLoryBright-Long,MD,CMD xi
PART I: INTRODUCTION 1
1. Developmental Considerations 5
2. Ethical Principles and Resources 11
3. Legal Issues 27
4. Salient Ethical Issues 37
5. Ethical Decision Making 43
Case1 46

Discipline:SocialWork 46
Setting:SkilledNursingFacility 46
PART II: ETHICAL ISSUES AND CASE
ILLUSTRATIONS 55
6. Professional Competence 57
Case2 57
Disciplines:Neuropsychology,Psychiatry,Mental
HealthCounseling 57
Setting:GroupPractice 57
vii
viii Contents
7. Human Relations 67
Case3 67
Discipline:Psychiatry 67
Setting:SkilledNursingFacility 67
8. Privacy, Confidentiality, and Informed Consent 77
Case4 77
Discipline:Psychology 77
Setting:IndependentPractice 77
9. Assessment 95
Case5 95
Discipline:Neuropsychology 95
Setting:Hospital 95
10. Treatment 105
Case6 105
Discipline:Psychiatry 105
Setting:OutpatientGeriatricMentalHealthClinic
105
11. Serving Special Populations 115
Case7 115

Discipline:Counseling 115
Setting:IndependentPractice 115
12. Health Promotion 125
Case8 125
Discipline:Psychology 125
Setting:IndependentPractice 125
13. Social Considerations 135
Case9 135
Discipline:Psychiatry 135
Setting:IndependentPractice 135
Contents ix
Case10 138
Discipline:SocialWork 138
Setting:SkilledNursingFacility 138
Case11 139
Discipline:Psychiatry 139
Setting:IndependentPractice 139
Case12 141
Discipline:PastoralCounseling 141
Setting:Long-termCareFacility 141
Conclusions 143
AfterwordbyFrankA.Cervo,MD,CMD 145
AppendixA:SelectedGuidelinesRelevanttoGeriatric
MentalHealth 147
AppendixB:QuestionnaireofSurrogateValues 153
AppendixC:AnswerstoLearningExercises 155
References 167
Index 179