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The literature related to major ethical and legal issues pertinent to older adults’ assessment, diagnosis, and treatment is abundant. For example, Farrell et al. (2020) concentrate on resource distribution models that include age and discuss the legal and ethical issues these approaches bring. One of the issues identified by the authors is ignoring groups of individuals under the triage routine to direct the distribution of constrained capacity during a public health crisis. The assessment score is related to the chance of in-hospital mortality, which is high for elders, thus discriminating this population. Next, Bush and Yochim (2022) highlight that clinicians must be prepared to discuss and resolve ethical concerns as well diagnostic and treatment issues unique to older persons, such as privacy, security, and informed permission, as well as independence, respect for human dignity, humanitarianism, and justice. Santivasi, Partain, and Whitford (2019) add replaced personal judgment and legal representative decision-making, disclosure requirements, withholding or canceling treatment, and perceived uselessness of care to complex ethical and legal issues. Thus, mental capacity and physical fragility determine the spectrum of the problems in assessing, diagnosing, and treating the elderly.
The other authors provide specific case scenarios of the issues discussed above. For example, the issue of consent is illustrated by Wangmo, Lipps, Kressig, and Ienca (2019), who describe how intelligent assistive technology is intended for vulnerable older adults with cognitive incapacity who frequently lack the competence to agree to their usage. Tampi, Young, Balachandran, Dasarathy, and Tampi (2018) emphasize that the most pressing of these challenges is the preservation of autonomy while assuring their security and the protection of those who care for them. End-of-life choices, including the creation of living wills, add to the complexity of treatment for these older persons.
There has been a significant movement toward telemedicine as a method of web counseling. The practice requires individuals to be able to connect to the internet, handle and repair audiovisual equipment, and converse without the cues given in person (Garofalo, Vaithilingam, & Ferrando, 2020). However, Many elders may find it challenging to do so due to impairments or a lack of technological skills (Lam, Lu, Shi, & Covinsky, 2020). Clinics and geriatric modes of treatment, such as home visits, are critical for these individuals.
Multicultural competencies for geriatric counseling need specific education, training, and expertise to diagnose and treat older persons who frequently come with various age-related alterations not generally observed in younger patients. Per the ACA (2014) Code of Ethics, psychologists are urged to investigate the individual components of diversity and the confluence of cultural identity in the older population. For example, as mentioned in AMHCA (2020), counseling should address the issue of “end-of-life care for terminally ill clients” (p. 30).
While there are well-known general obstacles to getting treatment throughout the public, particular barriers for older persons exist. As such, these obstacles include transportation issues, perceptions that it is acceptable to be stressed and sad in old age, and referrers’ beliefs that counseling is less likely to result in success. Moreover, the elderly are unable to utilize web counseling appropriately. Thus, more effort is needed to enlighten older persons about the necessity and benefits of psychological treatments, as well as the application of telehealth, to minimize this barrier to getting help. Public health institutions and community leaders might realize the advocacy for such an initiative.
References
ACA. (2014). ACA code of ethics. Web.
AMHCA. (2020). AMHCA code of ethics. Web.
Bush, S. S., & Yochim, B. P. (2022). A handbook of geriatric neuropsychology. Abingdon, United Kingdom: Taylor & Francis.
Farrell, T. W., Francis, L., Brown, T., Ferrante, L. E., Widera, E., Rhodes, R.,… Saliba, D. (2020). Rationing limited healthcare resources in the COVID‐19 era and beyond: Ethical considerations regarding older adults. Journal of the American Geriatrics Society, 68(6), 1143–1149. Web.
Garofalo, M., Vaithilingam, S., & Ferrando, S. (2020). Telemedicine for psychiatry and mental health. Telemedicine, Telehealth and Telepresence, 365–378. Web.
Lam, K., Lu, A. D., Shi, Y., & Covinsky, K. E. (2020). Assessing telemedicine unreadiness among older adults in the United States during the COVID-19 pandemic. JAMA Internal Medicine, 180(10), 1389. Web.
Santivasi, W. L., Partain, D. K., & Whitford, K. J. (2019). The role of geriatric palliative care in hospitalized older adults. Hospital Practice, 48(sup1), 37–47. Web.
Tampi, R. R., Young, J., Balachandran, S., Dasarathy, D., & Tampi, D. (2018). Ethical, legal and forensic issues in geriatric psychiatry. Current Psychiatry Reports, 20(1). Web.
Wangmo, T., Lipps, M., Kressig, R. W., & Ienca, M. (2019). Ethical concerns with the use of intelligent assistive technology: Findings from a qualitative study with professional stakeholders. BMC Medical Ethics, 20(1). Web.
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