The Erosion of Autonomy in Long-Term Care

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Oxford University Press, 1992 M09 24 - 216 páginas
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. This timely work is based on an observational study of two different types of settings which provide long-term care for the elderly. The authors offer a detailed description of the organizational patterns that erode autonomy of the elderly. Their observations lead to a substantial rethinking of what the concept of autonomy means in these settings. The book concludes with concrete suggestions on methods to increase the autonomy of elderly individuals in long-term care institutions.
 

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Contenido

The Meaning of Autonomy in LongTerm Care
3
How Did We Get Here? A Brief History
22
The Research Setting and Strategies
40
The Value Basis of LongTerm Care
57
Role Relationships
69
Restrictions
87
The Routine of Daily Life
112
Access to Space and Property
141
Physical Redirection and Restraint
155
Summary and Implications for LongTerm Care
168
References
183
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