Skip to main content
PMC home page
Journal of Medical Ethics logoLink to Journal of Medical Ethics
. 1988 Dec;14(4):184–187. doi: 10.1136/jme.14.4.184

The autonomy of demented patients: interviews with caregivers.

S L Ekman 1, A Norberg 1
PMCID: PMC1375579  PMID: 3236346

Abstract

Tape-recorded semi-structured interviews were conducted with 21 nursing aides and enrolled nurses in the geriatric clinic in Umeå, Sweden. The interviews focused on the difference between the care of demented and non-demented patients and ethical conflicts in dementia care. The results indicate that caregivers have problems in providing the demented patients with opportunities to act autonomously in everyday matters on the ward, mainly due to the difficulty of understanding what the patients wish and the fact that their wishes, when understood, often seem irrational. Measures to provide the demented patients with more opportunities to act autonomously in everyday matters are suggested.

Full text

PDF
186

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Athlin E., Norberg A. Caregivers' attitudes to and interpretations of the behaviour of severely demented patients during feeding in a patient assignment care system. Int J Nurs Stud. 1987;24(2):145–153. doi: 10.1016/0020-7489(87)90056-3. [DOI] [PubMed] [Google Scholar]
  2. Athlin E., Norberg A. Interaction between the severely demented patient and his caregiver during feeding. A theoretical model. Scand J Caring Sci. 1987;1(3-4):117–123. doi: 10.1111/j.1471-6712.1987.tb00612.x. [DOI] [PubMed] [Google Scholar]
  3. Komrad M. S. A defence of medical paternalism: maximising patients' autonomy. J Med Ethics. 1983 Mar;9(1):38–44. doi: 10.1136/jme.9.1.38. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Lynn J., Childress J. F. Must patients always be given food and water? Hastings Cent Rep. 1983 Oct;13(5):17–21. [PubMed] [Google Scholar]
  5. Mariner W. K. Decision making in the care of terminally ill incompetent persons: concerns about the role of the courts. J Am Geriatr Soc. 1984 Oct;32(10):739–746. doi: 10.1111/j.1532-5415.1984.tb04173.x. [DOI] [PubMed] [Google Scholar]
  6. McCullough L. B. Medical care for elderly patients with diminished competence: an ethical analysis. J Am Geriatr Soc. 1984 Feb;32(2):150–153. doi: 10.1111/j.1532-5415.1984.tb05857.x. [DOI] [PubMed] [Google Scholar]
  7. Norberg A., Hirschfeld M. Feeding of severely demented patients in institutions: interviews with caregivers in Israel. J Adv Nurs. 1987 Sep;12(5):551–557. doi: 10.1111/j.1365-2648.1987.tb03044.x. [DOI] [PubMed] [Google Scholar]
  8. Norberg A., Norberg B., Bexell G. Ethical problems in feeding patients with advanced dementia. Br Med J. 1980 Sep 27;281(6244):847–848. doi: 10.1136/bmj.281.6244.847. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Olins N. J. Feeding decisions for incompetent patients. J Am Geriatr Soc. 1986 Apr;34(4):313–317. doi: 10.1111/j.1532-5415.1986.tb04228.x. [DOI] [PubMed] [Google Scholar]
  10. Shatz D. Autonomy, beneficence, and informed consent: rethinking the connections. I. Cancer Invest. 1986;4(3):257–269. doi: 10.3109/07357908609018455. [DOI] [PubMed] [Google Scholar]
  11. Thomasma D. C. Freedom, dependency, and the care of the very old. J Am Geriatr Soc. 1984 Dec;32(12):906–914. doi: 10.1111/j.1532-5415.1984.tb00892.x. [DOI] [PubMed] [Google Scholar]
  12. Veatch R. M. An ethical framework for terminal care decisions: a new classification of patients. J Am Geriatr Soc. 1984 Sep;32(9):665–669. doi: 10.1111/j.1532-5415.1984.tb02257.x. [DOI] [PubMed] [Google Scholar]
  13. Wilson-Barnett J. Ethical dilemmas in nursing. J Med Ethics. 1986 Sep;12(3):123-6, 135. doi: 10.1136/jme.12.3.123. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Journal of Medical Ethics are provided here courtesy of BMJ Publishing Group

RESOURCES