Ethics and caring: cornerstones of nursing geriatric case management

1. Paternalism, the most frequent ethical concern voiced by both elders and their caregivers, is unilateral decision-making not in accord with the client's stated wishes or value system. 2. It is common that older people are intimidated by professionals and lack the sophistication and vocabulary to express their desires in a rational and assertive manner. 3. Often the family's decisions regarding client care do not correlate with the patient's choices in the sense that clients want to avoid needless pain and suffering and are more accepting than the families of the potential outcome of death. 4. Detailing the nursing care plan in writing and allowing several days for client/family review and approval lessen misunderstanding and dissatisfaction.