Ethical challenges of dementia for health care workers

Abstract

There has been an increased interest in the awareness regarding the experience of people with dementia. When diagnosed with such a disease persons with dementia are in need of great support from health care professionals who can offer their services to help these people adjust to living with dementia early on in the condition and prepare for the future when although the body will remain strong for a number of years, mental capacities, competencies accumulated during the years and lifelong memories will slide away. Taking care of ethical and social issues is a very important matter in the lives of these people and on the forefront to do so we find health care workers who during their day-to-day care of patients with dementia have to make themselves or assist the patient to take difficult ethical decisions continually. This situation prompted the need of researching the challenges our health care workers encounter when treating patients with dementia. The research was of a qualitative design as the aim was not to quantify the number of challenges health care workers meet but rather to identify these challenges. A self administered questionnaire was distributed to ten health care workers from different professions in two institutions in Malta that cater for persons with dementia, being the main Mental Health Institution in Malta and State Home for the Elderly. Wards l)ate1ing for such patients were chosen from each institution, catering for both male and female patients. The response rate was 100 %. Due to the diversity of the response given to the open-ended questions, these were analysed using a thematic analysis. The findings in the study showed that health care workers come across various ethical challenges, ranging from the patients autonomy to end-of-life issues. Respondents also tentatively suggested the need to further their education with more ethical sessions in course curriculum and continued professional development seminars regarding the subject. Most health care workers have shown a positive approach to address their patient's needs regarding ethical issues and expressed the need of better cooperation between professionals in multi-disciplinary teams. The study also discussed various theories and principles associated with the ethical challenges in today's society. Conclusively, while acknowledging the limitations of the study, such as the use of a convenience sample, the main aim was to motivate health care workers to recognise the ethical challenges they meet daily and to provide people with dementia the hope for dignified care with the love and respect they deserve.