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Hospice EthicsPolicy and Practice in Palliative Care$
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Timothy W. Kirk and Bruce Jennings

Print publication date: 2014

Print ISBN-13: 9780199944941

Published to Oxford Scholarship Online: March 2015

DOI: 10.1093/acprof:oso/9780199944941.001.0001

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Ethical Issues Associated with Hospice in Nursing Homes and Assisted Living Communities

Ethical Issues Associated with Hospice in Nursing Homes and Assisted Living Communities

Chapter:
(p.181) Chapter 9 Ethical Issues Associated with Hospice in Nursing Homes and Assisted Living Communities
Source:
Hospice Ethics
Author(s):

Jean Munn

Sheryl Zimmerman

Publisher:
Oxford University Press
DOI:10.1093/acprof:oso/9780199944941.003.0010

This chapter begins by describing long-term care, specifically nursing homes and assisted living communities, in the United States. It then explains complex issues that affect ethical decision-making such as variability among those dying in these settings, a high prevalence of dementia and consequent ambiguity in decision-making capacity, and a regulatory environment that may make death and functional decline appear the result of poor care rather than a natural part of the life cycle. It then discusses the role of hospice in long-term care settings and identifies times when ethical dilemmas are most likely to arise. In the final section, the chapter discusses a model of hospice that mitigates some of the difficulties and offers one way to integrate ethics, hospice, and long-term care.

Keywords:   assisted living, end of life, ethics, hospice, long-term care, nursing homes

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