SAFE & DEPENDENT or UNSAFE & INDEPENDENT: The Ethical Challenge of Providing Services To the Mentally Competent Consumer Experiencing Physical Decline Jennifer J. Strayer, LMSW Laura Remmel, RN

GENERAL OVERVIEW  Introductions of Presenters  The Home Health Care Team and Patient Safety  The Consumer’s Perspective  The Role of the Social Worker

GENERAL OVERVIEW  The Role of the Nurse  The Role of Adult Protective Services  Improving the System  Discussion with the Audience

The Home Health Care Team and Consumer Safety  Function and purpose of home health care  Team members (SN, PT, OT, ST, MSW, Personal care aides)  Services provided  Addressing concerns of consumer safety  Assessment of physical functioning/home safety  Assessment of mental competence

THE CONSUMER’S PERSPECTIVE  The consumer’s personal experience:  How does he/she feel?  What does he/she want?  Remaining at home: The decisional balance  Unsafe & Independent  Safe & Dependent

THE CONSUMER’S PERSPECTIVE Available options and resources Family / support networks Decision-making System navigation, service/ program access Long term care planning:

THE SOCIAL WORKER’S PERSPECTIVE  The role of the social worker in consumer safety  The social worker’s experience: Case examples  Personal reactions to field work

THE SOCIAL WORKER’S PERSPECTIVE  NASW (National Association of Social Workers) Code of Ethics  Self-determination  1.07(c) – Privacy and Confidentiality

THE NURSE’S PERSPECTIVE  The role of the nurse in consumer safety  The nurse’s experience: Case examples  Personal reactions to field work

THE NURSE’S PERSPECTIVE  American Nurses Association – Code of Ethics for Nurses  1.4 – Self-determination  3.2 – Confidentiality

ETHICAL DILEMMA  Professional obligation to consumer  Self-determination and Confidentiality vs. Personal safety  To report or not to report: Making the decision to refer to Adult Protective Services (APS)  Interdisciplinary discussion/consultation  Potential repercussions

THE ROLE OF ADULT PROTECTIVE SERVICES  Adult and Long-Term Care Facility Resident Maltreatment Act  Arkansas Adult Protective Services (APS) statistical information  Procedure for making an referral for APS investigation

ADULT PROTECTIVE SERVICES PERSPECTIVE  The role of the APS case worker in consumer safety  The APS case worker’s experience: Case examples  Personal reactions to field work

Improving the System Why?  Improve quality of life  Personal interest (this could one day be you or someone you love)  Decrease healthcare costs

Improving the System How?  Revising current programs and processes  Collaboration between State agencies, community service providers, and consumers

DISCUSSION WITH THE AUDIENCE Questions for the presenters? Ideas for improving the system Your professional perspective

CONTACT INFORMATION Jennifer J. Strayer, LMSW Medical Social Worker II Baptist Home Health Network Colonel Glenn Rd, Ste Little Rock, AR Office Laura Remmel, RN Baptist Home Health Network Colonel Glenn Rd, Ste Little Rock, AR Office